While your new baby is being placed on your chest, the uterus, now relieved of most of its contents, will respond with a sustained contraction, often helped by an oxytocin injection offered by your Lead Maternity Carer (LMC). This helps separate the placenta from the inner uterine surface and constrict the large blood vessels which had been supplying it. In a beautiful dual action, the placenta is then expelled from your body and your blood, which was earlier flowing to the placenta, is now directed back to full body circulation, leading to a flash of good feelings. Over the next few hours, the suckling of your baby encourages bursts of natural oxytocin, further contracting and shrinking the uterus and causing ‘afterpains’ – a reassuring discomfort returning your body to a non-pregnant state. It’s common and normal for these to be accompanied by some bleeding or clots which have been left behind, as the uterus effectively purges itself to stay healthy.
BLADDER AND BOWEL
Soon after birth you’ll be encouraged to eat and drink, and an important early task is to ensure you regularly empty your bladder. During vaginal birth it’s common for the bladder to become temporarily confused with regards to ‘normal’ function, and regular emptying is a good way to pre-empt any accidents. Depending on the circumstances of the birth, maternal bowel function should also be monitored and your LMC will question you about this. Avoiding constipation is a key goal!
During pregnancy, certain placental hormones were inhibiting your breasts from producing full milk supply. At the separation and birth of the placenta, these hormone levels fall, an important part of understanding why full breast milk production takes two to three days to establish. Fortunately, full-term healthy babies can easily wait out this time as they have enough hydration and energy reserves to last. The normal demanding newborn behaviour (read on for more) exhibited during days two and three also ensures your body is encouraged into lactation mode.
THE FIRST BREATHS
Within seconds of arrival, healthy babies born in good condition will startle and gasp and begin the simple yet vital task of breathing on their own. Their lungs are like little sponges, and similar to releasing a tightly squeezed sponge, they inflate with air when the baby’s body is released from the pressure of being in utero. This inflation is produced mostly by a very strong action of the breathing muscles, mainly the diaphragm and rib muscles.
Your baby has spent many months practising and rehearsing movements, such as breathing, hiccupping, yawning and even sneezing, which all strengthen their action when this moment finally happens. Crying within moments of birth helps keep the lungs inflated too, though many babies will not cry excessively if the initial gasp has sufficed. Within one minute, your baby will be breathing steadily and easily, with the occasional burst of crying, if required, for more inflation.
THE FIRST TEN MINUTES
At the one-minute mark, your healthcare professional now notes the baby’s first milestone called an ‘Apgar score’ – a composite measure of wellbeing designed to identify babies which require extra assistance with the transition to independence. Another few minutes elapse, and at the five-minute mark another Apgar score is noted for the same purpose. If these scores are satisfactory, the conventional practice is to keep the baby warm by placing them skin-to-skin on Mum’s chest. Around this time, usually within ten minutes, the umbilical cord is clamped and cut (attending persons are usually welcomed to participate in this part!) which truly separates the newborn; this time is also carefully documented. All of a sudden your baby is ten minutes old!
BABY'S FIRST MOTIONS
In the first 72 hours we must mention not only baby input, but also output! Being well-hydrated at birth, babies will pee frequently on the first day, but a bit less on days two and three prior to the full milk supply. Their first bowel motions are a sticky black goo called meconium. As the bowel empties this, and over the initial three days when milk is being ingested, the motions become more liquid and a pale yellow.
TWO FINAL TESTS
The two final important health milestones are the newborn screening ‘heel prick’ test taken sometime after 48 hours (this screens for a dozen rare, but silent, health conditions, AKA the Guthrie Test) and a newborn hearing screening test. Your LMC will guide you through these.
Finally we are through to 72 hours old. All going well, you’ll all be back home and settling into your new lives. Enjoy it all!