Preparing For Labour

Preparing for those first few hours after labour…What’s happening to your Newborn?

There are a number of things I would suggest you make sure you are aware of before going into labour. Most of these areas are covered in your antenatal classes, but for those of you that perhaps don’t plan on going to these classes or simply have forgotten (trust me…”pregnancy brain” is definitely not a myth), here are some reminders…

 

APGAR Score:

One of the areas I find very interesting yet was only told after the actual birth was the measurement system known as the APGAR Score that the doctor or midwife performs immediately after your little one has entered the world…

How this works:

  • Used to access breathing, muscle tone, heart rate, colour and activity.
  • It is performed at 1 minute, five minutes and ten minutes after birth.
  • Each category is scored between 0-2, with a total of 10 possible points.
  • A score of between 7 and 10 means that your baby is in satisfactory condition.
  • If the score is lower than 7 your baby shall be placed on a resuscitation trolley where oxygen can be given and mucus is cleared from the air passages by means of suction – normally only a few minutes needed to do this.

Don’t panic if your little one does have to be moved in this instance – remember he is in the best care possible. I know the feeling as I experienced this and you do panic at first.
While the APGAR score is done, the Dr or midwife will also weigh and measure the length and head circumference for future development. The average weight of a full term baby is between 3 – 3.5kg’s with average length of between 48 and 53cm’s. Remember this is a mere average and all babies are different.

 

Appearance of your newborn:

No! Babies are not born perfectly pristine and clean looking as they so often appear in the movies. So don’t be alarmed when your little one has any of the following…

  • Is covered in blood
  • Is covered in a whitish, waxy substance – called vernix which protects your baby from the water in the uterus
  • Has wrinkled skin
  • Had a bit of a bluish colour – this changes to a more pinkie colour
  • Has a marked or strange shaped head – this is common when you have had a natural birth as the pressure from the labour and the passage through the birth canal can cause this. DON’T WORRY the shape does regain its normal shape within two to three days.
  • Has a dry and scaly skin
  • Has a thin film of hair over the entire body – this is called lanugo and aids in protecting the baby’s skin in the womb. This also goes
  • Your baby has bluish marks – looks like bruises on the buttocks or lower back. These are Mongolian spots and disappear within a year or two.
  • Has swollen genitals or breasts. This is caused by maternal hormones
  • Passes very dark / black sticky stools in the first few days – called meconium

 

Paediatric Examination prior to hospital discharge…

Before you leave the hospital make sure that the Paediatrician on duty (or your own if specified) has done their routine check (this is normally standard and most hospitals will not discharge your baby if the check has not been completed).

The Paediatrician does a full medical examination to ensure that there are no foreseen problems i.e. Lungs, heart, spine, hips – to ensure they are not dislocated, eyes, abdomen, ears, genitals and reflexes.
Vitamin K – may also be given to your newborn – either by injection or orally. This is advised as newborn babies are deficient in vitamin K and by administering this vitamin it helps prevent a rare form of brain hemorrhage which affects a small number of babies.

 

Fontanelles / “soft spots”

There are two fontanelles or “soft spots” located on the top of your baby’s head. This is where the bones of the skull have not yet fused together. The one – located towards the back of the head is smaller and usually closes around 6 to 8 weeks. The second – slightly larger, is located towards the front of the head and takes approximately 12 to 18 months to close.

This does not mean that you cannot wash your baby’s head – it simply means be gentler and be careful not to knock it. A sunken fontanel can often mean that your baby is dehydrated – consult your Dr in this case – or if the fontanelle is bulging and more tender than usual.

 

Umbilical Cord:

The umbilical cord that is attached to the placenta is clamped and cut soon after birth – totally painless and helps prevent bleeding. This normally shrivels up and falls off within 6 to 10 days. Do not pull it. Rather let it fall off by itself. You will need to keep it clean with just warm water when you bath baby. I would also recommend you use Weleda’s Wecesin Powder rather than surgical spirits or spirit alcohol (sometimes too harsh for the baby’s skin) – it is simple to use and works really well. Simply apply the powder to the cord each time you change the nappy.

 

Jaundice:

Some babies develop a yellow discolouration of the skin a few days after birth. This is often due to the build-up of bilirubin – a yellow pigment produced in processing red blood cells. It is normally removed by the liver but in some cases the newborn baby’s liver is not able to perform the task efficiently. It often takes up to a week to clear – slightly longer if mom is breastfeeding. Some babies develop more severe cases where they need to be treated by phototherapy which involves the use of special lights.

 

Lynne Newman, The Parenting Netwrok SA, http://babeeze.co.za., 2021

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