While expecting, you spend a lot of time thinking about how you want your labor and delivery to go. Do you want an epidural? A water birth? A mirror to watch your progress? These considerations often take precedence over thoughts of what happens after baby arrives —but there are a lot of important decisions that take place in the minutes and hours following birth, too.
1. Skin-to-skin contact
Having your newborn placed skin-to-skin on your chest immediately after delivery has some big benefits for both of you. “There are so many advantages to holding a baby skin-to-skin during the first hour: They are warmer, they have better blood glucose levels, better respirations—basically they are healthier,” says Kajsa Brimdyr, PhD, CLC, international expert on implementing skin-to-skin and researcher at the nonprofit Healthy Children Project. “Babies cry less when they are skin-to-skin, which means they don’t use up valuable energy.”
The close proximity will also increase your odds of breastfeeding success. For best results, it’s recommended that you bring baby skin-to-skin fairly quickly following delivery. Research has shown that doing so can significantly improve the chances of exclusively nursing.
Skin-to-skin time primes both mom’s and baby’s hormones to fall in love, says Brimdyr. “Together, they can form the most important bond of their lives.” If your little one isn’t born healthy, skin-to-skin might not be an option right away, but if all is well, you should be allowed this period of bonding before his postarrival procedures. Don’t be afraid to ask for it if the nurses make a move to take baby away.
2. Delayed cord clamping
For years, cutting the umbilical cord immediately after birth was standard procedure. However, as research emerges highlighting the benefits of delayed cord clamping, the tides are changing. Waiting to clamp even a short time—think two to five minutes—can provide as much as a 30 percent increase in blood volume for full-term infants and a 50 percent increase for preterm infants, according to an article in the journal Nursing for Women’s Health.
If you’d like to hold off on clamping baby’s umbilical cord, rest assured that your partner can still have the honor of making that (surprisingly tough) snip. Baby can rest on your chest for several minutes with the cord still intact, and then clamping and cutting can take place.
Let your doctor know about your plan to delay clamping during one of your prenatal visits, and make sure that she is on board. Include the tidbit of information in your birth plan, and clue in your birthing team when you arrive at the hospital.
3. Cord blood collection
You might be interested in saving baby’s cord blood to donate to a public bank or store in a private bank for future use. Ideally, this decision should be made before your third trimester, so you can get the collection kit from your desired bank and address any upfront payment costs.
You can still delay clamping if you plan to bank your baby’s cord blood, and it won’t interfere with any postdelivery bonding opportunities such as breastfeeding or skin-to-skin. In fact, your delivery team should be able to collect baby’s umbilical cord blood almost unnoticed—just make sure everyone involved in your delivery is aware of your plans.
4. Placenta collection
You might also choose to save your placenta, either for storage (the tissue of this life- giving organ is chock-full of stem cells) or consumption (believers boast the benefits of mom ingesting her placenta postdelivery, most commonly in capsule form). If you want to hang on to baby’s wombmate, keep in mind that it will need to be treated the same way you would any other meat product: It can stay at room temperature for about two hours, and then it will need to be kept cold. Store it up to a day in a cooler with ice, up to 72 hours in the refrigerator or up to six months in the freezer.
Different hospitals have different rules regarding placenta removal. Some might flat out have a policy against it. Others might allow it but require that you bring your own supplies (sturdy plastic bags, ice and a cooler) or ask that a family member escort the organ out of the facility ASAP rather than allowing it to hang around in your recovery room. (In terms of hospital safety standards, it’s a biohazard for sure.) Some even require that you bring along a court order giving you permission to take the placenta home seeing as transporting an organ isn’t exactly an everyday event.
If your placenta needs to be examined by pathology or you have a communicable disease, you’ll be denied the opportunity to keep it.
5. Preventative measures
Upon his arrival, your little one can receive several treatments to help ward off possible infections.
Vitamin K injection. This vital vitamin is needed to help with clotting of the blood. “Unfortunately, newborns have very little vitamin K at birth and are at risk for bleeding problems throughout the first 12 weeks of age,” explains Jordan Leonard, MD, neonatologist with Banner Health. This includes bleeding in the brain, a scary prospect for sure. “By giving all newborns one injection of vitamin K in the leg shortly after birth, risks of prolonged or severe bleeding can be almost eliminated,” assures Leonard.
Antibiotic eye ointment. Infants have been receiving a dose of antibiotic eye ointment after birth since the late 1800s (although the formula has changed with time). It ensures that baby doesn’t receive any transmittable diseases from mom on the way out of the womb. Leonard points to chlamydia and gonorrhea as two common offenders because mom often doesn’t have any symptoms and isn’t aware she’s a carrier. (You can ask to be tested for these conditions prior to birth if you have any concerns.)
These drops won’t cause baby any pain, but they might lead to a temporary blurriness of vision. If you want to have some eye-to-eye time with him before the drops go in, simply share your wishes —as long as the ointment is administered within 24 hours, it’s effective.
Hepatitis B vaccine. Everyone from the Centers for Disease Control and Prevention (CDC) to the American Academy of Pediatrics (AAP) recommends that infants receive their first vaccine—the first of three injections to prevent hepatitis B—before they head home from the hospital or birthing center.
However, all immunizations are optional, and no one can give a vaccination to your baby without your authorization. Some parents prefer to put off this particular vaccine until a later date. Do your research ahead of time, and be sure that the pediatrician you’ve chosen is on board with your decision. It’s worth mentioning your timeline to the nurses caring for your baby in the nursery as well.
6. Newborn screenings
While it’s guaranteed that your baby will be subject to some type of newborn screening panel before being discharged from the hospital, what exactly that screening entails will vary from state to state. Mississippi screens for 59 different conditions; Georgia only 29; Utah’s panel consists of 44. (Find details about your state’s screening at babysfirsttest.org.)
Baby’s blood is drawn through a heel prick. If you’re worried about it hurting, don’t be afraid to ask to hold him during the process. (If you can’t do it yourself, your partner can fill in instead.)
If it’s a baby boy joining your family, you’ll want to know ahead of time whether you’d like him circumcised before he leaves the hospital. Although there are advocates and naysayers on both ends of the conversation, ultimately it’s a decision that’s personal to you and your family. Whatever you decide, clue your baby’s pediatrician in as soon as possible. She won’t perform the snip without your consent, but she can plan accordingly if she knows what you have in mind.
[tip] If you are exclusively breastfeeding and don’t want your baby to be given a pacifier in the hospital, ask your postpartum nurse to put a note on his bassinet so the staff is aware.