Pregnancy

What’s it like to be born? Of course babies can’t tell us. But we do know that it is a time of enormous transition. For nine months a baby grows in the warmth of his mother’s body, rocked by her movements, soothed by her heartbeats and nourished by the placenta. During the hours of labour, rhythmic contractions open his mother’s cervix, push him out of his uterine home and thrust him down through his mother’s pelvis. Soon the baby emerges from a dark wet world, where all his needs were met, into a world of air and light, able almost immediately to breathe his own oxygen and to suckle for nourishment.

The Baby’s Journey

Robbie Kahn, author of Bearing Meaning: The Language of Birth sees this transition as a positive experience for the baby: “Birth is an intense experience but not a trauma.” She describes the baby’s experience of labour this way: “I think of it as a strong and powerful massage; it helps physiologically by getting fluid out of the baby’s lungs. Labour awakens the baby. Some experiences in life are very strong and powerful and we shouldn’t shy away from that. Babies were meant to have this experience.”

When labour is going well, a woman will experience a release of hormones called endorphins, which help her to relax and cope with the pain. These hormones are shared with her baby. Ideally your baby will be massaged by your uterus through the first stage of labour, receive your pain-relieving, relaxing hormones and easily accept the strong pushes that thrust her into the world.

But not all births are straightforward. While drugs and interventions may not be the ideal, they may be necessary. If the situation is rushed or frightening, or a woman feels pushed into making an ill-considered decision, both she and her baby will experience the unwanted rush of stress hormones that result. If, on the other hand, the woman feels well supported and is comfortable with the decisions being made, she and her baby will both benefit. Psychiatrist Thomas Verny, author of Tomorrow’s Baby, believes that the mother may even be able to communicate reassurance to the baby, at an intuitive level.

In labour, trust that your baby, like you, is strong and resilient, able to endure and recover from challenging experiences. Kate Sykes, whose 14-month-old Simon was born at home, puts it this way: “The baby is just as eager to meet his mom as she is to meet him. That’s what gets them through.” When labour ends, you’ll hold your baby in your arms, and your baby in turn will be comforted by being nestled close to you.

Easing the Baby’s Transition into the World

When the moment of your baby’s birth arrives, you’ll want to do everything you can to ensure the transition from womb to world is as gentle as possible. Cheryl Stewart, a doula in York Region, Ontario, suggests asking your caregivers to suction your baby’s nose and mouth only if necessary, and to delay clamping and cutting the umbilical cord until after the baby has begun to breathe on her own.

At birth, babies have high levels of stress hormones, preparing them to respond quickly to the demands of their new world. After all, within seconds of their arrival they must take their very first breath. But like all of us, babies need to recover from stress by returning to what is familiar. Although the baby cannot return to the womb, parents can provide externally an environment that is similar to what the baby knew inside. What did the baby know? The baby knew her parents’ voices, her mother’s movement and the dark, warm, wet, noisy environment of the womb.

Placing the baby immediately on the mother allows the baby to return to something familiar. He will hear her heartbeat and her voice and feel her comforting touch and warmth. While some mothers will be ready to accept their babies immediately, others, like Kate Sykes, need to recover from the intensity of labour before they are ready to touch and welcome their child. Because she was very shaky immediately after Simon’s birth, Sykes’ husband held the baby against his bare chest. She believes that may be why the bond between them is now so strong.

Your baby will need warmth to help her maintain her body temperature. Many nurses routinely place the baby on a warming unit in the labour room to do this and then, after a short examination, swaddle the baby in two receiving blankets before returning the baby to its mother. How else can a baby be kept warm? Research tells us that newborns retain their heat best when placed naked on their mother’s (or father’s) bare skin. The baby should be dried off. To prevent heat loss a blanket or a heat source is placed over the baby.

Not so long ago it was believed that all babies were blind at birth. Today we know that babies are biologically programmed to seek out a face at birth and can spend long minutes gazing into their mother’s or father’s eyes. Babies focus particularly well about eight to ten inches away, the distance we naturally hold them in our arms.

Parents getting to know their babies tend to explore their entire bodies with their fingers, enjoying the wonderfully soft baby skin. Dr. Marshall Klaus and Phyllis Klaus, authors of Your Amazing Newborn, note that touch is important for another reason: “Touch has been demonstrated to increase production of growth hormones and aid the immune system.”

The baby knows her parents’ voices. A newborn prefers her mother’s voice to other women’s voices and is even familiar with her parents’ language. Sykes says baby Simon even knew their dogs’ barks as he never cried when they barked. He already felt at home even though he’d only just arrived.

