You’ve spent your pregnancy planning for the delivery. You learned about the signs and stages of labor so you’ll be ready when the time comes. You’ve learned how to cope with labor pain. And of course you’ve looked ahead to bringing the baby home, preparing your home, learning how to care for baby, etc. But what about the time between your baby’s delivery and the time you leave the hospital with him or her? Read on to learn everything you need to know about the hospital stay after birth.
Estimated reading time: 14 minutes
Table of contents
- Immediately Following Delivery
- Hospital Stay After Birth: The First Hours
- Hospital Stay After Birth: The First Day
- During Your Post-Birth Hospital Stay
- Hospital Stay After Birth: C-section
- Hospital Stay After Birth: Discharge
Immediately Following Delivery
Let’s talk about those first moments after your baby is born. Laying eyes on your little one is an incredible moment, yet the delivery room is still bustling with activity at this point.
What Happens with Mom?
Meeting Your New Love
As long as your delivery was uncomplicated and baby isn’t in distress, your caregiver will immediately place her on your chest so that you can finally gaze upon this little person you waited so long to meet. Unless there is a health concern with you or baby, you should have time to hold her skin-to-skin to begin the bonding process.
The World Health Organization and United Nations Children’s Fund recommend that “all healthy mothers and babies, regardless of feeding preference and method of birth, have uninterrupted skin-to-skin care beginning immediately after birth for at least an hour, and until after the first feeding, for breastfeeding women,” and this is echoed by the American Academy of Pediatrics (2).
Cutting the Umbilical Cord
When your baby starts breathing on her own, the umbilical cord is no longer necessary. Your caregiver, or sometimes your partner, will cut it within a few minutes after birth. It used to be common to cut the cord almost immediately, but many doctors now wait longer as more is known about the benefits of delayed cord clamping.
ACOG now recommends waiting at least 30 – 60 seconds after birth before clamping the umbilical cord (1). Talk to your doctor in advance about your cord-cutting preferences. If you want delayed clamping, be sure to write it into your birth plan. If you are banking baby’s cord blood, it is collected at this time as well.
Delivery of the Placenta
A few minutes (or up to about 20 minutes) after your baby is born, the placenta is delivered. Contractions are closer together and less intense than labor contractions. (And chances are you’ll barely notice them as you fawn over your new little one.) These mild contractions help the placenta separate from the wall of the uterus, help your uterus shrink back down, and help slow your bleeding. Delivering the placenta is not typically painful. The placenta itself is much smaller than your baby, and the organ is a blob-like mass without any bones or firm structures.
If nothing else requires separating mom and baby, you may begin breastfeeding immediately. Baby is awake and alert in the first hour — a time often described as the “golden hour” — and it’s a great opportunity for skin-to-skin contact as baby latches and begins breastfeeding.
Early breastfeeding not only helps to jumpstart the breastfeeding relationship, but it also stimulates mom’s uterus to contract, which can help quell any postpartum bleeding.
If baby doesn’t latch right away, don’t worry. There will be plenty of time in the hospital stay after birth to establish breastfeeding, as well as access to the help of a professional lactation consultant. Lactation consultants often do at least one visit to each mom in the postpartum stay, so be sure to request a visit if one does not happen automatically.
Massage of Uterus and/or Pitocin
Your uterus begins to shrink immediately after baby is born, and it doing so quickly and effectively helps stop bleeding. After delivering the placenta, your doctor or nurses will provide firm massage to your abdomen to stimulate the uterus to contract. Most moms are also given pitocin to encourage contractions, either as an injection or in your IV or IV hep-lock.
Stitches if Necessary
Your doctor will inspect your perineum. If you have a tear large enough to require repair, or if you had an episiotomy, you may need a few stitches to help you heal. A local anesthetic will prevent the stitching from being painful.
After you’ve delivered the placenta and received any necessary stitches, the area will be cleaned with warm water. Then you’ll receive a pair of stretchy, one-size-fits all hospital briefs with a sanitary pad and a clean gown. You may want to go to the bathroom during this time. A nurse will likely accompany you the first time you go to ensure that you’re able to pee and that you’re not dizzy or faint. But trust me, at this point you’ll be over caring who sees you going to the bathroom. 😉
What Happens with Baby?
