Preparing for Labor - THE BABY IS HERE!!!
- Apr 15
- 9 min read
To the Point
Things to Consider
Separate Patients: Mother and baby are often treated and billed as separately
Rest is Rare: Medical staff will perform frequent health checks in hospital; don't expect much uninterrupted sleep in the first 24-48 hours.
Feeding is a Skill: Breastfeeding is natural but not automatic; both mom and baby have to learn the process.
Mental Health: Be prepared for mental health screenings for both parents to establish a baseline for anxiety or depression.
Details to Consider
Delayed Cord Clamping: Decisions on when to cut the cord should be in your birth plan. Delaying clamping can increase the blood volume transferred to the newborn.
Meconium Complications: While passing meconium is a good sign, watch for "Meconium Aspiration Syndrome" if the baby inhales it.
Cesarean Discharge: If a C-section was performed, discharge depends on wound healing, the ability to walk, and managing pain.
The Car Seat Check: Many hospitals require a car seat inspection before release
Papa’s Prepare
Be the Support: Breastfeeding can be frustrating; stay supportive and help the mother through the learning curve.
Wipe Front to Back: When changing diapers (especially for girls)
Schedule Pediatrician Early: Try to book the first pediatrician appointment (usually within the first week) while still at the hospital to save stress later.
Check Yourself: Dads should be honest on mental health surveys; catching anxiety early helps prevent a breaking point.
Lets Talk
Typical Events Immediately Post Birth
Now your baby is here. But what happens now? There are a few typical events that happen immediately post birth (assuming there is not an emergency). Your post birth hospital stay is packed with events. Below, I hope to help you understand what those events may be and provide some education as to why they happen.
Immediately Post-Birth
One of the first major steps is cutting the umbilical cord. Whether you choose to do delayed cord clamping or immediately cut the cord. This decision should be something that you have in your birth plan. If you opt for delayed cord clamping, you are allowing more blood to transfer from the placenta to your newborn prior to severing that connection. According to Dr. Dennis Costakos, M.D. of Mayo clinic, “10–15 seconds after birth, 67% of the umbilical cord blood goes to the infant. By 1 minute of age, the amount of cord blood in the placenta passed to the infant increases to 80%.”
Following the cord clamping, medical staff will typically apply Erythromycin ointment to the baby’s eyes. Erythromycin, is an antibiotic which is typical applied as an ointment on newborn’s eye. It is a routine preventative measure used to protect the newborn from eye infections. Specifically, the ointment helps in preventing neonatal conjunctivitis, which can be caused by bacteria that the baby may have been exposed to during delivery. Birth can be messy, sometimes the babies get exposed to infections and bacteria, this ointment helps them early on while their little bodies are starting to develop their immune systems.
Something important to note is that from the time the baby has arrived (by whatever method), the mother and baby are treated as different patients and are usually billed separately. Babies first debt…….hurrraaaay.
On The Move…..Again
Not every hospital may move your family from the L&D room. However, it is common to be moved to another unit which specializes in post birth maternal and newborn care. So be prepared to pack up your stuff and move locations once again.
Post-Delivery Care
Once you get to the new room. Hunker down and get both of you hydrated. This is not the end of the fun.
Typically, there are a series of health checks for both mother and baby and education. I’m not going to lie to you, the medical staff has a job to do, and they don’t usually leave your family alone for very long to rest in the first 24 hours post birth. A typical hospital stay post birth is anywhere from 24-48 hours. Your stay can also be prolonged depending on any complications and their severity.
Newborn Shots/Vaccination
At some point near the beginning of the post-delivery care, the care team may suggest giving the baby shots. In my experience, they offered two. The first was the Hepatitis-B vaccine. I think that on is pretty self-explanatory what it’s supposed to be for. This is administered because the newborn can contract Hepatitis-B from the mother or other family member, which increases risk of complications due to Hepatitis-B. The second shot they offered was Vitamin K. Provider usually provide this one time shot for newborn because newborns are typically deficient in Vitamin-K. Vitamin-K helps will clotting blood. This means it help prevent bruising from excessively spreading or helps to stop other kinds of bleeding. Dennis Costakos, M.D. via Mayo Clinic Health Systems has a great article called “8 common questions new parents ask about vitamin K”. It is a fairly easy read so I recommend reading through it as it may answer some of your questions. Or, if you want to go deep diving, NIH has a fact sheet for professional simply named “Vitamin K”, which is packed with information.
