What is the primary rationale for monitoring a new mother every 15 minutes for the first hour after delivery?

The moment your baby is born can be very special, but there’s usually a lot going on too. What happens straight after birth will depend on your labour, how your baby is born, and how quickly your baby adapts to life outside the womb.

Uncomplicated vaginal birth
Most babies breathe and cry within a few seconds of being born.

If your baby is breathing well, baby can be placed naked, skin to skin, on your chest or belly straight after birth. Skin-to-skin contact keeps your baby warm, helps to steady your baby’s breathing and heart rate, and lets you and baby bond physically straight away. It’s also a trigger for breastfeeding.

The midwife will dry your baby while your baby is on you, and cover you both with a warm blanket or towels.

If you prefer, your baby can be dried, wrapped in warm towels or blankets for you to hold.

Forceps or vacuum birth
Most babies born with the help of forceps or a vacuum will breathe and cry at birth. But some babies might be a little stunned or slow to breathe, especially if they’re distressed during labour. If this happens, the midwife, obstetrician or paediatrician will take your baby to a special warming station. They’ll dry your baby and check baby’s breathing.

You can hold your baby once baby is breathing properly. You can ask for skin-to-skin contact. Or your baby can be dried, wrapped in warm towels or blankets for you to hold.

Elective caesarean section
Most babies born via elective caesarean section breathe and cry vigorously at birth.

If baby is breathing well, you might be able to have skin-to-skin contact before baby goes to a special warming station to be dried and checked. Sometimes baby’s breathing will be checked before baby is handed back for you to hold. You can ask to hold your baby skin to skin, or baby can be wrapped in warm blankets or towels for you to hold while on the operating table.

Sometimes you might need further medical attention, so that first cuddle might have to wait. Your birth partner can stay with your baby and give baby lots of cuddles and skin-to-skin contact until you get back to recovery or the maternity ward.

Unplanned (emergency) caesarean section
Babies born via unplanned caesarean section are more likely to need help to breathe at birth. The midwife or paediatrician will take your baby to a special warming station for drying. They’ll also check what type of help your baby needs.

When your baby is breathing well and your health is stable, you can hold your baby. Even if you’re still on the operating table, it’s OK to ask for skin-to-skin contact or cuddles.

If you’ve had a general anaesthetic, you’ll be able to hold your baby after you’ve recovered.

If your baby needs a lot of help to breathe at birth, your baby might need to go straight to the neonatal intensive care unit (NICU). Your first cuddle might have to wait until your baby is well.

Cutting the cord

After the birth of your baby, the umbilical cord needs to be clamped and cut. This can happen straight after birth, or you might be able to cuddle your baby for a minute or two before the cord is cut.

Your birth partner can usually cut the umbilical cord if that’s what you and your partner want. They won’t be able to cut the umbilical cord if your baby is born by caesarean section or needs to be taken quickly to the warming station after birth, or if you have complications like heavy bleeding. In this situation, the midwife or obstetrician will clamp and cut the cord.

The cord is quite tough to cut, but cutting it isn’t painful for you or your baby.

You can bond with your newborn baby as soon as your baby arrives. Early skin-to-skin contact is a great way to do this, whether it’s cuddling your baby on your chest or encouraging baby to breastfeed.

How your baby will look and behave after birth

It’s normal for your baby to look blue or purple in the initial few minutes after birth. If your baby is breathing well, your baby’s skin colour will gradually become pink within 7-10 minutes after birth. Your baby’s hands and feet might stay blue for up to 24 hours. This is because the blood vessels in your baby’s hands and feet are very small, and it takes time for blood to circulate properly there and turn them pink.

If all is well, most babies cry immediately after birth. Most then quietly gaze with large open eyes at their surroundings before falling asleep. But some might stay awake and want to feed.

If your baby seems ready, you can try breastfeeding within a few minutes of birth. The midwife will help you attach baby to your breast.

One of the keys to making breastfeeding work for you and baby is getting a good attachment at your breast. You can see how in our baby-led attachment video and our illustrated guide to breastfeeding. You can also read more about breastfeeding attachment techniques.

The Apgar score

The Apgar score is a rating of your baby’s heart rate, breathing, muscle tone, response to stimuli and skin colour. A score of 0, 1 or 2 is given for each of these five criteria, and the total is the Apgar score.

Your baby’s Apgar score measures how well your baby has made the transition from life inside the womb to life outside. Apgar scores are recorded in your baby’s child health and development book.

When your baby needs medical help after birth

If your baby isn’t breathing properly after birth and needs help to breathe, has a low heart rate (below 100 beats per minute) or is floppy, baby will be moved to the warming station. Staff will decide what sort of extra medical help your baby needs.

The doctor or midwife might clear your baby’s airways and help your baby to breathe by giving normal air through a special baby mask and breathing device. The breathing device and face mask might stay on until your baby can breathe independently.

If your baby’s breathing, heart rate and floppiness don’t improve, your baby might need oxygen through a mask or breathing tube.

If your baby needed help to breathe at birth, your baby will be taken to the special care nursery (SCN) or NICU for further assessment and close monitoring.

Most babies start breathing quickly in response to simple actions like drying and stimulation. Very few babies need help to start breathing. And fewer than 3 in 1000 babies need more active resuscitation like chest compressions (CPR) and drugs.

Checks and medications in the first 24 hours

Within the first hour of birth, the midwife will put two name tags on your baby.

Your baby will also be weighed at some time in the first few hours. When weighing your baby, the midwife will do a quick physical check.

The midwife will record when your baby first poos and wees. This is usually within the first 24 hours.

You’ll be asked to give your permission for your baby to have one or two injections. These injections are given into the thigh muscles after birth, either immediately or within a few hours. The injections are:

• vitamin K – this can help prevent a bleeding disorder caused by a vitamin K deficiency (haemorrhagic disease of the newborn)
• hepatitis B immunisation – this is the only immunisation required at birth, and is given as part of Australia’s universal immunisation program.

You can discuss these procedures with your midwife, GP or obstetrician at one of your appointments towards the end of your pregnancy.

Within the first 48-72 hours of your baby’s life, you’ll be asked to give your consent for newborn screening, which tests your baby for signs of rare conditions. In the early days, your baby will also be checked for developmental dysplasia of the hip (DDH) and screened for deafness and hearing impairment.

What is the primary rationale for monitoring a new mother every 15 minutes?

What should be monitored after delivery?

When assessing a new mother within how many hours after delivery would you expect to the uterus rise to the umbilicus?

How often do you monitor the mother and baby during the first 1/2 hours?