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6 Things You Should Think About Before Baby Arrives

What do you need to know about your baby’s care immediately after they’re born? More than you think!

It’s been an exciting 9 months. Your baby is just moments from being born, and your midwife asks you if you have any preferences for after your baby arrives

You wonder: 'What on earth does she mean'? All you can focus on is that last push and now you’re being asked to make more decisions? In the haze of oxytocin bliss and the best tea and toast ever, it can be difficult to make informed decisions. Hopefully, you’ll have thought all of these preferences through, having already discussed them in the clinic or your consultant’s appointment.
Many first time moms think that all that happens after birth is that your baby is weighed, wrapped and handed to you. As you’ll see, there’s much more to consider:

1. Do you want the cord to finish pulsating so your baby gets all the blood he’s supposed to?

International research recommends leaving the cord to finish pulsating for at least 3-5 minutes. Some maternity units are now following this practice, and not rushing this part of birth. However, we’re also learning that the blood can continue to flow after pulsation stops. UK midwives have adopted a simple birth preference to ensure your baby gets what he needs ‘wait for white’. The cord will turn white in a few minutes after birth so you can just cuddle up and enjoy this special time.

2. Do you want to have a managed or natural (physiologic) third stage of labour (for the delivery of the placenta)?

Natural means just that. The placenta comes out on its own with no pulling on the cord (usually within about 30 minutes). This is such a wonderful time to just hold your baby and breathe in that new baby smell without the distraction of staff standing at the bottom of the bed peering between your legs to see if there’s any sign of the placenta. If you choose a managed 3rd stage, is your hospital using the recommended drug Syntocinon instead of Syntometrine? Syntometrine comes with more negative side effects and is no longer recommended by the HSE. Not all hospitals are using Syntocinon, but they will have it in stock. Be sure to include this in your birth preferences.

3. Will you have immediate skin to skin with your baby?

Immediate skin to skin with your baby is so important for your baby. The warmth of your skin, your smell (which is very similar to amniotic fluid, where he just came from) and your voice all turn down your baby’s stress response. Think about it – he’s just moved house very unexpectedly and we all know how stressful moving house can be – and you’ll usually have had a few months notice! Immediate skin to skin also makes breastfeeding more likely to go well and for longer. If for any reason you can’t do skin to skin – Dad can. Your baby knows Dad’s voice and will settle quicker under Dad’s t-shirt in a chair, than wrapped up like a burrito in the glass casserole cribs.

4. Have you decided whether your baby will receive Vitamin K?

If so, which option do you prefer – injection or drops? Vitamin K is a supplement given to all newborns in Ireland to help your baby’s blood to clot. Some babies are born with a complication that causes their blood not to clot properly which can be fatal, and as we don’t know which babies are affected the vitamin k injection is routinely given to all newborns. International research recommends the injection however some parents opt for giving the medication orally (drops) over a period of several weeks. Ask your hospital for more information.

5. If you have Gestational Diabetes how will the midwives monitor your baby’s blood-glucose levels on the postnatal ward?

Some hospitals are excessive in taking blood frequently (heel pricks) – even when baby is showing no symptoms of low blood sugars. It is painful for your baby and can interrupt breastfeeding.

6. If your baby is born by caesarean section, will you and your baby get to stay together in recovery or will you be separated?

It could be up to 2 hours before you and your baby are reunited. This is something worth considering carefully when choosing your hospital. Moms and babies who have immediate skin to skin after a caesarean are more likely to breastfeed successfully; mom is less likely to have a life-threatening bleed; and your baby gets important contact with mom’s bacteria, protecting your baby from pathogenic (disease causing) bacteria, from the theatre and staff; and skin to skin regulates your baby’s temperature, stress levels breathing and heart rate.

When your baby is born he is looking for you. His brain is wired to find his food source and hearing your voice and touch helps to activate those feeding behaviours. If mom has had a general anesthetic (rare today) then the birth partner is the next best person to do skin to skin while mom recovers from the drugs(even if you are not planning on breastfeeding).

Baby knows your partner’s voice and will settle more easily when skin to skin with your partner. Staff will be happy to help get Dad and baby settled together.

(Note if you will be separated and you plan to breastfeed, be sure to inform staff not to feed your baby. Babies are not born hungry – they are born skin hungry so being kept warm and dry with Dad is all your baby needs until you are reunited. If you are gestational diabetic you might consider collecting colostrum so your baby’s blood sugars are maintained while he’s waiting for you.)

For more information on routine birth practices in Ireland pick up a copy of The Irish Better Birth Book at all good bookstores or online at GentleBirth.ie

About the Author

I’m Tracy Donegan, registered midwife and mum to 2 gorgeous boys. I’ve been working in Irish maternity services since 2005 and really enjoy helping Irish families have the best experiences possible. You may be familiar with my books – The Irish Better Birth Book and The Irish Caesarean and VBAC Guide, as well as the very popular GentleBirth Positive Birth app.

Comments

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Noemi
That is a very helpful article thank you!
25/08/2017 12:17:10

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