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What to Expect the First 24 Hours After Birth

After months of waiting (and hours of labor!) a mother finally gets to experience the moment that she has been waiting for the past 9 months: Meeting her baby!

There is no doubt that meeting that precious little one for the very first time is an incredible experience; however, after delivery, new moms and their babies don’t just go about their business and fall into a routine. There’s a lot that happens right after the birth of a baby, especially in those first 24 hours.

From a full physical exams for both mama and baby to some pretty weird changes that mom will start to experience almost immediately after delivering, there is a lot that happens in the first 24 hours after a baby is born.

Experienced moms are prepared for all of these changes, but for new moms, what occurs right after a baby is born may be quite surprising. Speaking from my own, personal experience, I was not at all prepared for some of the things that happened right after my first little guy was born – and I read every piece of literature out there and thought that I was fully prepared. I definitely was not.

To keep first-time mamas in the loop so that they aren’t caught completely off-guard right after their babies are born, here’s a look at some of the things that happen in the 24 hours after a baby is born. Some of these things are definitely expected, but some of them may be quite eye-opening.

After months of waiting (and hours of labor!) your baby is finally here! Here are 24 things you can expect to happen during baby’s first 24 hours in the world.

24 Your Baby’s First Breaths

The most profound thing that will happen after a baby is born is that first breath she will take.

While she was in the womb, her lungs were filled with fluid. That fluid is removed through the blood and the lymphatic system, and some of it pushes out while passing through the birth canal. Once the lungs are free of fluid, they are filled with oxygen, and her lungs must be able to process that oxygen. An intense circulation of blood will also commence inside the lungs immediately after birth.

That’s a lot of work going on in those tiny lungs, and as such, those first few breaths that a baby takes right after birth could very well be the most difficult breaths that she will ever take.

Not only is the process of lung function vital for the baby’s health and development, but it also allows mama to hear the first sound she will make – a cry. And believe me, it is the sweetest, most profound sound anyone can ever hear.

When your baby arrives, the doctor will suction out her mouth and nose to clear away mucus and amniotic fluid so that baby can begin breathing on her own.

23 Cut the Cord

In the moments after birth, the baby’s umbilical cord will likely be clamped and cut.

Throughout pregnancy, the umbilical cord serves as the baby’s lifeline to the placenta. It delivers important nutrients and blood to his body, and it also eliminates waste from the baby’s body. In the last stages of pregnancy, the umbilical cord also passes antibodies to the baby, as well, which helps to boost his immune system.

Once the baby is born, the job of the umbilical cord is completed and it is no longer needed. In order to disconnect the baby from the cord, it will be clamped and cut, thus freeing the baby from the cord and the placenta.

The doctor can cut the cord, but if anyone else would like to do it, like the mother or the father, the doctor should be notified before the birth. The medical team will provide the necessary instructions at the time of clamping and cutting.

The doctor will clamp and cut the umbilical cord. Or, your partner may be allowed to do it. If possible, talk with the doctor ahead of time about the benefits of delayed cord clamping and cord blood collection or donation.

22 The Apgar Test

Another thing that happens in first 24 hours after birth is the Apgar score. It allows doctors to know how a baby is doing right after birth, and helps determine whether or not the newborn is healthy and ready to meet the rest of the world, or if she will need medical assistance. This medical evaluation will be performed within one and five minutes after the baby is born.

The letters in Apgar stand for:

  • Activity
  • Pluse
  • Grimace
  • Appearance
  • Respiration

Each of these elements of the Apgar score will be rated on a scale of 0 to 2. For example, in the appearance portion, a child will receive a rating of 0 if the body is completely bluish-gray or pale, a rating of 1 if there is color in the body, but the hands or feet are bluish, and a 2 if the color is good all over the body.

The doctor will determine the baby’s Apgar score, which is based on heart rate, color, reflex response, activity and muscle tone, and breathing. The test is completed at one and five minutes after birth. Scores can range from 0-10, and anything above seven is deemed healthy.

21 You’re Not Done Yet

Once the baby is delivered, many mothers assume that is complete; however, delivery isn’t quite over after the baby is born – the placenta still needs to be delivered.

Anywhere from 5 to 20 minutes after the baby is born (though it can take longer,) the placenta will be delivered. The placenta was an important part of pregnancy, but now that it is over, it is no longer needed, and it needs to exit the body.

The uterus will continue to contract after the baby is delivered. Those contractions are about a minute apart, and they are much milder than the contractions that were experienced while the baby was being birthed. In fact, many mothers don’t even notice them.

Once the placenta is delivered, the birthing process is complete. It will be examined to ensure that it, the mother and the baby are healthy, and it will usually be discarded.