Drying and Warming
Since baby is born wet and also isn’t used to maintaining her own body temperature, she’s at a higher risk for temperature fluctuations. Nurses will begin to dry baby right away, as she is still lying on your chest. Then they will cover her with a warm blanket and place a cap on her head.
Assessing Health with Apgar
One minute after your baby’s birth, and again at five minutes after her birth, your baby’s health will be assessed. Caregivers use a scoring system called the Apgar test. This test assigns points in five different categories:
- Activity/muscle tone
- Pulse rate
- Grimace/reflex irritability
- Appearance/skin color
Baby will undergo a brief physical exam just to be sure there aren’t any obvious signs of problems. And if she seems to have any congestion in her airway, The doctor or nurse may suction her nose and throat. (The doctor usually does this after the head emerges, before the shoulders and body are delivered, but some babies need suctioning multiple times after birth.)
Hospital Stay After Birth: The First Hours
Change of Scenery
After you’ve delivered your baby and you’ve been monitored for a short time to be sure there aren’t any complications, you’ll move from the delivery room to the room where you’ll spend the rest of your post-delivery hospital stay. In some hospitals (and always if you’ve had a cesarean birth), there is a recovery room and then a move to your regular room. But most hospitals will transfer from the delivery room directly to a new postpartum room.
You will continue to experience contractions. (Sometimes called afterpains.) These contractions don’t occur at regular intervals and aren’t nearly as intense as they were when you were in labor, but they may be uncomfortable. Use your slow breathing techniques to get through them, and ask for a pain reliever like ibuprofen if you need it.
If your baby didn’t breastfeed immediately, she will be ready to do so in the first hour or two. If you’ve had any medication, baby may possible be a little less alert at first than the highly alert golden-hour baby that you read abou. But nevertheless, you should be able to establish breastfeeding in the first few hours after birth.
Eat and Drink
You may be ravenous after all of your hard work. And whether or not you feel thirsty, you could likely use some fluids. (Even if you received IV fluid during labor, you’ll still need to make sure you’re hydrated going forward, especially if you plan to breastfeed.) Ask your nurses if the hospital does meals on-demand (some do them like room service, and you can order whenever you want.) If not, have them bring you whatever snacks are available or munch on whatever snacks you packed in your hospital bag.
Some additional procedures will be done either immediately following the Apgar and health assessment, or within the first couple of hours. It depends on the hospital, but in many cases, mom and baby will be allowed to spend some time together first, as long as both are healthy.
- Weight, length, and head circumference are measured
- Check temperature, respiratory rate, and heart rate
- Eye ointment to prevent infection that could be caused by bacteria in the birth canal
- Vitamin K shot which aids in blood clotting
- Footprints taken
- ID bracelets (most hospitals put one on the wrist and one on the ankle) to identify baby
Hospital Stay After Birth: The First Day
Vaginal bleeding will be heavy and bright red at first. (The flow will get lighter in amount and color over time and will stop in a few weeks.) You will be given maternity sanitary pads, which are large, heavy-flow pads. If you pass clots that are larger than a 50-cent piece, tell your doctor.
You will continue to experience cramps, or afterpains. The amount will increase when you’re breastfeeding, because breastfeeding causes an increase in hormones that help the uterus shrink back down to its normal size.
If your perineum tore or required an episiotomy during delivery, you will have some pain as it heals. The nurses will teach you how to care for your wound. You will likely be given a squeeze bottle that you can fill with warm water to gently rinse the perineum after urinating. You can also ask for ice packs to put on the perineum, for an inflatable “donut” pillow to sit on to take the pressure off of the area, or for pain reliever.
Unfortunately, going to the bathroom will likely be painful for a while. Some women find that using the squeeze bottle to rinse the area while urinating hurts less, because it dilutes urine, which is acidic. You can also ask your doctor about using a stool softener for a while so that you don’t strain while passing stool.
Your perineum may be swollen and painful even if you didn’t experience tearing or an episiotomy. It still went through tremendous stress and pressure and stretching. You still may find that an ice pack helps with the pain, and you can also ask for pain reliever if you need it.
In the past, babies often spent much of their hospital stay in the nursery. Today, most hospitals not only allow but encourage rooming in, which means baby staying in mom’s room. A bassinet will be brought to your room, and baby can stay with you as much as you desire. Don’t feel guilty if you need to get some uninterrupted rest, though. (Your body has been through so much!) It’s okay to ask the nurses to take baby to the nursery for a bit.