Meconium
When babies are first born they, they don’t have typical poops. For the first 24-48 hours, they usually pass a substance called Meconium. It is a tar-like dark black/green substance which is made up of , “Meconium is made of water, cells, pee, hair, mucus and any other materials a developing fetus swallows inside the uterus” according to Cleveland Clinic-Meconium. Newborns passing meconium is generally a good sign. However, there are complications that can arise from it. A couple of complications are Meconium Stained Amniotic Fluid (MSAF) (which can lead to complications that may result in emergent cesarean due to infections), and Meconium Aspiration Syndrome (MAS) (occurs when the fetus inhales meconium).
The First Feedings
When the first feeding takes place can vary highly baby to baby. Some babies will drink milk within the first couple hours after birth. Then, they may choose to take a long nap and not eat very much within the first 24-48 hours, according to Johns Hopkins Medicine - Breastfeeding. Though it is important to still try to get the little one to drink milk. My first born drank once in the first few hours, then took a 12-hour nap. Though we tried to feed her, she just kept going back to sleep.
It is important to note that even though breastfeeding is natural, it is not an automatic behavior. Both the mother and baby have to learn how to do it. The mother has to figure out what the baby like and learn the signs of when to switch breasts, and the baby has to learn to latch and communicate what they need. This can be easy for some or very difficult for others. Don’t let the mothers get discouraged. Help them and try to be supportive.
Sometimes nipple injuries can happen in the early stages of the breastfeeding learning process. Remember the nipple shields from Hospital Bag Essentials? This is where these may come in handy. Nipple shields help protect the breast and areola. Make sure to get the appropriate size though. They usually have general sizing guides for them when purchasing.
Early Education
Some hospital have consultations and educations that first 24-48 hours. While not available at every hospital, some consultations/educations may include,
Lactation Consultants
Help teaches mother and father about breastfeeding
Different techniques to try (how to hold baby, different latching techniques, etc…)
Injury prevention
When to switch breasts and how to tell(when one runs out of milk)
What Colostrum is
How much baby should be eating and how often
Diaper changing basics
What to do and what not to do
Diaper sizing
Wipe front to back! Especially for girls.
Parental mental health
keeping an eye out for possible anxiety and depression
Some hospitals ask you to take a mental health survey.
The lactation consultants were helpful for my family because our little one had some issues learning to latch and it was frustrating to the mother, baby, and myself. The consultants helped to show us different techniques to help get baby to feed appropriately.
When changing diapers, there are a few things to consider. The first is the diaper size, diaper fitment is important in avoiding leaks or chaffing on the baby. A hospital CNA came in to show us/make sure we understood how to change diapers and how often to change them. The second thing is wiping front to back. This is very important, especially with girls. You do NOT want to wipe fecal matter into their privates or it may cause illness or infections.
Parental mental health screenings are seemingly becoming more and more of a standard in the healthcare industry. These surveys are no only for the mother, but for the fathers as well. This first one is good to get a baseline for how you are doing. In subsequent pediatrician appointments you may be asked to complete these again. This helps to trend data if you are becoming more anxious or depressed. I know a lot of us like to think we understand ourselves. Let’s face it Dads, most of us are not so in tune with our mental health as we should be. If you get the chance to take these surveys, I recommend that you do. If for nothing else than to make sure you are doing ok. Be honest on these surveys. You may find out that you are just fine, or that your anxiety and outlook is slowly escalating over time. Catching anxiety onset early on helps you to get some sort of intervention before a breaking point is reached. Please take care of yourselves both physically and mentally. Newborns at home can be a difficult adjustment. Don’t let your anxiety build to an unmanageable level.
