Immediate Care After Birth

Following the birth of a baby is a time of great responsibility for a birth attendant. You must safeguard the health of both mother and baby and help get the baby off to a good start in life. This video will show how to care for both the mother and baby right after birth.

Immediately after the birth, place the baby on his mother’s abdomen. Assess the baby as you thoroughly dry him with a clean cloth. The baby is well if he breathes easily, cries a few times, and moves actively. Be ready to resuscitate if the baby is not breathing within a minute of birth. If the baby is breathing normally, there is no need to suction the baby’s mouth and nose.

Change the wet cloth for a dry one and place the baby naked on his mother’s bare chest. This skin-to-skin contact keeps the baby at a perfect body temperature and helps establish successful breastfeeding. Keep the baby and mother covered. Feel the mother’s lower abdomen to be sure there is not another baby. Let the mother know you will give her medicine to prevent her from bleeding. Then give 10 units of oxytocin in her thigh muscle within a minute of the birth.

Delay cutting the cord until it has gone limp, after a few minutes. This gives the baby his full iron stores and prevents anemia. Clamp or tie the cord 2 finger widths away from the baby’s belly. Pinch the cord with your fingers and push the blood away from the baby. Two fingers widths away from the first clamp, clamp or tie again. Cut the cord with sterile scissors or a new blade. Do not put anything on the cord stump unless advised by your country’s policy. Leave it open to air.

Now turn your attention to the delivery of the placenta. Watch for signs that it has separated. You may see: a gush of blood, the cord lengthening, or feel the firm round uterus in the lower abdomen. The mother may deliver the placenta herself – or if it’s part of your training, you may carefully assist its delivery. When the next contraction comes, hold the uterus back with one hand while applying steady tension in a downward direction with the other hand. Never pull hard on the cord. As the placenta delivers, hold it in both hands and twist it to bring all the membranes together.

The main risk to the mother now is heavy bleeding. Check that the uterus feels hard. If there is bleeding, rub the uterus to help it contract and stop bleeding. Check it frequently to be sure it stays hard and there is almost no bleeding from the vagina. Inspect the placenta to be sure it’s completely intact and there are no missing pieces. Using good light, gently separate the labia and inspect the lower vagina and the perineum for tears. Suture if needed. Then gently cleanse the perineum and apply a clean pad.

In the first few hours after birth, try to ensure uninterrupted mother-baby contact to give the baby a chance to start breastfeeding. In this time the baby is in a special state of alertness and will find his mothers nipple if given the chance. Allow the baby to be at the mother’s breast for as long as he wants. Check the baby and mother every 15 minutes for the first hour, and every half hour thereafter. Be sure the baby is breathing well, his feet are warm, he has pink lips and normal activity. Check the cord for bleeding.

Take the mothers blood pressure, pulse, and temperature. Feel her uterus for firmness and check for bleeding. You can teach the mother how to feel her uterus and rub it to keep it firm. Her baby’s suckling also helps the uterus contract. Wait until the baby has had skin-to-skin contact for at least an hour before you provide other newborn care. Keep the baby with the mother. Give Vitamin K, preventative eye medication and vaccines if this care is part of your country’s practice. Wipe off any blood or meconium but don’t give a bath. A bath can make the newborn dangerously cold. Wait at least a day. Keep the baby warm when you weigh him.

Remember, place the baby skin-to-skin on the mother right after birth. Wait until the cord is limp before cutting it. Closely monitor the mother for bleeding and the baby for breathing and warmth.