You might have delivered the baby, but you still have to deliver the placenta. Your uterus will continue to contract to push the placenta out. Your doctor may give you pitocin to speed up those contractions, and might even knead your abdomen to help ease the placenta out.

20 Weighing In

Once the Apgar score is completed, the baby will receive his first bath.

The bath, which is usually completed by a nurse, will rid the baby of all of the “stuff” that is left on him from the womb. If there seems to be extra fluid in the mouth and nose, they will be suctioned. The baby will also be washed down, having any blood, tissue matter, and vernix (the yellow, cheesy-like substance that coated the baby while he was in the womb, protecting his skin from the amniotic fluid) removed.

The eyes will be wiped clean and an antibiotic ointment will be put on his eyes. This ointment helps to prevent the development of neonatal conjunctivitis, or pink eye. It also helps to prevent the development of other bacteria and/or viruses that may enter the baby through the eyes, such as Chlamydia and Gonorrhea.

While you’re pushing out the placenta, your baby is likely getting cleaned up, weighed, and measured. Your baby will also likely receive antibiotic eye drops, a vitamin K shot, and a Hepatitis B vaccine at this time.

19 You May Need Stitches

The baby isn’t the only one who needs to be cleaned up after birth; mama does, too. She just did a huge job, and it involved some things that will leave her pretty, well, messy.

Nurses will clean up mama. Her legs and her nether regions will be cleaned, removing blood and anything else that may remain after the birth of her baby.

Mama may also need to have stitches “down there.” If her perennium tore or if she needed to have an episiotomy, she will likely be stitched up. The site may be sore and itchy, especially the first few days after birth, but they will dissolve in a few weeks. Ice packs, rinsing with lukewarm water and a sitz bath will help to ease the pain and ensure that the area remains clean even after mama and baby go home.

If you delivered a large baby or stretched and tore during delivery, or required an episiotomy, you will likely be stitched up. They may be sore and itchy as they heal, but will dissolve in a few weeks. Try using ice packs, rinse, and use a sitz bath every time you go to the bathroom.

18 Skin to Skin Time

If both mama and baby are willing, right after the baby is born is the best time to begin breastfeeding. If the baby is healthy and no medical intervention is needed for him or the mother, he will likely be placed on the mother’s chest, directly on her skin, until the first feeding session is accomplished.

Right after birth, the breasts begin to produce colostrum. This nutrient-rich pre-milk that is packed with antibodies will be the first fluid to nourish the breastfed babies, and it provides the baby with exceptional benefits, like the ability to fight off infections and diseases.

The baby may seem to have trouble locating the source of milk, but don’t worry; he will eventually find his way. If needed, direct him to the breast, or ask a nurse or a caregiver for assistance. A lactation consultant will also be available to provide assistance or answer any questions.

If all goes well with delivery, your baby may be placed on your chest immediately. This bonding time has many benefits for mother and baby. Mom’s skin keeps a new baby warm, reduces a baby’s stress, and helps to regulate the baby’s blood pressure.

17 Will You Breastfeed?

If you plan on nursing, you will be encouraged to try breastfeeding. You will be producing colostrum immediately after birth. Colostrum is the first nutrient-dense and antibody-rich milk that will take care of your baby’s needs until your milk comes in.

16 Hello, Nurse(s)!

Nurses will come into to check on the mother and the baby throughout entire hospital stay. They will check the mother to ensure that everything is going well, examining her nether regions, if needed, or her incision, if a C-section was needed. They will also provide help with any postpartum bleeding, including changing maxi pads and bed liners. Nurses will also encourage mama to get up and start walking as soon as she can, and assist her with using the restroom, if needed.

Nurses will also check the baby to ensure that she is doing well. They will change diapers, if the mother would like them to, and show mom how to swaddle the baby. They will also teach mom how to care for the umbilical cord stump, and if the baby is a boy, they will show you how to care for the circumcision, if the parents elected to have one done.

Maternity nurses are a huge help. They provide wonderful, insightful information and go above and beyond to make sure that mama and baby are healthy, comfortable and happy.

Nurses will come in periodically to check on you and the baby. They will show you how to swaddle the baby and care for her umbilical cord stump. (Nurses will also speak to you about circumcision, if you have elected to have that done.) They’ll also encourage you to move around if you are able, help you to the restroom, and show you how to take care of yourself. Ask your nurses for extras of everything to take home--mesh panties, hospital pads, rinse bottles, and ice packs.

15 A Lactation Consultant Will Visit

Mothers who are planning on breastfeeding will be visited by a lactation consultant. This person specializes in breastfeeding and will provide any assistance that is needed and answer any questions that the mom may have.

For some mothers and babies, breastfeeding comes naturally; however, for many, many mothers and babies, assistance is required. Mothers who find that they or their babies are struggling will find a lactation consultant invaluable.

