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Hello friends,

We had a lovely meeting this past Monday! Thank you so much to everyone who was able to attend. Your participation added a great deal to the meeting and we appreciate it. For everyone who was unable to attend this month, we hope that this post will allow you to attend our meeting virtually and maybe we’ll see you in person next month!

Our speaker this month was Brooke Connor, a newer doula in our community. Brooke has seven children, six were VBACs, and she has a wonderful passion for mothers, babies, and birth that shines through whenever I’ve worked with her at a birth or talked with her about birth. Her passion certainly shone through during this past meeting, despite having been awake almost all the previous night at a birth.

We had a full room of attendees ranging from mothers with older babies, pregnant women, nurses, doulas, a high school senior, and local business owners. The six older babies played happily on the floor as we met and there was a precious little newborn to snuggle as well. Everyone present seemed eager to learn and participate in the discussion.

Our topic this month was: The First Hour After Birth

The first hour after birth is so important that it has been called the “Golden Hour.” This hour is the perfect time to bond with your baby because your hormones, as well as the baby’s, are primed and ready to form one of the strongest bonds possible – the bond between a mother and child. The first hour is also the perfect time to initiate breastfeeding while your baby is alert and ready.

Certain medical interventions can interfere with this precious time. It’s very important to understand how they can affect your first hour and to be prepared to decline any interventions that are not medically necessary. If the interventions are necessary then the benefits outweigh the risks and you can always do things later on to increase bonding and get some of the benefits of the first hour even if you have to miss it for any reason. Your health and your baby’s health need to come first.

Now, let’s talk about the first hour after your baby’s birth!

Believe it or not, newborns aren’t always beautiful just after birth. Sometimes they enter the world looking a little bluish or bruised, or with a little bit of a conehead from the passage through the birth canal. Sometimes babies are covered with vernix – a white creamy substance that is actually quite good for their skin if you rub it into their skin instead of washing it off. Sometimes babies will have small white bumps on their faces, their reproductive organs may be swollen, and girls may have a little bit of bloody discharge – all aftereffects of their mother’s hormones.

This is all normal and within just a few days (sometimes even hours), the marks of childbirth will have faded or disappeared completely.

Newborns are almost always very alert just after their birth. Their eyes are wide open and they are ready and eager to meet their parents! They can’t see well at all distances, but if they’re in your arms, they can see your face, and will focus intently on it. Eye ointment is an intervention that can interfere with bonding by making the baby’s vision blurry. You can ask them to give it later, and they are usually fine with that.

Your baby has just come from a very warm place, and will want to be immediately snuggled up in your chest, skin-to-skin. If you put your finger in the baby’s palm, baby will automatically hold and squeeze it.

Sometime during the first hour after birth, your baby will be ready for his first breastfeeding session. Don’t rush it – just snuggle and enjoy him, and let him hear your voice and study your face.

When your baby is ready to eat, he will begin to wiggle, fuss, and suck or chew on his hands. During the first hour after birth, most babies will be ready to begin nursing, and will even initiate nursing themselves if you do not! Don’t worry if he doesn’t latch on immediately. Babies usually like to smell and lick the nipple before taking it in their mouths. Give him time to get comfortable with you, and feel free to ask for help from your nurse, midwife or doula if you want or need to.

Colostrum is the first milk a mother produces – it is thick and rich and perfect for a newborn’s tiny tummy. It contains large amounts of leukocytes that defend against viruses, and antibodies that protect the baby’s vulnerable mucous membranes. It also has a laxative effect, which is protective against jaundice. Newborn babies’ stomachs only hold about 1 teaspoon and colostrum is all that your baby needs before your milk has come in.

This article explains the Nine Instinctive Stages of Development and they are summarized below:

“The first hour after birth is a developmentally distinct time for a baby, and there are… nine observable newborn stages happening in a specific order that are innate and instinctive for the baby.”

1. The Birth Cry – Very distinctive first cry.
2. Relaxation – Skin to skin with mother.
3. Awakening – About 3 minutes after birth.
4. Activity – Rooting and mouthing movements begin about 8 minutes after birth.
5. Rest – Periods of rest may happen between periods of activity throughout the first hour.
6. Crawling – Breast crawl – there are a great many excellent videos on youtube showing how the Breast crawl works!
7. Familiarization – Getting familiar with the nipple.
8. Suckling – This usually happens about an hour after birth.
9. Sleep – Babies usually fall asleep about 1½ to 2 hours after birth.

