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Natural Birth
Questions about post delivery
I am reviewing the postpartum options provided by my midwife, and I have some questions!! I am hoping there are some experienced mamas/papas out there who could offer their advice? Or really anyone who has done research on any of these topics?
Should I delay newborn procedures (bathing, measuring, physical exams) until an hour after birth so I can bond with my baby and immediately breast feed? Or do I want my baby bathed first? Along these lines, what is the benefit of immediate skin on skin contact versus being cleaned before being handed to me? Finally, should the baby be dressed and evaluated in my presence?
Thank you!
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Re: Questions about post delivery
Well, these are all procedures that you'll have to check with your own MW about, of course. In my experience, and I dont think this is uncommon anymore in healthy vaginal births, once LO is out they're handed straight to you. There's no need to rush them off for measurements if they're healthy and all went well.
With DS (a water birth at a birth center) I stayed in the tub for a while after he was born, snuggling him on my chest. After I delivered the placenta I needed to get out of the tub and I suspect this is where they took him, measured and weighed him, and wrapped him up (it's hard to remember/pay attention to after a 30 hour labor). The only dressing that was done was done by DH and I. I guess the nurses put him in a diaper and onesie, but we kept him in that and were responsible for diaper changes, etc. Oh, and I actually don't think he had his first bath until we were home.
With DD (hospital delivery) I again was handed her immediately. The nurse even pulled my gown down so she'd be directly on my chest for skin-to-skin. I think they took her for measurements, etc as I was transferring from the bed to the wheelchair to go to my room. Again it didn't take long, DH stayed with her (it was still in the same room as me), and it was just a quick diaper/swaddling. I think they bathed her in the hospital, but did it in the nursery while I rested, but it was quick.
In both cases, immediate skin-to-skin wasn't really an 'option'; it just happened. And LO hardly ever left my side, I was responsible for diaper changes, "dressing", and swaddling, and LO roomed in with me (in DSs case there wasn't even a nursery should I have wanted one) . I think in both cases I prolonged the eye drops as I wanted their vision to be clear (as clear as a newborns is) for as long as possible.
IMO, there's zero need to have them bathed before being given to you (I dont even really think that's an option in this day and age). They get wiped off pretty well and are rally not that messy when they come out. Some people even leave the vernix (white stuff some babies are born with) on intentionally because it keeps baby's skin moisturized.
I delivered DS myself and pulled him right onto my chest. He didn't have much vernix and I honestly didn't care at that point. He stayed there for about 30 minutes and the nurse took his APGAR scores while he was on my chest. She also took his temperature. He had a slight fever, which is apparently common in babies whose moms have epis. She suggested we give him a bath to cool him down a little because if the fever stayed he would have to go to the NICU.
DH bathed him and placed him on the scale afterwards. When the nurse was done recording his weight and length DH picked him up and handed him back to me. Then we had our first nursing session. No one but DH or I held DS until until the next day when we had visitors (our parents). The nurse touched his foot to stretch it out to get his height, but no one actually held him but us.
The vernix is good for baby's skin. Like PP said, it keeps it moisturized and less likely to get irritated in the first day or so. As for the benefit of immediate skin-to-skin, I try to think about it from LO's perspective. The only thing s/he really knows is your smell and voice. I think taking him/her away from that prematurely has got to cause anxiety. I'd preferred to keep LO with me as much as possible to avoid it.
I would absolutely have all tests done in the presence of either you or your partner. We were transferred to our postpartum room before they did any tests or procedures other than measuring weight/height. We declined the eye prophylaxis and the vitamin K. The heel stick was done 3-4 hours after birth and the hearing text was done the next day. DH went with DS to the NICU to do the hearing test. The hospital we delivered at only had a NICU - babies who don't need to be in the NICU are roomed-in - there's not an option on that, which I loved about our hospital.
Babies are not usually bathed right away after delivery. They are wiped down good with a towel to get the crud off though! Until their temperature stabilizes, which can be several hours after birth, they usually won't give your baby a bath. Infants do not regulate their temperature well to start out there first few days so keep in mine that their temperature is check to ensure they are either dressed enough or unwrapped if too warm.
I had a home water birth with both girls and both Lily and Carly were put on my chest right away and then later their evaluations were done right on the end of the bed with me watching. The APGARs were done while on my chest. We did not bath either child for several days- what was left after being washed off in the water birth we rubbed into their skin.
I will say that we weighed both babies pretty quickly because they both started pooping pretty much right after they were born and we wanted to get an accurate read.
I'm having a hospital birth, and the policy is that baby goes straight to breast to suckle or chest (if FF). They'll wipe him down and do the basic evaluation while he's in my arms. Bonding is done next. For how long depends on how Baby and mom are doing, 1-2 hours (unless baby requires NICU time). Then, he goes upstairs to the nursery for bath, PKU, measurements, etc while mom gets settled in her room. After that, baby and mom aren't separated unless something happens.
I'm not sure yet if anyone has commented on why immediate skin-to-skin is good for you and baby, but it is. The hormones released when your baby is immediately placed on your chest skin to skin will help your uterus contract down, helping you to birth the placenta and helping your uterus clamp down, which can prevent excessive bleeding or hemorrhage. These hormones will also help things get going in your body to help along breastfeeding.
Your baby (at least, in an unmedicated birth), will be the most alert in the hour or so after the birth, which is an ideal time to be uninterrupted to start with breastfeeding. Isn't it handy that the umbilical cord is just long enough for baby to go up to mom's tummy or chest--that's right where baby is supposed to be!
That is not to say that if this process is interrupted for some reason, or you have a medicated birth and groggy baby, that you won't be able to pick things up together later and get back on the bonding & bfing train--many people do so successfully. I just figure we may as well try to set the stage for the best outcome if we can, assuming no big problems with either of you cause you to be immediately separated.
I was able to have an uncomplicated (besides needing an episiotomy) natural birth and this is what we did.
DD shot out and the doctor placed her onto my chest, then rubbed her down with a towel. She and I cuddled and attempted to nurse while they expelled the placenta. DD then went with H to the newborn table 2' away (and still in my room so I stared at her the entire time) for weight/measurement/drops while my Dr sewed up my ladybits. Then she was swaddled and brought back to me for another attempt to nurse (we were not successful with it for a few hours, doh!) and some cuddle time.
I think she received her first bath about 4 hours after birth? They wiped off most of the goo and the bath was just a wet washcloth, then water over the head and a combing to get the birth goo out of her hair. The only time she was ever out of our sight in the hospital was when she had to get her blood drawn (she spiked a fever at 20 hours out and they needed to do tests) since she was too tiny for the regular nursery to be able to do it.
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