After the Birth
The pinnacle of nine months of physical chaos and emotional oscillation, of queasy stomach, lost car keys, aches, pains, and hair-trigger laughter and tears has arrived. Your baby is here, placed skin to skin to feel his mother's outside warmth for the very first time.
Meeting Baby
A thousand different feelings and emotions, from utter exhaustion to indescribable joy, will flood you as you look down at that little scrunched face, still adjusting to his new waterless environment. Wrapped in a blanket with a little stocking cap to keep his head warm, he looks so perfect yet so vulnerable.
If you're planning on breastfeeding, you can nurse him while you get acquainted, even in the recovery room if you've had a C-section. It's awe-inspiring how he knows just what to do, instinctively rooting for your breast with his eyes barely open and then latching on. Spend as long as you want getting familiar and let baby's daddy share in the bonding, too. This is a precious time for your new family.
Baby's First Doctor's Visit
After you've met your child, she'll need some initial tests and treatments to ensure a healthy welcome into the world. The first is an Apgar test, which is simply an assessment of baby's reactivity, health, and appearance at birth. Created by noted pediatrician Dr. Virginia Apgar, the Apgar measures Appearance (skin color), Pulse, Grimace (reflexes), Activity, and Respiration. The Apgar is given just one minute after birth and again five minutes after that. The attendant will assign a score of 0 to 2 for each category and add the numbers together for the total Apgar. An average score is 7 to 10.
After the Apgar, your newborn will be measured, weighed, and have prints taken of her feet and fingers. Silver nitrate or antibiotic eye drops or ointment may be put in her eyes to prevent infection from anything she encountered in the birth canal. She'll also receive a vitamin K injection to prevent bleeding problems; a heelstick blood draw to test for PKU and hypothyroidism; and in some hospitals a hepatitis B vaccine. Further tests may be administered if you have a chronic illness or have experienced complications during pregnancy. If you have diabetes, for example, your newborn will have her blood glucose (sugar) levels tested.
Taking Care of Mom
After the birth you'll have some assistance cleaning up and will be given a good supply of super absorbent sanitary pads. You'll also be provided with a peribottle, a plastic squirt bottle used to cleanse and soothe your perineal area with warm water each time you use the bathroom.
You'll be expelling lochia for up to six weeks following birth, whether you've had a vaginal birth or a C-section. Lochia — a mixture of blood, mucus, and tissue that comes from the implantation site of the placenta — will be quite heavy in the days immediately following the birth, so don't be alarmed.
If bleeding is soaking more than a pad an hour, let your provider know. It could be a sign that a piece of placenta is still retained in your uterus. This condition usually requires surgical removal of the placental fragments, called
If you've had a C-section, you'll spend some time in the recovery area before heading to your hospital room. Your incision will be checked regularly and pain medication will be administered as needed. The next day you'll be encouraged to walk as soon as possible to get your digestive tract active again, and you'll be asked about your gas and bathroom habits ad nauseum. The nursing staff is just trying to ensure that everything is returning to normal in gastrointestinal land.
Women who are given episiotomies will take sitz baths (also known as hip baths) to relieve pain, promote healing, and keep the area clean. A sitz bath is a small shallow tub of water, sometimes with medication added, that you sit in. Some mild pain relievers may also be prescribed to ease episiotomy pain.
Hospital Stay
Many hospitals have rooming in, in which your baby can sleep in your hospital room with you and you can begin the process of learning to care and comfort him. It's a marvelous way to promote early bonding. However, if you are exhausted and your little guy seems to be having a problem getting to sleep, don't hesitate to get some help from the nursing staff. If you need a nap, they can wheel him down to the nursery for a few hours while you sleep. Childbirth, whether vaginally or by C-section, takes a physical toll from which you need to recover in order to parent effectively.
For the same reason, don't feel bad about keeping visitors to a minimum. Your hospital will have a visitor's policy, which will help somewhat. Although introducing immediate family members to their new relative is important, friends, neighbors, and coworkers can wait. At many facilities, you can also request that the switchboard hold phone calls to your room. Anyone who has a cold or other infection, even a family member, should not come in contact with your baby right now because of the risk of infection, and hand washing is a must for all visitors. Your baby's little immune system is just starting to rev up. (For more on introducing children to their new sibling, see Chapter 11.)
Recovery from a C-section will take a bit longer than from a vaginal delivery. When you laugh, sneeze, or cough, hold onto your incision with both hands. You'll find that using extra pillows for support over the incision area will allow you to cuddle and breastfeed your baby in comfort.
If you are planning on breastfeeding, now is the perfect time to get your technique down. Your OB nurses will likely ask you how breastfeeding is progressing, and they may request that you write down the time and frequency of nursing so they can assess baby's progress. They can also examine your latching technique to help you troubleshoot if breastfeeding isn't yet going smoothly. In some cases there is even a lactation consultant available, and hospitals frequently offer breastfeeding classes to their new-mother inpatients. (For more on breastfeeding, see Chapter 19.)
Remember that even though it will take a few days for your breasts to start manufacturing milk, you are still providing your child with nutrient-rich colostrum, the prelude to breast milk. When your milk does arrive (or
