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After baby is born: what to expect in the first hours

0-1 months

Finally your baby is here. Knowing what to expect in the first hours after baby is born can make it easier for you to relax and start getting to know your newborn.

First minutes after baby is born

The moment your baby is born can be both magical and stressful. What happens straight after birth will depend on your labour and how your baby is born.

Uncomplicated vaginal birth 
Most babies breathe and cry within a few seconds of being born.

If it’s clear that your baby is breathing OK, he’ll be placed skin to skin on your chest or belly straight after birth. Skin-to-skin contact keeps your baby warm and lets you and baby bond physically straight away. It’s also a trigger for breastfeeding.

The midwife will dry your baby while she’s on you, and cover you both with a warm blanket or towels.

Forceps or vacuum birth
If your baby is born with the help of forceps or a vacuum, he might be a little unresponsive or slow to breathe, especially if he was distressed during labour. If this happens, the midwife, obstetrician or paediatrician will take your baby to a special warming station, where they can make sure he’s OK.

Once your baby is breathing properly, she’ll be dried, wrapped in warm towels or blankets, and given back to you. Then you can hold her and have skin-to-skin contact for bonding, warmth and breastfeeding.

Caesarean section 
Most babies born via caesarean breathe and cry vigorously at birth. After your baby is born, the midwife or paediatrician will take your baby to a special warming station to dry him, assess him and check that he’s breathing properly.

The midwife or obstetrician will wrap your baby in warm blankets or towels and give her to you while you’re on the operating table (so long as you didn’t have a general anaesthetic). Some hospitals provide for skin-to-skin bonding when you’re in theatre, and you can ask for this to happen if you want it.

Sometimes you might need further medical attention, so that first cuddle might have to wait. Your birth partner can stay with your baby and give baby lots of cuddles until you get back to the maternity ward.

Cutting the cord 
After the birth of your baby, the umbilical cord needs to be clamped and cut. The cord is quite tough to cut, but cutting it isn’t painful for you or your baby.

Your birth partner can usually cut the umbilical cord if that’s what you and your partner want. This is OK after both uncomplicated vaginal and caesarean births.

If your baby needs to be taken quickly to the warming station after birth, or you have complications like heavy bleeding, the midwife or obstetrician will clamp and cut the cord.

Video

Bonding

2:43

In this short video, parents share their experiences of bonding with newborns. Parents describe joy and also the experience of not feeling an instant attachment to their child. These parents discuss how they formed that bond later.

You can bond with your newborn baby as soon as he arrives. Skin-to-skin contact is a great way to do this, whether it’s cuddling your baby on your chest or encouraging baby to breastfeed. For more information, you might like to read our article on bonding with your newborn.

How your baby will look and behave after birth

Some important changes happen in your baby’s body as she moves from the comfort of your womb to the outside world. As she cries and takes her first breaths, oxygen and blood flow through her lungs as they expand.

It’s normal for your baby to look blue or purple in the initial few minutes after birth. A newborn baby’s colour will gradually become pink within 7-10 minutes after birth, but his hands and feet might stay blue for up to 24 hours. The blood vessels to his hands and feet are very small, so it takes longer for his blood to get to his hands and feet and change their colour to pink.

If all is well, most babies cry immediately after birth. Most then quietly gaze with large open eyes at their surroundings before falling asleep. It’s normal for babies to fall asleep, but some might stay awake and want to feed.

If your baby seems ready, you can breastfeed her within a few minutes of birth. The midwife will help you attach baby to your breast.

One of the keys to making breastfeeding work for you and baby is getting a good attachment at your breast. You might like to check out our breastfeeding videos or our illustrated guide to breastfeeding. You can also read more about breastfeeding attachment techniques.

Your baby’s condition after birth: the Apgar score

An Apgar score is a rating of your baby’s heart rate, breathing, muscle tone, response to stimuli and skin colour. A score of 0, 1 or 2 is given for each of these things.

When does your baby get an Apgar score?
Your doctor or midwife will give your baby an Apgar score:

  • immediately after birth
  • at one minute after birth.
  • at five minutes after birth.

If your baby’s Apgar score is below 7 at five minutes after birth, the doctor or midwife will keep doing Apgar scores every five minutes until the score is 7 or more.

Why your baby needs an Apgar score
Your baby’s Apgar score measures how well your baby has made the transition from life inside the womb to life outside. It helps your doctor or midwife decide whether your baby needs extra medical assistance immediately after birth. It doesn’t diagnose any specific disease or indicate whether your baby needs resuscitation at birth.

What to expect when medical staff do the Apgar score
Your doctor or midwife will do the first Apgar check within 30 seconds of birth.

If your baby breathes at birth, has a heart rate above 100 and moves his arms and legs, he’ll get an Apgar score of 7-10. Don’t be worried if your baby doesn’t score a 10. Many babies aren’t pink until 10 minutes after birth, so they can’t score 2 for colour at one or five minutes.

If your baby isn’t breathing properly, has a low heart rate (below 100) or is floppy, she’ll get an Apgar score of 4-7. She’ll probably be moved to the warming station, where staff will decide whether she needs extra medical help. The doctor or midwife might give your baby some oxygen using a special breathing device and face mask until baby can breathe on her own.

If your baby needs help to breathe and to maintain his heart rate and circulation, he’ll get an Apgar score of less than 4. He might be given extra oxygen. Some babies might need a breathing tube. Very few babies (fewer than 3 in 1000) will need more active resuscitation like CPR and drugs.

If your baby needs a lot of resuscitation at birth and gets low Apgar scores at five minutes or more, she’ll be taken to the neonatal intensive care unit (NICU) for further assessment and close monitoring.

Apgar scores are recorded in your baby’s child health and development book.

Very few babies need to be resuscitated at birth or need help to start breathing. Most respond quickly to simple actions like drying and stimulation.  

Checks and medications in the first 24 hours

Within the first hour of birth, the midwife will make sure everyone knows who your baby is by putting two name tags on him. 

Your baby will also be weighed at some time in the first few hours. When weighing your baby, the midwife will do a quick physical check. After the weigh-in, the midwife will put on your baby’s first nappy.

The midwife will record when your baby first poos and wees. This is usually within the first 24 hours.

You’ll be asked to give your permission for your baby to have one or two injections into her thigh muscles after birth, either immediately or within a few hours. The injections are:

  • vitamin K – this can help prevent a bleeding disorder caused by a vitamin K deficiency (‘haemorrhagic disease of the newborn’)
  • hepatitis B immunisation – this is the only immunisation required at birth, and is given as part of Australia’s universal immunisation program.

You can discuss these procedures with your midwife, GP or obstetrician at one of your appointments towards the end of your pregnancy.

Within the first 48-72 hours of your baby’s life, you’ll be asked to give your permission for newborn screening, which tests your baby for signs of rare disorders and illnesses. In the early days, your baby will also be checked for developmental dysplasia of the hip (DDH) and screened for hearing impairment.

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Last updated or reviewed
06-02-2017

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