Immediately After the Baby is Born

Your baby's first check-up happens within a minute of the birth.

Even after the baby is born, lots of things are happening. Sometimes women and their families are so focused on the idea of giving birth that they don't learn very much about what happens just after the birth.

After the baby is born, the umbilical cord is cut and the end remaining with the baby is clamped.

Your body still has to give "birth" to the placenta. In many hospitals, a woman is offered medications to speed up the contractions that expel the placenta and to reduce bleeding. The placenta is usually expelled within 20 minutes of the birth. After the placenta is gone, you will continue to experience bleeding (called lochia). See our self-care pages for more information.

Your baby's very first "mini" check-up will happen within a minute of birth. The results of this check-up are called the child's Apgar score. The Apgar score is a standard way of measuring how responsive your baby is at birth. Five aspects of your baby's health are assessed, and a score from zero to two is given for each of these. The scoring is repeated five minutes after the baby is born, with the hope that the score will stay the same or be higher.

The Apgar test measures:

• Activity and muscle tone
  No points are given if the baby is limp, one point for some movement of the arms and legs, and two points for an active baby.
• Pulse (or heart rate)
  Zero points are given for no heart beat, one point for a slow heart beat (less than 100 beats/minute), and two points for more than 100 beats/minute.
• Grimace response (or reflexes)
  Babies are generally agitated at birth. No points are given if the baby does not show signs of irritability, one point for a facial grimace, and two points if the baby cries vigorously when stimulated.
• Appearance (or colour)
  A baby that got limited oxygen may appear blue at birth. A baby that is all blue gets no Apgar points. A baby whose arms or legs are blue but whose body is pink gets one point, and a baby whose entire body is pink gets two points.
• Respiration
  Zero points are given if the baby is not breathing, one point if the breathing is slow and irregular and the cry is weak, and two points are given for a strong cry.

The highest possible Apgar score is a 10 but scores are rarely higher than nine out of 10.

The Apgar score is generally not an indicator of the infant's future health but does help the birthing team decide what kinds of care or observation your baby needs in the first days of life.

Once the umbilical cord is clamped, the baby is dried off, wrapped and given hospital identification. From there, he or she is placed under a heater to keep the body temperature at a healthy level. Within the first hour of life, vitamin K and erythromycin ointment are given to your baby. Erythromycin ointment protects the baby's eyes from infections. Vitamin K helps the baby's blood to clot. In adults, this vitamin is produced by bacteria in the intestinal tract; however, babies do not yet have the bacteria to produce vitamin K.

Before the baby leaves the hospital, he or she will have another check-up. This exam will be an extensive one, to look at the infant's entire body and abilities. By checking infant reflexes, the doctor or midwife can determine your baby’s neurological health. Your baby will also have a blood test to screen for possible problems with:

• blood sugar
• thyroid
• bilirubin levels
• Rh+ factor

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