The first 15 minutes of life

Posted on 16 August 2013

You’ve waited nine months for your baby. Here’s what happens in those first crucial moments.

Words Lisa Templeton

From the moment your baby first enters the world it’s all systems go. ‘The first breathing movement and the establishment of adult-type blood circulation are surely the most important events in the first 15 minutes,’ says Dr Francis Elemva, gynaecologist and obstetrician at Mediclinic Sandton. ‘And the meeting between mom and newborn is probably one of the most touching moments you can witness – it’s one of the things that inspired me to become an obstetrician.’

What will happen to your baby…
As soon as your baby’s head emerges, fluid will be cleared from her mouth and nose with a bulb syringe to clear her airways and help her take her first breaths.
Next your baby should bellow, which happens spontaneously or with a little encouragement by rubbing her back or tapping her feet. This helps to get her breathing and get oxygen flowing around her body.
Once delivered, her umbilical cord will be clamped and cut, and a sample of her blood taken from the cord for analysis.
Next it’s time for the Apgar test, which is performed at one minute and again at five. She’ll be scored between one and 10 on heart rate, muscle tone, respiratory effort and reflexive response to stimulation and colour. It’s a quick way to assess how she is adapting to life outside the womb.
She’ll also be weighed and measured; and she’ll get an identifying band on her wrist or ankle. If necessary, she’ll be placed in an incubator.

What mom can expect…
After a natural delivery:
The placenta comes next, and the doctor may press your stomach to make sure it is delivered completely.
If you’ve had an episiotomy (a small, controlled cut to make it easier for the baby’s head to emerge) the doctor will stitch the cut.
Once your baby is breathing and free of her umbilical cord, you’ll be introduced to her.
You may want to breast-feed your baby.
Your breasts will hold colostrum initially, which is full of immunising power, proteins and fats for your new baby.

After a Caesarean section:
Once your baby has been delivered, the amniotic fluid will be suctioned out and, with the cord cut, your doctor will remove the placenta and close the incision. This may take up to 30 minutes because of the layers of muscles that must be closed.
Now’s the time to meet your baby (this happens while the doctor closes up your cut).
Don’t be alarmed if your baby coughs and splutters – it’s normal for Caesarean babies. During natural childbirth, fluid would have been squeezed out of the baby’s lungs, but a baby born by Caesarean may take shallower, quicker breaths until their airways are clear.
You’ll now be wheeled into a recovery room, where you’ll be monitored closely for a few hours. If your baby doesn’t require further attention, she’ll join you here.

What the birth partner can expect…
In natural childbirth you may be invited to cut the cord – this is not for everyone, but very meaningful to some.
With a Caesarean you won’t actually see the operation but will get the first glimpse of your baby over the screen.
After your baby has been cleaned, you’ll get to hold her.

What the doctor does…
The doctor is in charge of seeing you and your baby through childbirth safely.
A paediatrician will also be on hand to check your newborn.

What the nursing practitioner does…
It’s generally the nursing practitioner who will get your baby to cry, wipe away the vernix (the greasy deposit that covers your baby’s skin at birth) and dry off the amniotic fluid, before placing your baby on a warming table for a quick check by the paediatrician. She may also give your baby eyedrops and a shot of vitamin K, which prevents internal bleeding that was once common in newborns. Then she’ll wrap your new baby in a nappy and blanket, and hand her to you or
your birth partner.

Fast fact
How aware is your newborn? Babies can be amazingly alert and keen to socialise in their first hour of life. Reseachers have proven that new babies can see, hear, taste and smell better than we thought, and respond to the sight and touch of their parents.

Did you know?
In the old days babies were dangled upside down by their feet and spanked on the bottom to
bring on crying, but now we know that that just isn’t necessary.

The information provided in this article was correct at the time of publishing. At Mediclinic we endeavour to provide our patients and readers with accurate and reliable information, which is why we continually review and update our content. However, due to the dynamic nature of clinical information and medicine, some information may from time to time become outdated prior to revision.