This professional will teach the mother how to properly position her baby to achieve the best latch. She will also provide tips and suggestions, including how often the baby should be fed, how to keep a diary of wet diapers, and even how to use a breast pump.

After leaving the hospital, mothers can continue to consult with a lactation consultant, if needed, until they feel confident that they and their baby have achieved breastfeeding success.

A lactation consultant may stop by to see if you have any questions and to help you get accustomed to nursing. The LC or a nurse will show you how to keep records of time spent nursing and may also ask you to track how many wet and dirty diapers your baby makes.

14 You’ll Be Visited by a Lot of People

There are probably going to be a lot of people who want to welcome that new little bean into the world. Friends and family members will be allowed to visit the hospital during certain hours. They will be required to check in with the hospital. Do note that only a certain amount of people will be allowed to visit at one time. Also, if anyone who is planning on visiting is sick, even with a minor cold, it is best to ask them to wait to until they are well. Newborns have a weak immune system and even the smallest could be easily passed on to the baby.

Mothers will also be visited by people they don’t know. A customer service representative from the hospital may stop by to see if the mother is happy with the care that she is receiving. A photographer may also come in to discuss a newborn photo shoot. The baby’s pediatrician will also make an appearance to fully examine the baby.

A hospital customer representative may stop by to see if you are satisfied with your care. Some hospitals have photographers that will pop in and do a newborn photo shoot if you are interested. And of course, you’ll have lots of friends and family members coming by to meet your new little one!

13 A Visit From the Pediatrician

A pediatrician will evaluate the baby at some point during your stay. They will check your baby for jaundice. A heel prick will also be done so the doctor can run a metabolic screen, depending on what tests are required by your state.

12 You’ll Still Have a Belly

Many women are surprised to learn that they still look like they have a baby bump after they deliver the baby. Not only did the belly stretch out to a large size at a rapid rate, but so did the uterus. It’s going to take some time for that ‘baby bump’ to disappear.

The uterus begins to shrink immediately after delivery; however, it takes about 6 weeks for it to shrink back to its original size. Even then, it may not return back to the size it was before pregnancy. It’s also going to take some time for all of that fluid that was retained during pregnancy to exit the mama’s body.

Eating a well-balanced diet and practicing certain exercises (as long as it is cleared by the doctor) can help a new mama get her belly back to ‘normal.’ Do remember though, that it took 9 months to grow that baby and for the belly to get that big, so it’s going to take some time for it to return back to its pre-pregnancy size. And, the presence of a ‘baby bump’ may always remain, and that is perfectly OK! It took 9 months for your belly to get that big, and your uterus needs time to shrink back to its pre-baby size and shape. The doctor may give you pitocin to help shrink your uterus, and the nurses may “massage” your belly to encourage it to shrink. (Unfortunately, it’s not as nice as it sounds.)

11 You’ll Still Have Contractions

As your uterus begins to shrink, you’ll feel contraction-like cramps. You may also feel these when you breastfeed, as breastfeeding releases hormones into your bloodstream which cause the uterus to contract and start shrinking.

10 You Might Get the Shakes

You might not be cold, but you might shiver! Your hormones will shift wildly after birth, causing your limbs to shake like crazy. Sometimes women react to IV fluids and pain medicine with a case of the shakes, too.

9 There Will Be Blood

Remember how nice it was not having a menstrual period for the 9 months of pregnancy? Well, not that the baby is born, bleeding will return, and it may seem to come back with a vengeance.

Postpartum bleeding, known as lochia, begins immediately after the baby is delivered. All of that extra blood the mother produced during pregnancy, as well as remaining tissue, will vacate the body, and it will do so in the form of vaginal bleeding. Even mothers who have C-sections will experience postpartum bleeding.

At first, the bleeding will be extremely heavy – think of it as a menstrual period magnified – but it will start to lighten in the days and weeks following the delivery of the baby. In most cases, postpartum bleeding completely stops by about 6 weeks after delivery.

If the bleeding seems to be extremely heavy for a long period of time, or it lightens and then gets heavier again, or if it is accompanied by cramping, speak with a doctor.

Remember how nice it was to not have a period for 9 months? This is payback. Postpartum bleeding is made up of blood, mucus, and tissue, and it can be heavy for a week or more after delivery. It will eventually taper off, and stop altogether sometime between four to six weeks postpartum.

8 You’ll Be Sore

Delivering a baby isn’t easy. In fact, it is one of the most physically demanding things that a person could ever do. For that reason, new mamas are going to feel sore right after delivery.

For mothers who delivered vaginally, pain and soreness will be experienced in the crotch area. If there was a tear or an episiotomy was needed, that soreness will likely be even greater. Mothers who had a C-section will experience pain in their abdomen.

