by Amy Hartley

Created on: May 14, 2008

The process for immediate postpartum changes almost yearly. The process should be one to bring baby and mother together. As a DOULA, nurse, and mother I have seen techniques change frequently.

A typical birth with no complications is straight forward catch clamp and clean. Of course with any slight complication this changes.

Immediately following delivery your baby is turned head down and the cord is clamped. This is done to encourage fluids in the nose and mouth to evacuate with the assistance of gravity. With the cord clamped doctor or dad will cut the cord between the two metal clamps that have been placed on the cord. Baby is placed on your chest, which is best skin to skin.You can take your gown off or pull the gown up over your breast. This skin to skin contact facilitates greater bonding between a child and its mother. This contact also transfers your body heat to your baby, reducing risks of decreased basal body temperature in the infant. Low basal body temperature of the infant may cause shivering and decreased blood sugar which will require medical interventions such as blood sugar monitoring and possible sugar supplements being given to your baby.

At this point the nurse and doctor will continuously rub and stimulate your baby encouraging it to cry. This is a good time for you to get a good look at your new infant because she is not swaddled in blankets yet. The rubbing also cleans the baby of amniotic fluid and any blood or lunugo that may be on her. Lunugo is a creamy covering protecting her from absorbing to much fluid in her skin and also helps with lubrication.

Once you have had a good look at your baby the nurse will take her over to an infant warmer to begin the assessment of the baby. They will continue to rub and move baby around to stimulate her. They will measure length, weight, and head circumference. Reflexes are checked and temperature is monitored. The nurse will listen to the heart and lungs with a stethoscope. Usually a hat is placed on the head to retain warmth, because most heat in our body exits through our heads.

During this process you are being checked by the doctor and the placenta is being delivered. A lot of women do not remember this part of their labor because they are intently watching their new baby.

The nurse will place vancomycin ointment in the babies eyes to prevent eye infections. Your baby will receive her first shots at this time. Vitamin K is given to help the baby produce clotting agents for her blood since she lacks this ability. Also the first of many Hepatitis B vaccines is given. Your infant is so stimulated and overwhelmed that some infants do not appear to respond to these injections with a cry.

As things begin to settle down and the doctor is done with your care the nurse will swaddle your baby and bring her to you. At this point breastfeeding should be started if you plan to do so. Studies show that babies who nurse within 1 to 2 hours of birth are more successful at continuing to nurse in the future. The nurse will assist with the latch on and educate you on the nursing dos and dont's.

While your baby is nursing peer into her eyes and bond. It is okay to touch feel and kiss your baby as she nurses. Take this time to really spend quiet time with your partner and new addition.

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