As soon as the baby is born, the doctor holds him upside down to allow the amniotic fluid, with which the baby’s lungs have been filled in the uterus, to run out, and also to allow the blood in the umbilical cord to flow back into your body.
While the cord narrows and whitens as it is emptied of blood, the doctor suctions the mucus out of the baby’s nose and mouth, wipes the baby clean and watches for the first breaths. If your delivery has been un-medicated, he may put the infant on your stomach while he clamps the umbilical cord, and cuts it.
The stump of the cord, about two inches long, is bandaged. Then the baby’s eyes are treated with an antibiotic solution or silver nitrated to prevent any possibility of gonorrhea infection.
The doctor now returns his attention to you. While he waits for the expulsion of the afterbirth—the placenta, with umbilical cord attached—he sutures any tears that may have occurred. If he has performed an episiotomy, he repairs that cut. If you are awake at this stage, the doctor may give you the baby to hold for a moment. To aid in uterine contraction, the doctor or a nurse will massage the abdominal wall until the uterus feels firm and hard.
The baby is now weighed, measured and examined. If the baby is premature, it will probably weigh less than if it had been born at the end of the nine months’ gestation. While weight is important, it is not the only factor in determining the condition of a premature baby. Babies whose weight falls below some normal figure (2.5kg is usually considered normal) are not necessarily treated as premature. If the baby at a lower weight is fully developed and healthy, he or she can be treated like any other newborn.
CONVALESCENCE AFTER CHILDBIRTH
Today, a woman who has had a normal delivery with little or no medication is usually capable of walking, talking, and eating just a few hours after her child has been born. Many women experience some ‘afterpains’ for several days after childbirth.
This is caused by the contractions of the uterus, which is rapidly shrinking back to its original size. If the pain is particularly troublesome, it can be alleviated with aspirin. Some women need a mild laxative to encourage a first bowel movement. Those who have had a forceps or breech delivery may have trouble urinating, and will be catheterized until the opening leading from the bladder resumes normal functioning.
The episiotomy incision may also cause soreness, which can be relieved by a warm sitz bath, a heat lamp, or an ointment if recommended by your doctor.
The four or five days you spend in the hospital should be time for renewing your strength and making friends with your baby. The maternity section of any hospital is usually a happy place to be. Enjoy it while you prepare yourself for a long life together with your new baby.
GIVING YOUR BABY A GOOD START IN LIFE
THE FIRST DAYS
Two things are useful to remember when you return to your home. The first is: Trust yourself. Even if you are a mother for the first time you know much more than you imagine, and in an amazingly short time you will find yourself responding instinctively and correctly to your baby’s needs.
You will get more than enough advice from friends and relative. Take only what seems sensible to you. The care and love parents naturally give their babies are infinitely more valuable than checking the exact temperature of the bath water or knowing the best way to fold a diaper.
The second thing to remember is that you should get all the help you can for the first month or two, and especially during the first two weeks. If you can afford to hire a practical baby nurse from a reputable agency, or a dayworker to clean and cook so that you can concentrate on the baby, by all means do so.
But first make sure that anyone you hire is in good health. Ask for proof of a recent medical checkup or, at the very least, insist on a chest X ray.
If you cannot find or afford paid help, arrange to have a visiting nurse or public health nurse come in and show you the fine points of preparing formulas, diapering, bathing the baby, and whatever else you need to know. The nurse may make one or several visits, depending on your needs, usually at minimal cost to you. Arrangements can be made through the hospital where you have your baby, through local or state health departments.
You may be able to get other help—and a lot of moral support—from any friend or relative who has some free time and with whom you feel comfortable.
Above all, get help from your husband—he is just as much a parent as you, and he may be feeling a little left out and is simply waiting to be asked. If he can take some time off from work to help with baby care, meals, shopping, or cleaning—or just to be there so you can have an afternoon nap or go out to walk—it will certainly make the first days easier, and he will be part of things instead of feeling in everyone’s way.
Conserving your Energy
Pregnancy and childbirth are normal, natural events, but they are also trying, both physically and psychologically. Even if you feel marvelous when you come home from the hospital (and you probably will), do not overtax yourself. You will need daytime naps during the period that the baby wakes for night feedings. It is difficult to limit visitors, but do it; an endless parade of well-wishers can be tiring. If you feel uncomfortable about putting visitors off, just tell them you’re acting on your doctor’s advice.
If you have no help for such jobs as cooking, shopping and cleaning, keep the meals very simple and let the dust collect. Heavy housework can certainly wait.
You may take a shower or sponge bath as soon as you want, and a tub bath in two or three weeks. Ask your doctor before you use a douche. You may wash your hair whenever you like.
You may have heard a good deal about the so-called ‘post-partum blues’ or ‘new-baby blues’—sudden feelings of weepiness or depression, or perhaps a loss of self-confidence coupled with excessive anxiety about the baby’s welfare. Such feelings are fairly common, especially after the birth of the first child. They usually occur a few days or even weeks after the mother’s return from the hospital and are nothing to be ashamed of.
Women go through considerable physical and glandular changes after childbirth, and it can be a shock to make the transition from the hospital—where new mothers are pampered and waited on—to the normal responsibilities of a household plus the care of a brand-new baby. If you are troubled by the ‘blues,’ remember that the feeling is temporary. This is a good time to ask someone you trust to look after the baby for a few hours while you go out—for a movie, some pleasurable shopping (new non-maternity clothes are a special delight), a lunch or dinner with good friends.
If, as sometimes happens, the feeling persists and you can’t shake it on your own, or if it gets considerably worse, ask your doctor or clinic to refer you to a psychiatrist or community mental-health center for counseling.
Delay sexual intercourse until you have had a checkup, usually about six weeks after childbirth. At this time, your doctor will examine you to make sure your tissues have healed thoroughly. If you use a contraceptive, discuss this with your doctor now; if you wear a diaphragm, you will definitely need a new fitting. If intercourse is painful, take a hot bath first, and then use a vaginal jelly to lubricate the vagina. If the pain persists, consult your doctor.
Menstruation usually returns within four to eight weeks. The first menstrual period is almost always unusual in some way. The flow may be profuse, there may be clots, or it may stop and start again. The second period should be normal or nearly so. Menstrual periods are often irregular, or postponed, altogether while a mother is nursing her baby—but this does not mean that nursing mothers cannot get pregnant again.
It may take a while for your muscles to recover their springiness and your figure to return to normal, especially if you gained excess weight during pregnancy. Whether or not to wear a girdle is up to you and your doctor. If you suffer from back pain, a well-fitted girdle may be helpful, even if you do not normally wear one.
Exercises also help, but consult your doctor before starting them. Most new mothers can start exercise program within two weeks, but those whose babies were delivered by cesarean section may have to wait considerably longer
Sources and References
Reader’s Digest Family Health Guide and Medical Encyclopedia
Forceps Delivery in Modern Obstetric Practice by Roshni Patel and Deirdre Murphy
What New Mothers Need to Know: Perspectives from Women and Providers in Georgia by Winifred Thompson et al