Articles (EN)

The first hours after childbirth: what happens

2026-05-27 12:00 Childbirth
In short: the first two hours after childbirth are the "golden hour" for mom and baby. At this time, the placenta is born, obstetricians assess the condition of both, skin-to-skin contact and the first attachment to the breast begins. Staying in close contact with your baby is a powerful start for lactation and attachment.

Birth of the placenta: the third stage of labor

After the birth of the child, the third stage of labor begins - the birth of the placenta (afterbirth). This usually happens within 5-30 minutes. The midwife will ask you to push a little or press lightly on the uterus to help the placenta separate.
Active management of the third period (administration of oxytocin intravenously or intramuscularly immediately after the birth of the child) reduces the risk of postpartum hemorrhage by 2 times. WHO recommends it to all women in the absence of contraindications.

Apgar assessment of a newborn

In the first and fifth minutes of life, the neonatologist assesses the baby's condition according to the Apgar scale (5 signs, each 0-2 points): heartbeat, breathing, muscle tone, reflexes, skin color.
A score of 7-10 points is normal. 4–6 — moderate depression, requires observation. Below 4 - resuscitation is needed. Most children get 8-9 points - bluish hands and feet in the first minute are considered normal.

Skin-to-skin contact

Immediately after birth (in the absence of indications for resuscitation), a healthy baby is placed on the mother's stomach. This skin-to-skin contact triggers a chain of physiological reactions:
  • The mother's body warms the baby more accurately than any incubator.
  • Mother's skin bacteria "populate" the baby's skin, forming a microbiome.
  • The levels of oxytocin and prolactin in the mother rise sharply - this triggers lactation.
  • The baby calms down: stress cortisol decreases.

Cutting the umbilical cord

Today, delayed cord crossing is recommended - 1-3 minutes after birth or after its pulsation stops. During this time, the baby receives 80-100 ml of extra blood from the placenta, which is rich in iron and stem cells.
WHO recommends delayed cord crossing for all term and most premature newborns. If you want to cut the umbilical cord yourself (or your partner will do it), indicate this in the birth plan.

First attachment to the breast

In the first hour of life, most healthy newborns actively seek out the breast – this is the "window of neuronal imprinting". The first application during this period stimulates the production of colostrum and strengthens the bond between mother and baby.
Don't worry if your baby doesn't latch on right away: some babies just lie on their chest at first and inhale a familiar smell. This is also valuable. Read more in the article breastfeeding in the first days.

Examination of the mother after childbirth

While you are holding the baby, the midwife:
  • examines the perineum and, if necessary, sutures;
  • controls the tone of the uterus (the uterus should be dense, "like a ball");
  • measures blood pressure and pulse;
  • estimates the amount of blood loss.
You will spend the first 2 hours in the delivery room under observation – this is the "postpartum observation period". Most postpartum hemorrhages occur at this time, so monitoring is necessary.

What Mom Feels

After childbirth, many women feel a powerful surge of emotions: from euphoria and love to confusion and even indifference – this is normal. Hormonal storm, fatigue and shock from the experience make the emotional spectrum very wide. If the feelings are "wrong" – do not blame yourself: the bond with the child is formed gradually.
Shivering, chills, and sweating after childbirth are normal reactions: the body loses heat and restores water balance. Ask for an extra blanket.

When to see a doctor

Inform the midwife immediately if in the first hours after childbirth:
  • bleeding is profuse (it soaks the pad in less than an hour);
  • severe headache, visual impairment, pain under the ribs;
  • high fever (above 38 °C);
  • You feel that you are losing consciousness or very weak.

Frequently Asked Questions

Is it possible to refuse the administration of oxytocin after childbirth?

Technically, yes, this is your right. But the risk of postpartum hemorrhage without active management of the third period is much higher. Discuss this with your doctor beforehand and weigh the risks.

When will the baby be weighed and measured?

Routine procedures (weighing, measuring, eye drops) are carried out after the first hour of skin contact so as not to interrupt it. In most maternity hospitals, this is already the standard.

Is it possible for a partner to be close at this time?

Yes. Your partner can be present at the birth of the placenta, cut the umbilical cord, hug you during the examination of the sutures and take the first minutes with the baby - if allowed by the policy of the maternity hospital.

Conclusion

The first two hours after childbirth are not just a medical procedure, but the most important period for mom and baby. Contact, warmth, the first attachment – all this lays the foundation for lactation and attachment. Let your wishes know to the team in advance, and the first minutes with your child will be exactly as you want them to be remembered.

Bibliography

  1. WHO. WHO recommendations: intrapartum care for a positive childbirth experience. 2018. https://www.who.int/publications/i/item/9789241550215
  2. AAP. Management of Neonates Born at 34–36 Weeks' Gestation. Pediatrics. 2022.
  3. Mercer JS et al. Delayed cord clamping in very preterm infants. J Perinatol. 2010.
  4. NICE guideline CG190. Intrapartum care. 2014. https://www.who.int/publications/i/item/9789241550215
  5. Ministry of Health of the Russian Federation. Clinical recommendations: Normal delivery. 2021. https://cr.minzdrav.gov.ru/
This material is for informational purposes only and does not constitute medical advice and is not a substitute for medical advice. If a child's sleep is accompanied by alarming symptoms, a pronounced deterioration in health, problems with breathing, feeding or weight gain, it is necessary to consult a qualified medical specialist as soon as possible, and not rely only on information from the Internet.