The first hours after birth: what happens to you and your baby

So much attention goes into getting ready for labour that the hours after birth can come as a surprise. Your baby is here. Now what? Here is a gentle timeline of what usually happens in the first hours, so you know what to expect and what to ask for. Things may happen in a slightly different order where you give birth, or differently after a caesarean, but the basics are similar.

The first minutes

• Skin to skin. If you and your baby are well, your baby is often placed straight onto your bare chest and covered with a warm towel. Skin-to-skin contact helps keep your baby warm, steadies their breathing and heart rate and helps with feeding. It is lovely after a caesarean too, if you are both well.
• The cord. If all is well, many hospitals wait a short time before clamping and cutting the cord, which can benefit your baby. Your partner may be invited to cut it.
• Quick checks. Your midwife watches your baby's breathing, colour, heart rate and muscle tone. Much of this can happen while your baby is on your chest.

The placenta

After your baby is born, your womb continues to contract to deliver the placenta. Your midwife will discuss the options with you, which usually include an injection to help the placenta come away more quickly and reduce bleeding, or waiting for it to come naturally. The placenta is checked to make sure it is complete.

Checks and stitches

Your midwife will check how much you are bleeding, your blood pressure and pulse, and whether you have any tears. Many women have some tearing; small tears may heal on their own, and others need stitches, given with local anaesthetic. Ask for pain relief if you need it.

The first hour: the first feed

Many babies are alert in the first hour and may root around and try to feed. If you are breastfeeding, a midwife can help with your baby's position and latch. Do not worry if feeding does not come easily straight away; it is a skill you both learn. If you are formula feeding, your midwife can help you give the first feed.

Your baby's first checks

• Your baby will be weighed and may be measured.
• You will be offered vitamin K for your baby, which helps prevent a rare bleeding problem. You can ask for information about it before birth.
• A fuller physical examination of your baby is usually done by a midwife or doctor in the first few days.
• Your midwife will ask you to note your baby's first wee and first poo.

Your body in the first hours

• Bleeding is normal and will be heavy at first, like a heavy period.
• Afterpains, cramps as your womb shrinks, are common, especially while feeding.
• Shivering and shaking are common straight after birth.
• Your first wee may sting, especially if you have stitches. Your midwife will want to know you have passed urine.
• Eat and drink something. You have worked hard.

Warning signs to tell someone straight away

For you: heavy bleeding that soaks a pad in an hour or less, large clots, feeling dizzy or faint, a fast heartbeat, fever or shivering, severe headache or vision changes, chest pain or breathlessness, or pain and swelling in one leg.

For your baby: difficulty breathing, grunting, a blue or very pale colour, being floppy or very hard to wake, not feeding, a high or low temperature, or yellow skin in the first 24 hours.

Whenever your baby sleeps, lay them on their back in a clear cot or Moses basket, with no pillows or loose bedding. If you feel very sleepy while holding your baby, pass them to someone else or place them in their cot.

Joy after anguish

Jesus used birth itself to describe the joy that follows sorrow:

“A woman when she is in travail hath sorrow, because her hour is come: but as soon as she is delivered of the child, she remembereth no more the anguish, for joy that a man is born into the world.” (John 16:21)

Not every woman feels a rush of joy at once. Some feel shock, relief, exhaustion or numbness first, and that is normal. Love often grows over days. Psalm 22:9 speaks of God as the one who brought the psalmist safely from the womb. The same God was with you through labour and is with you now, in these first tender hours.

A prayer for our first hours together

Lord, thank You for bringing my baby into the world. Watch over us both as we rest and recover. Help us learn to feed and to know each other, give me grace for every feeling, and fill this room with Your peace. Amen.