After the intensity and inward focus of the latter part of labor, a mother’s psychological awareness literally opens up on a new existence, for herself and her baby, in the first hours and minutes after birth. It’s not unusual for a mother to feel a new kind of alertness, although it’s limited in scope. Some moms will describe a kind of “halo” of awareness that surrounds herself and her baby, but beyond which her surroundings are literally blurred and insignificant. Within that halo, fascinating and important things are happening.
First, and under most circumstances, both she and her baby are especially alert and sensitive to each other. At that time, most babies are quiet and looking around. While some moms quietly cry (in wonder and relief), most are like their babies … quiet and simply pondering what has happened. This is a time of re-acquaintance and of adding a new dimension to a bond that has grown with pregnancy and gestation.
To the extent that it’s possible, this is a time for moms to hold their babies so that the two of them can gaze at each other. Babies are usually wide-eyed at this time, and while their vision is not perfect, it is functional and effective at about eight to twelve inches from what the baby is trying to focus on. The very best thing to focus on is his/her mom’s face. Her voice (and that of her partner’s) will be familiar, and the baby will usually respond by turning to the source of quiet, soothing words within that little “cocoon” of focus and awareness.
Typically, there’s a lot of baby care going on right after birth, but most of it can occur with a mom holding her baby, or at least within her sight. Additionally, most babies (unless heavily medicated during labor) are ready to suckle and can be put to breast. Note, too, that the distance from a mom’s face to her breast is about eight to twelve inches, or within the baby’s best visual range. If she can and does breast feed, the baby will benefit from early suckling and ingestion of colostrum, a precursor to human milk and a good source of calories and protective antibodies. Early nursing will also release maternal oxytocin, a hormone that will help the mother’s physical recovery from birth.
If it’s possible and if a mom desires, there are also benefits to skin-to-skin contact between mom and baby. A baby’s skin surface—relative to body weight a newborn’s largest sensory organ—will usually respond to mom’s touch by calming and quieting. Additionally, a mom is a better source of temperature regulation for a baby than any warming machine. In some hospitals a warming light can be placed over the mom as she holds her baby skin-to-skin, but under any circumstances she herself does more to keep her baby appropriately warm than anything or anybody else. If a blanket is used, it can be placed over both of them, together.
One aspect of care that occurs during that “magic” first hour is installation of antibiotic ointment to protect the baby’s eyes from infection. Use of antibiotic ointment is frequently regulated by law, but in order to make optimal use of the baby’s capacity for vision early on, parents can request that the ointment be instilled toward the end of the hour.
At about one to one and a half hours after birth, most babies will begin to get drowsy and will go into a fairly prolonged, deep sleep. At the same time, most moms are ready to sleep also, and they need and deserve that quiet time to begin to recoup the energy expended in delivering their babies. While mutual regulation is a “dance” that will occupy many months (if not years) of a baby’s new life and a mom’s new life, this first step is an important one that gets both of them off to a good start.
Mary Ann Zettelmaier, MSN specializes in maternal-infant communication, with a comprehensive clinical focus on developing programs of family-centered care.