I think midwives here would faint dead away if they had to do half the
observations on mothers and babies that are done most places in the US.
We keep an eye on maternal bleeding during third stage and the first couple
of hours after that, either by watching as we are suturing, if necessary, or
simply palpating the fundus every once in a while.  We do not count a
newborn's heart or respiratory rate unless baby seems to be in trouble.  We
do Apgars mainly by gross estimate except if a baby is limp and
non-responsive.  If a baby is crying vigorously after a minute and has good
color, who cares whether its pulse is 110 or 150?  We sure don't.  We check
infant temperature after two hours, and when they are skin to skin the temps
are always fine.  We monitor blood glucose in babies under 2500 g, by one
check after two hours, and two more at approximately 6 hour intervals if the
first one was normal, more often if the first was low.
We check a healthy mother's blood pressure before she gets up to shower, if
we can manage it.  A lot of women are in the shower before we get around to
it.  Of course we have different policies for hypertensive women.  Unless
mother has been known to have a fever, we don't check maternal temperatures
before transfer to post partum.  CS mothers do check their own temps twice a
day and are asked to report anything above normal.  
Even removing the baby from mother's chest to weigh it, has been shown to
disturb the interaction between mother and baby so that the incidence of
ineffective, painful latch is increased.  That is why we try to avoid such
separation at all costs.
As far as not bathing the baby at all, it works great if there isn't a lot
of blood on the baby.  Blood in skin folds smells pretty ripe after a day or
so, and most parents don't think it enhances the baby's appearance in photos
to have caked dried blood in their hair.  If you just rinse them in water,
they still smell newborn afterwards.  We usually do this while the mother
takes a shower, after they have been undisturbed for the first couple of
hours.
Rachel Myr
Kristiansand, Norway

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