Christine asks about examples of what others do regarding "routines" in the immediate postpartum period.

In New Zealand (where every women is attended by a midwife, even if a doctor is there as well) it is normal practice for the baby to go straight to mum's chest where the baby is dried off and left to rest with warm towells surrounding the baby and a warm hat on. This may need a bit of mental preparation for the parents to witness the transition time the baby takes to breathe and pink up. This may change if the baby needs some sort of resus or the mother wants the baby dried off first (not very common). If this is so, I usually do this at the foot of the bed and then pass the baby to mum.  The placenta is usually birthed while the baby is on mum's chest.  There is no hurry.

About 40% of women will have a physiological 3rd stage and the cord is still attached so the baby isn't going far anyway!  Weighing and Vit K will be done within the next hour or two once the baby has had that first good long feed.  Bathing is never done on the labour ward - always the next day on the postnatal ward.

Parents bring their own baby clothes which are pre-warmed.

In the case of a difficult birth with perhaps forceps or ventouse, the baby may be taken straight to a warmer for assessment and warming until recovery is achieved.  Vit K will be given straight away.  But within moments the baby goes straight back to mum for skin to skin. This may be done by Dad or someone else if the mother is not well. We try and avoid weighing and measuring until the baby is stable.

The midwife cannot leave the room for the first hour anyway, ensuring mother and baby are both stable.  So paperwork and documentation have to wait.

The mum usually leaves the delivery unit about 2 hours after the birth for her postnatal area.  Mother and baby are never separated unless the baby requires admission to NICU.

In the event of a c/s, the baby is dried, checked, weighed and given Vit K, alongside the mother and held by dad (sitting beside Mum) until the mother leaves theatre. We are experimenting with skin to skin in theatre with mixed success, but will keep trying!! The baby is then tucked up in bed with mum in the recovery room  for the next hour or two (hopefully feeding) until transfer to the ward.  Once again the baby is never away from the mother.

There are no central nurseries.

Our B/f initiation rates are 95%.  I would like to say they stay like that until 6 months of age, but that is another story!


Karen Palmer
midwife and IBCLC
New Zealand


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