What to Expect the First Hour After Birth

Whether you’ve labored for days, hours, or have a scheduled C section, there’s nothing like finally getting to meet your baby. Here’s what to expect from the moment your baby is born.

Here’s what to expect in an uncomplicated vaginal birth in a hospital setting. As baby is being born you may notice a couple of extra people in the room. Along with your labor and delivery nurse and your care provider, an additional labor and delivery nurse and a nurse tech will come into the room. If your baby is at increased risk of infection, or is considered higher risk for other medical reasons, a few members of the NICU team may also come into the room.

Once your baby is born, most providers will place baby right on your abdomen. If the umbilical cord is long enough you can lift baby up to your chest. After about a minute or two, your provider will prepare to clamp the umbilical cord. They will ask you or your partner if you’d like to cut the cord and then give guidance on what to do. If neither of you want to cut the cord, your OB or midwife will do it. While you are snuggling with your baby, your care provider will be assessing your bleeding as well as if there are any repairs needed for your perineum and surrounding areas. They will also be waiting for your placenta to be born.

Your labor and delivery nurse will be on hand to help monitor bleeding and chart time of birth, method of delivery, etc. Their job is to also make sure you are feeling OK while monitoring your vitals. Your labor and delivery nurse may have started running a bag of Pitocin to help minimize your bleeding.

If the NICU team is in the room they will wait to see if baby cries and if they are transitioning well to life outside of the womb. Typically they stay in the room for a few minutes. If needed, the NICU team will bring your baby to the warmer in your room and help your baby more easily transition to life outside the womb. They will try to bring your baby back to you as soon as possible for more skin to skin time. If your care provider and the NICU team agrees that baby is doing well, they will exit the room. More often than not, babies cry immediately and transition very well and the NICU team quietly exits the room without ever needing to intervene.

The additional labor and delivery nurse will be on hand to act as the baby nurse or “stork nurse”. Their role is to soley focus on your new baby. While baby is on your abdomen, they will dry baby with some warm blankets and towels and try to stimulate them to cry if the baby has not yet done so. They will also take your baby’s temp and listen to their heart and respiration rate. They typically do this in the first few minutes after the birth and then again around 10-15 minutes after the birth. As long as baby looks like they are doing well, the stork nurse will leave the room and come back around the first hour mark to do a full assessment of your baby. This is when they will take the baby to the warmer in your room and do a head to toe exam as well as get the weight of the baby and other measurements.

Around 10-15 minutes after the birth your labor nurse will do a fundal massage. This is when they apply very firm pressure to the top of your uterus (the fundus) to see if there are any clots that need to be expelled. This fundal massage will happen about every 15 minutes for the first couple of hours after you give birth. If you are bleeding more than what your OB would like to see they may give you other medications to help minimize your bleeding.

Once your placenta seems about to deliver your care provider will ask you to give a small cough or push. The placenta often will come right out. Your care provider will check to make sure that there are no abnormalities and that the placenta is intact. If there are missing pieces your OB may try to remove them manually. If you need any repair work done your OB will either make sure your epidural is still working or give you a shot of lidocaine if you’ve had an unmedicated birth. Once you are numb, they will proceed with doing any repairs. Then they will work with the nurse tech to count instruments and anything else they used during the delivery and repair work. After they are done with repair work your OB will offer you their congratulations, tell you when someone from their practice will check on you again, and then they will exit the room.

Once your care provider has left the room the nurse tech may help clean you up and put the end of your labor and delivery bed back together. They may also help clean up any fluids and dispose of any medical waste in the room. Sometimes they assist the labor nurse with putting new pads under you as well as giving you an ice pack to keep against your vulva. After all this the tech will leave the room.

Your labor and delivery nurse will continue to monitor vitals and do fundal massages as needed. They’ll keep a close eye on your bleeding.

During all of the above you will hopefully have had baby with you right against your skin. Your baby may begin showing signs of feeding cues. If you feel ready, you can ask your labor and delviery nurse can help you get your baby latched on for their first breastfeeding session. If you are choosing another way to feed your baby you can ask your labor nurse about infant feeding options.

Your partner will likely be right by your side during this first hour. This is a great time to take a few first pics and just enjoy looking at your new baby together. Your partner can also give you something to drink and may even feed you a small snack.

While thie first hour after birth is a busy time, the time goes by very quickly. Enjoy this first hour snuggling with your baby and getting to know them.