Now that we know about the 9 Instinctive Stages, what might we want to do differently in order to give time and space for our newborns to go through these stages at their own paces, rather than being pushed through them, however gently?

Being calm and relaxed about nursing and not rushing into it or feeling like you need to be in a big hurry can help a lot. Sometimes if we rush into nursing before the baby is ready yet we can cause or exacerbate latch issues and cause unneeded frustration for both mom and baby.

Just like the eye ointment, cord clamping, vaccines, and baby’s first bath can interfere with bonding if they are done too soon. Cord clamping can be delayed for at least 3-5 minutes, allowing the baby to receive most of his blood from the placenta. Vaccines can easily be delayed at least until the first pediatrician appointment or longer.

It is normal for babies to lose up to 10% of their birth weight in the first few days after birth. They should be back up to their birth weight by 2 weeks after birth.

After the baby comes out, you still have to birth the placenta! The placenta usually is birthed on its own within about half an hour. Your care provider may need to apply gentle traction with the umbilical cord to help it come out.

In the hospital Pitocin is usually given via the IV or a shot, usually in the thigh, within about ten minutes of the baby being born. Pitocin, an artificial form of Oxytocin, triggers contractions, which encourage the placenta to detach from the uterine wall. The Pitocin is also administered to help the uterus return to its normal size after your delivery. Your nurse will show you how to massage your uterus to help it return to size as well.

You can ask the doctor to skip the Pitocin if you intend to breastfeed. Afterbirth contractions are triggered by oxytocin, which is released during breastfeeding. If you choose to skip the Pitocin, your doctor will stress the importance of fundal massage.

At a homebirth the placenta is usually expelled spontaneously within 20 or 30 minutes. Breastfeeding and fundal massage are all that are necessary in most cases to prevent excessive bleeding. Most midwives carry Pitocin that can be used if needed.

In the hospital, your doctor will usually check for tears and do necessary repairs immediately after the placenta is delivered. You can always ask for them to wait a little while. As long as you are not bleeding excessively, they can wait until you’ve had a chance to enjoy your baby for a little while.

At a homebirth they usually check for tears a little later in the process unless there is excessive bleeding from a tear. They have 6 hours to suture. After 6 hours there’s really no point in suturing at all because the tissues have healed up too much by then.

During this first hour, your hormones are primed to bond and fall in love with your baby. You will experience one of the highest levels of Oxytocin that you’ll experience in your lifetime. Oxytocin is the falling in love hormone. It does not work in isolation, but is part of a “complex hormonal cocktail” that includes prolactin, which is known as the “motherhood hormone” and these hormones induce a strong love of your baby.

You can make a list of things to discuss with your care provider, to help make sure that you can take advantage of this critical time in your baby’s life. Birth plans are very helpful in doing this as well. Generally, with birth plans, it is best to choose just 5 things that are your “hills to die on” regarding your birth and 5 more things regarding the baby after the birth.

If there are complications during your labor or birth, then you need the interventions that are being done, and you can still have skin to skin bonding time after the first hour. Try not to feel badly if you miss that first hour because of a medical complication. But if there is no complication, enjoy that first hour, it will never come again!

There are even ways to make a c-section a more “natural” experience for you and your baby. In this video on youtube (which contains footage of a cesarean birth), you can see that the mother gets to hold her baby immediately after birth and they are able to do everything they need to do – stimulate the baby and even suction the baby – while the mom is holding her baby.

In this longer video, you can hear how the procedures surrounding a c-section can be altered and then watch a cesarean birth where the mom and baby are able to get a more natural experience – more like what they would experience with a vaginal birth.

For more information about implementing skin-to-skin care after a cesarean as well as the benefits of and recent studies about skin-to-skin care after a cesarean birth, please check out this article from Evidence Based Birth.

For more general information about the first hour after birth, you can check out this website as well: www.womenshealth.gov/pregnancy/childbirth-beyond/baby-first-hours.cfm

Thank you for taking the time to join us at our meeting and/or to read this recap ❤ I hope you all have a lovely week and please let us know if there are any topics you'd particularly like for us to cover in future meetings!

~Betsy Alger
CBC Co-leader and Secretary