What to Expect: The First Hour After Birth

by Julie Snyder (Pregnancy.org Staff)

Your baby is here! You've heard a first cry! The announcement of boy or girl has been made. The first test, the Apgar, has been administered and everything is great, but there's more.

Excited, tired, relieved and amazed are all normal feelings after delivery. As long as there have been no complications, your baby will probably be placed skin to skin on your tummy. For me, this was a wonderful time -- to see and feel and hear the little one I'd had "tucked away" so long. I could have stroked the tiny arms, touched the velvety forehead, drawn in the smell of that baby for hours.

Bringing the baby up toward my breast and snuggling seemed the most natural thing. If you feel this way, go ahead and see if baby is interested in nursing. Many will open their mouths and turn towards the stimulation when you stroke their cheek. For more information on helping your baby get started, see Anne Barne's When Latching and Jack Newman's Starting Out Right. Sometimes a baby is more interested in just soaking in cuddles and staring at the surroundings. That's okay, too.

Usually within 30 minutes after the birth, the placenta detaches and passes from the womb. Some women's contractions continue until after the placenta is delivered. If you are uncomfortable, concentration and breathing may help. For many women, attention is focused so exclusively on the new baby that they barely notice the placenta being delivered.

Interventions

To quote a midwife friend of mine, "The first hour after birth you can expect to have your uterus smashed, and have your baby nurse and sometimes to have the repair (if any) done."

• Episiotomy repair: If you had an episiotomy or have a tear requiring stitches, your midwife or doctor will repair your perineum
• Bladder check: Someone will probably check your bladder and ask if you can go to the bathroom. A full bladder interferes with your uterus contracting properly. It was awfully hard for me to quit staring at the baby long enough to satisfy these health care providers.
• Catheter: If you had an epidural catheter, it might be removed now.
• Massage: About every 15 minutes your midwife or the labor nurse will "massage your uterus" to help it contract and stop bleeding. I found this process a bit uncomfortable but after the first time was ready to relax with my birthing techniques. When the nurse massaged, it felt like at least a gallon of liquid gushed out (I know it wasn't that much, but sure felt like it!). The next time there was less and then even less. Sometimes they'll teach you how to find the top of your uterus so you can self-massage.
• Check vitals: Probably your blood pressure and perhaps other vitals will be checked every few minutes. I'm really not sure because I was a bit focused on the baby. I do know that she had her respirations and temperature checked each time I had my vitals taken.
• Help nursing: If you haven't already had a chance to nurse the baby, your midwife or other provider may help you get started.

Reflection

Looking back, two things surprised me. First, my daughter was so alert. She looked right at us with her intense blue-grey eyes, scanning first one and then the other and seemed to move her mouth to mimic our speech. My second surprise was to be so awake and vibrant. I had expected to be exhausted since she was born at 2:30 am. Instead, even after she was contentedly snoozing, I was too excited to sleep, and totally in love with this tiny creature we'd been waiting to meet.

So how will you feel? You may feel like bouncing off the walls! You may be exhausted and euphoric all at the same time. You may be a little scared of the responsibility for this new life. You may not feel up to anything at all except a need to sleep. It's okay. Just relax and enjoy this time with your baby, and your partner. You have a lifetime to get even better acquainted.

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