What happens to baby immediately after birth?

Image captured by Kalyn Noland Photography

The majority of our clients have an idea of what their birth preferences are regarding their personal care, but quite a few clients have a lot of questions when we ask about newborn procedures.

We want you to know what options you have regarding your baby’s care, too. So once baby arrives, what happens?

Baby should go right to your chest after your birth for immediate skin to skin. There are numerous benefits to this. Babies have an easier time transitioning to the outside world when they are skin to skin and the umbilical cord is left intact for delayed cord clamping.

In the first 1-5 minutes of birth, your care team will be watching baby and using the APGAR assessment to determine how they are transitioning. You likely won’t notice that they are doing this because it’s a mostly a visual assessment. They’ll use the stethoscope to listen to baby’s lung sounds and they’ll assess activity, pulse, grimace, appearance, and respiration. Any score below a 7 may need additional support for a smooth transition.

Your baby will stay with you, skin to skin, for the first hour – often referred to as “The Golden House”, but if baby needs to make a move to the warmer for extra support it’ll be okay. After some time has passed and baby has latched well for the first time (if that’s your plan), they’ll be measured, weighed, and have footprints done.

At this point, there are 3 standard procedures that you should know about:

  • Erythromycin ointment
  • Vitamin K injection
  • Hepatitis B vaccine

Let’s breakdown some must have information about each of these procedures.

Erythromycin ointment is an antibiotic ointment applied to the newborn’s eyes to prevent infection. These infections are rare and primarily caused by STIs, but if contracted can lead to vision issues and blindness in extreme cases, so giving this ointment is the standard of care.

Vitamin K is given as an injection. When babies are born, they don’t yet have the ability to produce vitamin k and this can impact the way their blood clots. Vitamin K is given as a preventive against internal bleeding, primarily brain bleeds, because we can’t determine which baby will have an issue and which ones won’t. Drops are available as an alternative, but Clarksville and Nashville hospitals don’t typically carry them.

Hepatitis B vaccine is given because most adults are unaware that they are positive for Hepatitis. Hepatitis is highly contagious so the vaccine is given routinely to all infants. Many of our clients choose to delay this until the first appointment with their pediatrician or skip it all together.

As with all things throughout your reproductive care and birth, YOU have the right to decline the procedures you aren’t interested in. It’s important to discuss this with your partner (if applicable) and your pediatrician. Assuming that baby is thriving, all of the immediate newborn procedures are done after that initial bonding time while you’re still in your labor and delivery room in all Clarksville and Nashville area hospitals.

Everything that you choose or opt out of will have risk and benefits. Your job, as a person and as a parent, is to decide which risk you are most comfortable with. If you have concerns about these procedures, Evidence Based Birth is a website full of information and resources. Your provider should also have additional information to help you sort through what you’re feeling and your other options.

As your doulas, we will be there to support you regardless of what you choose.

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