We wait and ponder for many months about the birth of our babies. We dream about the moment when our eyes first meet – when we can first wrap them in our arms, count their fingers and toes, and look on their sweet face. For so many of us, it isn’t a thought that the first glimpses we get of our new baby will be so brief that it will leave us pining for more and our arms aching as we wait for our baby’s return. It has been the result of many hospitals’ policies for decades now that mothers and babies are separated during those first critical moments after birth. Those moments are critical because during the first few hours after birth the hormones (oxytocin and prolactin) that initiate bonding and breastfeeding are the highest in both mother and baby, making those hours the optimal time for mother and baby to get to know one another and to get breastfeeding off to a positive start. But, instead of being placed in mother’s arms, babies are being whisked away to a warming tray, measured, weighed, given eye ointment and shots, and some of them are given a bath before spending any time in the arms of their mother. Then, babies are taken to the nursery where they are placed in a bassinet in the window to be alone for the most part. The artificial lights, the absence of their mother’s smell and voice, and the many loud sounds of other babies and equipment has to be unsettling. In many hospitals this mode of care is changing as research is showing that the best and safest place for the newborn is in his/her mother’s arms.
An essential part of every birth plan (written preferences for birth, postpartum, and newborn care) is the portion where you record your preferences for your baby’s care beginning immediately after birth. This portion of your birth plan should be discussed with your care provider, nursing staff, and your baby’s pediatrician before the birthday (in the case of the hospital staff, a copy of the birth plan can be given to them upon your arrival at the hospital). Choices to consider and include for this important time are:
- Would you like to hold baby skin to skin (kangaroo care) immediately after birth? Studies show that this is more effective at stabilizing baby’s temperature than the artificial lights of the warming tray.
- How soon would you prefer the umbilical cord to be clamped and cut? If baby is doing well and needs no special attention, there is no need to immediately clamp and cut the umbilical cord, and there may be advantages to waiting.
- Would you like to breastfeed as soon as baby shows signs of readiness? Do you want to assist the baby in latching on, or would you like to try baby-led latch?
- What newborn procedures will your baby receive and when will they receive them? As a parent, most of the typical newborn procedures are your individual choice and can be accepted or declined as you see fit. As with any medical procedure, research, discuss with your care providers, and make the decision that is best for your baby and your family. Typical procedures include: vitamin K injection, Hep. B vaccination, eye ointment, weighing, measurements, bath, PKU testing, and a hearing exam – circumcision for boys. Most of these procedures can be delayed safely until mother and baby have spent a significant amount of time together, or they can be performed while the newborn is in the mother’s arms.
- Do you want to make it clear that your baby is not to receive artificial nipples during your hospital stay? This includes pacifiers and bottles. Nipple shields for breastfeeding need to be discussed with a lactation consultant or WIC peer counselor before use. Baby’s who are learning to breastfeed can become confused by artificial nipples, and also not feed well because of becoming full from formula bottles. This can adversely affect mother’s milk supply and hinder breastfeeding. You can obtain a free card stating your wishes for no artificial nipples or formula from the local health department, your pediatrician, or you can make your own. This card is to be placed in the baby’s hospital bassinet.
- If baby is placed in NICU, or transported to another facility for an emergency situation, can you be transported as well, or receive a room close to your baby’s?
- If your baby is doing well and everything is normal, ask about allowing your baby to room in with you. Studies show that mothers and babies both sleep better and babies cry less the more that they can be together. If you have given birth via cesarean, make sure you have someone to help you with the baby so that you can easily room in, or don’t be shy about calling in your postpartum nurse to help you. They are there for that purpose.
Mother’s Advocate (the website created by InJoy Videos and Lamaze International) has a downloadable PDF file that you can use to create your birth plan. The above video is also one of many from their website. I invite you to take a look at Mother’s Advocate and view all six of the videos and PDF files before creating your birth plan. Once you have your preferences in place, you will want to discuss all of them with your care provider before the birthday. Having a birth plan can be a great way to help you become more satisfied with your birth experience and to feel more comfortable in the process. Including newborn care, will help you protect your first moments as a mother to a newborn and make those moments as glorious as possible.
Many happy days to you and yours,