Screenings
Your stay at the hospital may include copious number of screenings and checkups for both the mother and baby. Some typical screenings are,
For Baby
Blood sample via heel stick
Metabolic diseases
Phenylketonuria (PKU), and Galactosemia
Endocrine diseases
Hemoglobin disease
Immune Deficiencies
Some states also test for Severe Combined Immune Deficiency (SCID)
Hearing test
Pulse Oximetry
Looks for Congenital Heart Disease and other abnormalities
For Mom
Iron levels
Could be a signs of post-partum anemia
Blood glucose check
Typically, if Gestational Diabetes was observed during pregnancy or Type II Diabetes is present
Extra Discharge Criteria (Cesarean)
If a cesarean was performed, the hospital may have additional criteria in order for the mother to be discharged from their care. While each hospital is different, there are some common criteria. Criteria such as
Wound closure
Making sure the incision is healing as expected
Ability to walk
Stable vital signs
Ability to urinate
Pain is manageable
Car Seat Check
Some hospitals require a car seat check prior discharge. This is an inspection to make sure that,
You have an adequate car seat
You know how to use the car seat
Car seat checks can sometime be performed prior to labor. Which is one less thing that you need to worry about. Check with your care center if this is required via their policy or your local laws. If so, you should ask them or do an internet search for car seat checks locally. Some hospitals will even allow you to do the check with a certified team member. But it is best that you work out these details with your care team prior to labor. That way the discharge process is simple (as simple as it can be) for your new family.
Schedule First Appointment With Pediatrician
Once you get home, you get too busy or tired to remember to schedule the first pediatrician appointment. The first appointment is usually scheduled within the first week of the baby being born. When you get time between people visiting and the seemingly endless consultations and checkups, schedule this appointment. Having that scheduled and taken care of can be a big relief and allow you to make planning decisions should the pediatricians office be too busy. I talk about this more in The First Few Baby Appointments.
Resources
Sources
Costakos, D. (2022, June 30). Delayed umbilical cord clamping. Mayo Clinic Health System. https://www.mayoclinichealthsystem.org/hometown-health/speaking-of-health/delayed-umbilical-cord-clamping-benefits
Sinha, S. (Ed.). (2024, March 21). Erythromycin uses, dosage & side effects. Drugs.com. https://www.drugs.com/erythromycin.html
Makker, K., Nassar, G. N., & Kaufman, E. J. (2023, July 17). Neonatal conjunctivitis. StatPearls [Internet]. https://www.ncbi.nlm.nih.gov/books/NBK441840/
Costakos, D. (2024, February 12). 8 Common questions about Vitamin K. Mayo Clinic Health System. https://www.mayoclinichealthsystem.org/hometown-health/speaking-of-health/common-questions-about-vitamin-k
U.S. Department of Health and Human Services. (2021, March 29). Vitamin K. NIH Office of Dietary Supplements. https://ods.od.nih.gov/factsheets/VitaminK-HealthProfessional/
Staff, J. H. (n.d.). Meconium aspiration syndrome | Johns Hopkins Medicine. Johns Hopkins Medicine. https://www.hopkinsmedicine.org/health/conditions-and-diseases/meconium-aspiration-syndrome
Gallo, D. M., Romero, R., Bosco, M., Gotsch, F., Jaiman, S., Jung, E., Suksai, M., Ramón Y Cajal, C. L., Yoon, B. H., & Chaiworapongsa, T. (2023, April 1). Meconium-stained amniotic fluid. American journal of obstetrics and gynecology. https://pmc.ncbi.nlm.nih.gov/articles/PMC10291742/
Breastfeeding | Johns Hopkins Medicine. (n.d.). https://www.hopkinsmedicine.org/health/conditions-and-diseases/breastfeeding-your-baby/breastfeeding
Clinic, C. (2022, February 21). Colostrum: What is it, benefits & what to expect. Cleveland Clinic. https://my.clevelandclinic.org/health/body/22434-colostrum
U.S. Department of Health and Human Services. (n.d.). NICHD. Eunice Kennedy Shriver National Institute of Child Health and Human Development. https://www.nichd.nih.gov/health/topics/factsheets/newborn
My doctor online. My Doctor Online. (n.d.). https://mydoctor.kaiserpermanente.org/ncal/structured-content/newborn-tests-and-treatments-820876/pulse-oximetry
Hudak, M. (2023, August 25). Newborn screening tests. HealthyChildren.org.
Macones, G. A., Caughey, A. B., Wood, S. L., Wrench, I. J., Huang, J., Norman, M., Pettersson, K., Fawcett, W. J., Shalabi, M. M., Metcalfe, A., Gramlich, L., Nelson, G., & Wilson, R. D. (2019, April 14). Guidelines for postoperative care in cesarean delivery: Enhanced recovery after surgery (ERAS) society recommendations (part 3) - american journal of obstetrics & gynecology. Guidelines for postoperative care in cesarean delivery: Enhanced Recovery After Surgery (ERAS) Society recommendations (part 3). https://www.ajog.org/article/S0002-9378(19)30572-1/fulltext
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