From the moment baby enters the world, a mom wants to make sure she's doing everything she can to bolster her baby's wellness and promote bonding. Although we tend to think of nurses whisking the baby right away to a radiant warmer for observation, cleaning, and quick testing, there are beneficial steps that can come first, as long as mom and baby are doing well.
Here, the seven things moms should be prepared to do immediately after birth …
1. Delay cord clamping.
Trained professional doula Lindsey Monroe advises moms to make sure that part of their birth plan is waiting for several minutes for the umbilical cord to stop pulsating before clamping and cutting. The latest research shows that doing this could potentially reduce the number of infants with iron deficiency. Neonatologist Susan J. Dulkerian, MD, medical director of newborn services at Mercy Medical Center in Baltimore, Maryland, explains, "Delaying the cord clamping allows more blood from the placenta to transfer to the infant, thus an increased volume of red blood cells. All infants normally become relatively anemic in the first months of life, so starting at a higher level lessens the severity of the anemia."
2.Ask for "kangaroo care," or skin-to-skin contact with your baby.
Many practitioners and researchers agree that the practice of placing the baby, immediately or shortly after the birth, on the mother's chest ("kangaroo care") has a bevy of benefits. In fact, the World Health Organization recommends all newborns receive skin-to-skin care, no matter the baby’s weight, gestational age, birth setting, or clinical condition. Plus, "all of the newborn evaluations that are routinely done by health-care professionals immediately after birth can be done with the newborn on the mother's chest, as long as the newborn is stable," explains Hailey Hall, MD, OB/GYN with the Texas Children's Pavilion for Women in Houston, Texas. Studies have shown doing this can lead to less breast engorgement and pain at three days postpartum, less anxiety after the birth, more effective suckling during the initial breastfeeding session, and babies who are 12 times less likely to cry during the observation period, explains Monroe. And there are long-term benefits, too: One study found babies who received early skin-to-skin care were two times more likely to be exclusively breastfeeding at 3 to 6 months. Still, research from the Centers for Disease Control and Prevention (CDC) found in 2009 that only 43 percent of hospitals implemented skin-to-skin care for most women and babies within one hour after an uncomplicated vaginal birth, which is even more reason for women to add it to their birth plans and to try to work with health-care providers to ensure their request is honored. Ask your doctor to perform your baby's APGAR assessment while the baby is still on your chest.
3. Make sure your wishes regarding your placenta are carried out.
Most hospitals will treat the placenta as biohazardous waste, but you may want to keep it and have it turned into capsules you can take to experience various benefits — from guarding against postpartum depression to increasing breast milk supply. For that reason, you (or someone on your birth team, like your doula or partner) may need to do a little extra legwork to make sure that your wishes are carried out.
4. Confirm whether or not you want your baby to get a vitamin K shot.
Most babies are born with a deficiency of vitamin K, which rarely but in some cases can lead to an extremely rare but serious bleeding disorder called hemorrhagic disease of the newborn, or HDN. For this reason, it's considered standard care for a newborn to receive a vitamin K shot in the delivery room. However, there are some concerns about the shot being synthetic, filled with preservatives, and possibly responsible for increased instances of jaundice. So many experts advise moms to research whether or not they want the shot administered to their baby before the birth. You can also choose to have your baby given the blood clotting protection of vitamin K with an oral dose that is an effective alternative. "I always encourage my clients to take the time to research the newborn procedures that will take place shortly after their baby is born," says Monroe. That way, you'll know which way to go — and hopefully, your health-care provider will be on the same page — when the typical time for the shot comes.
5. Be prepared to okay -- or decline -- eye ointment.
Right after babies are born, many hospitals require that they are given an antibiotic (tetracycline or erythromycin) or silver nitrate eye ointment, meant to guard against a type of pink eye/conjunctivitis infections stemming from syphilis, gonorrhea, or chlamydia. But if you've been tested for those sexually transmitted diseases during pregnancy, you can likely decline the ointment, which has actually been linked with irritation, possible difficulty bonding, and a type of chemical conjunctitis, according to the CDC. You may also have the option of delaying the ointment for an hour or so — until you've had a chance to bond and breastfeed.
6. Make your wishes about the hepatitis B vaccine known.
One of the routine procedures that happens right after a delivery is a vaccine for a sexually transmitted, or blood transmitted, disease, hepatitis B. The reason: About 9,000 of the 18,000 children annually infected with the disease in the first 10 years of life caught the virus from their mother during birth, according to the Children's Hospital of Philadelphia. But there are concerns that the risks of a serious reaction to the shot may actually outweigh its advantages. That said, you can request that your child does not get the vaccine right after the birth.
7. Tell your doctor if you want your newborn bathed or not.
Most hospitals will whisk baby away after delivery for bathtime. But the baby's skin is coated in the vernix, which is meant to soften, moisturize, and protect the infant from infection and has been shown to have immune-boosting properties. So you may not want to disturb that right away. Plus, the bath could lower the baby's body temperature, which will require time on the warming table, which is time away from mom and beneficial skin-to-skin contact. Considering these possible drawbacks, you may want to be prepared to tell hospital staff that you'd like to pass on a bath — or delay it for 24 hours after which the vernix absorbs into your baby's skin.