Never ever take your baby out of the car seat when the car is moving, even if he is purple in the face and bellowing and your pulse is racing. We have all been tempted to do this but it’s extremely dangerous. Always pull over somewhere safe before you get him out.
hello!
The mind-blowing first few days
For many of us, the first ‘hello’ is not as we’d expected. There is no lightening-strike recognition, no heavenly choir, no soft-focus twinning of souls. Most of us, after giving birth for the first time, are exhausted, shocked and mind-blown by the whole experience. And most new fathers are reeling too. That it can take a while for ‘baby love’ to kick in (and it will, eventually) says nothing about your capacity to be the world’s greatest parent. Meeting your new baby can truly be the best moment of your life. But equally, it can be a bit weird.
What happens immediately after the birth?
Head, shoulders, body…a rush of fluids and astonishment: you’ve done it! It’s a real baby, right there, and she’s yours. Your baby should–the moment she’s out–be put on to your tummy with her skin against your skin (‘skin to skin’), usually with a towel over her to keep her warm. She does not need to be whisked off to be washed, weighed, measured or anything else at this point, unless she needs urgent medical attention, in which case she will be taken to a resuscitation area in the delivery room where the doctor will help her. But if all is well, your baby belongs on you and you alone now, and if possible you want to keep her there, skin to skin, for at least the first thirty minutes of her life. Studies show this really helps mother-baby bonding, reduces crying and helps breastfeeding. It’s really worth putting this in your birth plan as it may not automatically happen.
If you have a Caesarean and your baby doesn’t need urgent medical attention, ask to have her put immediately on your chest against your skin, lying across your body with your partner’s hand supporting her back or bottom. If she is healthy there’s every reason to keep your baby as close to you as you would after a vaginal birth. You may get knee-jerk objections to this from staff who have never been asked to do it before. But it is your baby, so be assertive.
After a vaginal birth, if the midwife speeds up the delivery of your placenta with an injection (a ‘managed third stage’), she’ll cut the umbilical cord as soon as your baby emerges. But if you have chosen to deliver the placenta without an injection, the midwife will leave the cord until it stops pulsing. This isn’t as freaky as it sounds: blood rich in oxygen and nutrients carries on going into your baby via the cord for a short while after she is born. Sometimes the cord does not stop delivering this blood to your baby until after the placenta is out. Many dads decide to take the scissors for this historic cord-cutting moment, and it is completely trauma-free: the cord has no nerves, so cutting it is painless for mother and baby, and there is no blood. The midwife then clamps the end of the cord with a plastic clip near your baby’s tummy. This ‘stump’ will drop off some time in the next two weeks, leaving a perfectly formed belly button.
THE APGAR SCORE DECODED
ACTIVITY/muscle tone: limp/ no response/active/taut arms and legs
PULSE/heart rate: absent to more than 100 beats per minute
GRIMACE: first breath response–none to sneeze or cough
APPEARANCE: colour–white/ blue/grey to pink all over
RESPIRATION: (absent to good/cry)
When your baby is only one minute old, the midwife or doctor will run down a quick ‘healthy signs’ checklist (in their head). They check your baby for five signs that she is healthy, and for each one they give her a score–anything from zero (bad) to two (the best possible). If, for instance, your baby has completely limp arms and legs, she’ll get zero for ‘Activity’. If she is moving a bit she’ll get a one, and if she’s actively wriggling–the healthiest sign in a newborn–she’ll get a two. This score helps them to assess how well she has coped with the birth, and whether she needs any medical attention. The most a baby can get is a ten, though it’s rare to get this at one minute. By five minutes, when the Apgar score is done again, most babies are a good solid ten.
How soon your baby will want a feed after the birth varies, but if you are both healthy, the midwife should help you to try your first breastfeed within about thirty minutes of giving birth.
After the birth you will usually stay put in your delivery suite for a couple of hours. If you tore or had an episiotomy, the midwife or doctor will stitch you up; she’ll also weigh your baby, and put two identity tags on each of her ankles. You should be offered the chance to pee, have a shower or wash. It’s absolutely fine to have a bath at any point after giving birth, but don’t make it too hot or you might faint–largely through exhaustion. Finally, after a couple of hours, when the midwife has done the paperwork, you have decided to name your baby after her and you are really, completely sure you’ve counted all those fingers and toes, you will be trundled on to the ward, usually in a wheelchair. You may be allowed to carry your baby in your arms as you go, or it may be the hospital’s policy to wheel your baby next to you in a Perspex cot (a see-through plastic box on trolley wheels that looks a bit like a prop in a 1960s B-movie). If the hospital insists on moving your baby in the cot and not in your arms, it is a health and safety thing: some units don’t want to be put in a tricky position by exhausted mummies dropping babies en route to the ward.
If you had a Caesarean, you will be taken from the operating theatre into a recovery room or observation area. How long you stay in recovery varies from hospital to hospital. In some, you stay there for twelve to twenty-four hours; in others, you’ll only be there for a couple of hours before being taken to the ward. But you’ll be very closely monitored wherever you are for the first twenty-four hours after a surgical birth, and you’ll need regular doses of pain relief.
Vitamin K
This makes our blood clot properly. On rare occasions, a newborn doesn’t have enough and may bleed dangerously (known as ‘vitamin K deficiency bleeding’). Most newborns now are given vitamin K by injection when they are first born, but you can give it orally in two doses when she’s a few days old. Some studies in the 1990s raised worries about a link between injected vitamin K and childhood cancer, but the current scientific consensus is that there is no evidence to support these worries and that injected vitamin K is safe. Ideally this is something you should think about before the birth–talk to your midwife.
‘Recovery’
After the midwife or doctor has made sure you and the baby are doing well, they’ll leave you all together for a bit–possibly in a ‘recovery room’–so that you can get to know one another, before moving you to the ward where a Perspex cot will be put next to your bed. It can be unsettling and even strangely lonely to find that you–and you alone–are suddenly in charge of your tiny newborn. Midwives may be too busy to answer questions like ‘Am I holding her right?’.
Most new mothers, when they talk about the midwives they had for the birth, are overcome with gratitude and admiration. Midwives in general do a superlative job. But they are not superhuman. On the maternity ward the midwives are likely to be extremely over-stretched. ‘There was one midwife for ten women on the ward,’ says Heather. ‘I had had a C-section and couldn’t pick Ellie up to cuddle or feed her. At one point she was crying next to me for 40 minutes and the midwife couldn’t