In the first 24 hours, baby will get a full exam by a pediatrician. If your baby is rooming in with you, most hospitals and doctors allow this to be done right in your room. For as long as baby remains in the hospital, she will be examined by a pediatrician each day.
During Your Post-Birth Hospital Stay
Doctors and Nurses
A doctor will do rounds at the hospital each day, and will check up on you. Feel free to ask questions during that time as well. Otherwise, nurses will be in and out of your room, getting you anything you need, making sure you’re eating and drinking, and helping you with anything you need. They will also check your vital signs, feel your abdomen to be sure that it is shrinking back properly, and check your incision if you had a c-section.
There are some forms that you’ll need to fill out during the hospital stay after your baby’s birth, but don’t worry. The hospital will give them to you, and they have helped many new parents fill them out. You’ll need to fill out information for your baby’s birth certificate and Social Security card.
Ask the Experts
You will have the opportunity to learn from the nurses while you’re at the hospital. If you haven’t had a lot of practice caring for a newborn, have them show you anything you need to know. They’ll teach you how to care for baby’s umbilical cord, how to care for the wound if your baby was circumcised, and you’ll usually find them happy to help with anything else you need.
Also, ask for help with establishing breastfeeding if you need it. Typically, nurses will help you get started if this is your first breastfed baby, and those nurses are experienced and a great source of knowledge. However, you may need more help, and most hospitals have a lactation consultant available if you ask. (If not, reach out to La Leche League to make contact with a local consultant.)
Baby will see a pediatrician each day until discharge, just to be sure that she is still looking healthy and that there are no concerns.
Sometime during the post-birth hospital stay, baby will have some tests done. What tests are included may vary based on where you live — all states have required newborn screening tests, and there’s a little variance in what’s included. All babies should have a hearing screening, a heart screening to check for congenital heart defects, and a blood test to look for health conditions that are rare but could be serious so they want to detect them early. (The variation in states’ screenings comes in on the third category; some states screen for more or different conditions than others.)
The hearing and heart screenings are simple and painless, and the blood test just requires a heel prick to get a little bit of blood.
Hospital Stay After Birth: C-section
Right After Delivery
Your baby will be suctioned and have Apgar tests done, just like a baby delivered vaginally. She will not be delivered and placed immediately on your chest like she would if delivered vaginally, but as long as she’s doing well, the nurses will swaddle her and either put her on your chest or hand her to your partner (who will be seated by your head) so that your partner may hold her near your head while your procedure is finished.
Doctors want to see certain things before you’re able to be discharged from your post-birth hospital stay. You’ll need to be able to walk on your own. You’ll need to be eating and drinking without vomiting. You will have to have urinated with a catheter and passed gas so that they know function has fully returned after your c-section.
A Little Extra Care
For the most part, baby will be cared for in the same way as described above. However, babies delivered by c-section sometimes have a little more fluid that they need help clearing. (This is because they don’t get the same squeeze as a baby moving through the birth canal. And this squeeze pushes the fluid out of the lungs in a vaginal delivery.) They may need some extra suctioning of the mouth, nose, throat, and sometimes even deeper into the windpipe.
Most hospitals require a little bit of observation time in the nursery for babies who were born by c-section. Since you will have just had surgery, you’ll need to be moved from the operating room to recovery room anyway. As long as both of you are doing well, it won’t be long at all before the two of you will be reunited in your new room where you can bond skin-to-skin and also start breastfeeding if you’d like.
Hospital Stay After Birth: Discharge
In most cases, you’ll be able to go home around 48 hours after baby’s birth. (Maybe another day or two if you had a c-section.) If you and baby look healthy and there are no complications, and you’ve filled out the paperwork and such, it’s time to go home! A nurse will probably take you to the car in a wheelchair (just hospital policy most places), and most hospitals require a car seat safety check (to be sure you’ve installed it correctly), and then you’ll be on your way to start your new life with your new love! Congratulations again!
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- Delayed Umbilical Cord Clamping After Birth. ACOG. (n.d.). https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2020/12/delayed-umbilical-cord-clamping-after-birth.
- Crenshaw J. T. (2014). Healthy Birth Practice #6: Keep Mother and Baby Together- It’s Best for Mother, Baby, and Breastfeeding. The Journal of perinatal education, 23(4), 211–217. https://doi.org/10.1891/1058-1243.23.4.211