Being sore is natural after childbirth, no matter if the birth was vaginal or via a C-section. Walking and moving around may seem like a difficult task; however, nurses will advise new mothers to get up and out of bed and start walking around as soon as they can. Doing so promotes circulation, which speeds up the healing process and avoids the onset of other issues, like blood clots in the legs. Medications can be taken to dull the pain.

Your body has done a lot of work. If you had a c-section, you’ve been through major abdominal surgery. You will naturally be sore and exhausted, but getting out of bed and even trying to walk around can promote good circulation and even help speed up healing.

7 You’ll Be Swollen

The belly isn’t the only thing that will be swollen after the baby is born; a new mother’s feet, hands and face may also be swollen.

During pregnancy, a woman’s body retains a tremendous amount of fluid. It’s going to take some time for all of that fluid that the body was holding onto to exit the body. IV fluids may also exacerbate the issue, increasing the swelling. Don’t worry, those hands and feet won’t be the size of balloons for long.

The swelling will decrease quickly, and in most cases, women will see that swelling has completely subsided within a week or so. Ice packs can be used to ease any pain that is associated with swelling. Also, elevating the feet will help to speed up the process, as will moving. Walking around will get the circulation going, which will help to ease any swelling that may be experienced.

Your feet and hands may be swollen for a while after delivery as your body works to get rid of stored-up fluids. Your nether regions may also be very swollen and even bruised, especially if you pushed for a long time. Don’t be alarmed; it’s normal. You can use ice packs for a little while to help ease the pain and swelling.

6 Your Catheter Will Be Removed

If you had an epidural, you likely had a catheter inserted. Once the anesthesia wears off and you are able to walk, the catheter will be removed so that you can try to go to the bathroom on your own. Rinsing your genitals with tepid water may help relieve any stinging sensations when you go to the bathroom.

5 Going to the Bathroom May Not Be Easy

For many new moms, the bathroom is a place that they dread.

Going to the bathroom right after delivering a baby is a difficult task. For moms who delivered vaginally, there may be pain in the region, which may increase when trying to use the bathroom. For C-section moms, a walk to the bathroom may seem like trying to scale Mt Everest.

Many new moms also find that they are constipated right after delivery, or that passing a bowel movement is extremely hard. The pain they are experiencing only complicates matters. The mom may feel like bearing down will pop any stitches either in the abdomen or in the vagina. Also, pain medications can make it difficult to go, as can supplements, like iron and prenatal vitamins.

Drinking plenty of fluids and eating a diet that is rich in fiber will help to make the process a lot smoother. A stool softener can help, too.

You might not poop right away after delivery. Your stomach muscles were stretched throughout your pregnancy and your body is probably in rough shape after delivery. You also probably haven’t had much to eat, plus you might be worried about hemorrhoids or your stitches. Take it easy. Eat lots of fiber, drink lots of liquids, and ask your nurse about using a stool softener to make things easier when nature does finally call.

4 Your Baby’s First Poop

Your baby’s first poo is called meconium. It will be black, tarry, and sticky. It may look like that for the first few bowel movements. Eventually, it will turn to a mustard yellow color (if you’re breastfeeding) or anything from yellow to green to brown if you’re using formula.

3 Can You Hear Me Now?

At some point during your hospital stay, your baby will have a hearing test. An audiologist will place headphones on your baby, play sounds, and monitor how the baby responds. You should receive a record of this test (and all tests) to give to your pediatrician at your baby’s first visit.

2 Your Baby Might Lose Weight

Your baby will be weighed again before you are discharged. Don’t be alarmed if your baby loses weight. It happens often. A 7-10% loss of weight is normal for breastfed babies while 5% is okay for formula-fed babies. Most babies regain this weight (and then some) by the time they are two weeks old.

1 Time to Go Home!

At last! The moment that all new mothers have been waiting for – taking their babies home!

Once the hospital confirms that both mama and baby are in good health, they will be cleared to go home. Prior to leaving, new parents may have to attend a discharge class. A staff member will go over any forms that the new parents need to take care of, such as obtaining a birth certificate and a social security card, and any insurance matters, too. New moms and dads will also likely have to watch a video and attend a class regarding shaken baby syndrome. Shaken baby syndrome is the most common form of child abuse, and it often happens to newborn babies. The video and the class will educate parents about the dangers of shaken baby syndrome and will provide them with tips and other important information.

Once it is time to go home, mama will be wheeled out of the hospital in a wheelchair, while she is holding her baby, if she would like. Do note that a member of the hospital staff will likely check the car seat to ensure that it is properly installed. Once given the green light, the new family will be able to head home!

Your hospital may offer some sort of “discharge class” before you check out. A staff member will go over forms for things like obtaining the baby’s birth certificate, social security, insurance, how to pay for your stay, and your aftercare instructions.

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