The baby knows her mother’s smell and taste. The taste of amniotic fluid that she finds on her hands attracts her to her mother’s breasts, which have a similar taste. For this reason, you may want to ask that your baby not be washed immediately after birth.

Babies know how to suck. They have been sucking in the womb on their fingers or hands. Within an hour after birth they are eager to return to that familiar experience and find great satisfaction in attaching themselves to their mother’s breast. Many need little help, just the opportunity to nestle skin to skin with their mother.

Appreciating the many abilities of our newborn babies helps us to respond more completely to them, making their arrival richer and more satisfying for the whole family. This early interaction is called bonding and is considered a significant contributor to a loving, long-term relationship between parent and child.

But what if birth is complicated? Can parents still welcome their baby gently and lovingly into the world? Following Sarah Anderson’s unexpected Casearean, her husband, Jamie, was given baby Thomas to hold. While her abdomen was being stitched up, Jamie positioned Thomas so that Sarah could look into his eyes. “I felt a heartwarming connection. I badly wanted to touch him, but my hands weren’t free. Instead our faces touched.” Half an hour later, Sarah had more contact with her baby. “My most vivid memory was when Thomas was placed skin to skin on me. That had been in my birth plan. It felt so natural. I couldn’t believe how soft his skin was.” Within an hour of Thomas’s birth, Sarah sat up to breastfeed her son. “I remember the recovery room was dimly lit and quiet.”

Stewart notes that in many hospitals, routine practices and procedures are carried out immediately following the birth, taking precedence over bonding time. Babies, however, are at their most alert and responsive in the first hour after birth. Ask your caregiver if weighing and measuring, bathing and administering medications like vitamin K and eye drops, can be delayed so that your new family has some time to get to know each other. (Your baby will also need to have some routine blood tests done about 24 hours after birth. You can ask to hold or breastfeed your baby to comfort him during the procedure.)

As your baby settles into his first sleep a few hours after birth, you’ll have time to reflect on his arrival. You and your baby will have shared the intensity of labour and the magical moments of your first face-to-face, skin-to-skin encounter. You will have experienced each other through all your senses. If you remained close immediately after birth, your baby may hardly have cried at all. Your shared experience on this day will cement a bond that began in pregnancy and will continue to grow for many years to come.

Smoothing a Rough Start

A premature baby lies in the Neonatal Intensive Care Unit (NICU) in a heated isolette, separated from the world by a plexiglass barrier. An IV runs through the baby’s hand. A tube inserted through his nose and connected to a ventilator assists his breathing. Monitors measure his heart rate, oxygen and carbon dioxide levels. His blood pressure is checked regularly.

When babies need round-the-clock medical support, what can anxious parents do? Luisa King, a nurse working in the NICU of Sunnybrook and Women’s College Health Sciences Centre in Toronto, has some advice:

Provide breastmilk: When the baby is ready to receive food, she can be fed pumped breastmilk through a nasogastric tube, that goes through her nose and into her tummy. Breastmilk provides antibodies and is nutritionally perfect for her.

“Cup” the baby: Provide firm boundaries with your hands, like your uterus did. Hold the baby’s head and feet and push them gently together. Or place a hand on the baby’s belly. Cupping babies helps their heart rates settle down and they relax into sleep better.

“Kangaroo” the baby: Put the baby skin to skin against mom’s or dad’s chest as soon as the baby is stable enough to come out of the isolette. Research has shown that kangarooing a premature or sick infant helps by lowering the heart rate, increasing the oxygen the baby absorbs, increasing mom’s milk supply, decreasing stress both in parents and baby, and improving baby’s long-term development.

Create a quiet environment for the baby. Cover the isolette with a blanket to make it darker. Leave your baby alone if he is sleeping and calm. Too much stimulation is not helpful to premature babies.

Spend time with the baby. Parents are encouraged to spend as much time in the nursery as they want. It’s open 24 hours a day.

Soothe the baby during painful procedures like frequent heel pricks to draw blood. Giving the baby a pacifier can provide some comfort. King has also done blood work while the baby breastfeeds, though she acknowledges that it’s not always possible.

Provide a pacifier: In an isolette babies don’t have a lot of ways to comfort themselves. Preemies need non-nutritive sucking through pacifiers, which also help them to start producing digestive enzymes.

King adds a word of encouragement for anxious parents: “Over the years I have seen how much better babies are doing as the medical community becomes more in tune with their needs, and as we recognize the important impact parents have on their babies’ well-being even when they are confined to a NICU.”

Recommended Reading

Your Amazing Newborn, by Marshall H. Klaus, MD, and Phyllis H. Klaus, CSW, Perseus Books, 1998.

Originally published in Today's Parent Pregnancy & Birth, Winter 2002/03