Ask Your Midwife Elizabeth Stein, Certified Nurse Midwife Ask your Midife Articles
Postpartum Care in the Delivery Room

By Elizabeth Stein, CNM

Question
What can I expect to happen in the delivery room after my baby is born if I have a full-term, normal, vaginal delivery?

Answer
Whether you deliver in a birthing room or a delivery room, the postpartum routine is basically the same for the staff, even though this is the most important, special day of your life! Your baby may be placed on your abdomen, rubbed dry, and covered with a warm blanket or towel. Or he may be taken to a nearby warmer where this is done. It's important to keep him warm, as babies lose body heat very quickly. Your baby's nose and throat will be gently suctioned. He'll be given an injection of vitamin K, which helps the blood to clot. Antibiotic ointment will be applied to his eyes to prevent infection. Your baby can see you through this ointment and it is not irritating. Your baby will be footprinted, and identification bands will be placed on his wrist and leg. You will also be fingerprinted. Ask for a copy of these prints.

Meanwhile, you'll have to deliver the placenta. The placenta may slide out within minutes after the baby, or may take as much as 30 to 60 minutes. The placenta is about one-fifth the size of the baby. It has no bones and is soft, but you may still feel intense cramping. After the placenta is delivered, you will receive medication call Pitocin (oxytocin). Pitocin can be given as a separate injection or mixed with the IV fluids you are already receiving. Pitocin will help your uterus contract so you won't bleed excessively. To achieve the same effect as Pitocin, your uterus may be externally massaged, or your nipples may be stimulated, or your baby may be put on your breast to suck.

Your midwife or doctor will then inspect your genital area for lacerations. Any lacerations and the episiotomy (if one was performed) will be repaired. A small amount of local anesthesia will be used to numb the area, so during the repair you may feel a little pressure but not pain. You or your partner may be holding your baby, or he may be placed in the warmer. Bonding is a lifelong process. It does not just happen in the moments after birth. Most moms are exhausted and just need to rest during the repair. This a good time for the new dad to be with his baby. Or the nurse may be caring for your baby at this time.

After the inspection and repair are completed, the area will be cleaned with warm water. A sanitary pad will be placed under your perineal area. You'll be helped into a clean gown and then covered with a warm sheet or blanket. Some moms shiver intensely and this warm sheet helps it resolve. Then you'll finally be able to rest. You may be very hungry and it'll be okay to eat and drink. Both parents should hold, stroke, kiss, and talk to their newborn baby. Talking is important -- your baby already knows your voices and will be soothed by the familiar sounds! You might try breastfeeding if you're not too exhausted. Your baby will enjoy sucking, but he won't be hungry yet. Although family and friends may be waiting outside or expecting a phone call, a little quiet time together as a new family is a good idea.

You'll probably be kept in the delivery area for one or two hours (although this may vary) for observation of any immediate postpartum problems, especially bleeding or changes in blood pressure. After that, you'll be transferred to a postpartum room to recover for one or two days before going home.


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