Baby's Care in the Delivery Room

The birth of a baby is one of life's most wondrous moments. Few experiences can compare with this event. Newborn babies have amazing abilities. But they depend on others for all of their needs—food, warmth, and comfort.

Great physical changes occur with birth. When your baby is delivered, the umbilical cord is cut and clamped near the navel. This ends the baby's dependence on the placenta for oxygen and nutrition. As your baby takes their first breath, air moves into the lungs. Before birth, the lungs don't take in oxygen or release carbon dioxide. As the baby takes in air, their heart and blood vessels also change.

Some babies have extra fluid in their lungs. Stimulating the baby to breathe by drying and gently rubbing the skin can help the lungs reabsorb the fluid. Any mucus is suctioned from the baby's nose, mouth, and throat.

Providing warmth for the newborn

A newborn baby is wet from the amniotic fluid, and blood and can easily become cold. Drying the baby and using warm blankets and heat lamps can help prevent heat loss. Often, a knitted hat is placed on the baby's head. Placing your baby skin-to-skin on your chest is the ideal way to keep the baby warm, if possible.

Immediate care for the newborn

The newborn is checked right away. A brief physical exam is done. One of the first checks is called Apgar scoring. Apgar scoring is a quick way to evaluate the condition of the newborn at 1 and 5 minutes after birth. The baby's muscle tone, heart rate, reflexes, color, and breathing are checked. Each of the five parts is given a score of 0, 1, or 2. A baby's Apgar score can be between 0 and 10. The total score means:

• 7 to 10 - The baby doesn't need much extra support.

• 4 to 6 - The baby needs some extra support and careful monitoring.

• 3 or below - The baby needs immediate life-saving support.

Physical exam of the newborn

A brief physical exam is done to check for obvious signs that the baby is healthy. Other procedures will be done over the next few minutes and hours. These may be done in the delivery room, in your room, or in the nursery, depending on the condition of the baby and several other factors. Some of these procedures include:

• Temperature, heart rate, respiratory rate, and oxygen saturation.

• Measurements of weight, length, and head circumference. These measurements help determine if the baby's weight and measurements are normal for the number of weeks of gestation. Small or underweight babies, as well as very large babies, may need special attention and care.

Other routine procedures

• Cord care. The baby's umbilical cord stump will have a clamp to prevent bleeding. It needs to be kept clean and dry.

• Bath. Once a baby's temperature has stabilized, the first bath can be given.

• Vitamin K. Vitamin K is given as an injection to prevent severe bleeding in the newborn.

• Eye care. Antibiotic ointment is placed in the eyes to prevent infections that might cause blindness.

Before a baby leaves the delivery area, identification bracelets with identical numbers are placed on you and your baby, as well as your partner or another support person. Babies often have two, one on the wrist and one on the ankle. These should be checked each time the baby comes or goes from your room. Many hospitals also attach a small security device to the baby's ankle or umbilical cord clamp.