New Parents Survival Guide: Happy Birth Day

You have now made it to the hospital for the baby’s big arrival.

Well hopefully you have made it to the hospital; I have had several babies born at home, in the car or in the parking lot of the hospital. Things have probably already not gone according to plan. Dad may have forgotten half the stuff he was supposed to remember yet still managed to bring a moving van’s worth of stuff and everyone is a nervous wreck.

We should start with some basics. What do you absolutely need for the baby while you are in the hospital? Luckily if you have forgotten everything you will be fine. The hospital has assumed you are idiots and will have everything you will need while you are there. It is a good idea to have some clothes to bring the baby home in and to take the all important hospital picture. You will need a car seat you have properly installed or the hospital will not let you put the baby into the car to take it home. (Most fire departments and some police stations will check to make sure your seat is properly installed and it is a good idea to let them help you before the baby arrives, as they require almost rocket science to install). You will also need some receiving blankets to wrap the baby up to take it home. The hospital will have gowns, diapers, ointment, milk and everything you could possibly need while you are there.

So the time for the baby to get here has arrived.

You have heard all your friends and family say how pretty their babies were when they were born. Your baby arrives, they hold it up for you to see and you see a bloody, wet, ugly looking alien. Do not freak out; after the initial shock, the drugs will kick in and it will be a magical moment where you too will remember your baby looked beautiful. I did not even have any drugs and I thought my little, white, gooey slimy alien was cute.

They will make your baby cry and start drying it off in a fast and almost abusive looking way. They may suction its mouth and nose and almost immediately start giving it grades, called an APGAR score at one and five minutes of age. To hear most parents talk about their baby’s scores you would think they were the equivalent to an IQ test. The baby is given one to two shots, wrapped up in some blankets, given back to Mom and Dad for awhile to bond with and then whisked away to the mysterious nursery. This nursery must be a very magical place, because the baby will come back looking clean, pink, very cute, and probably very hungry. Now you look back and wonder…what just happened?

Let us go through the previous scenario and try and explain what just happened. After the baby is born the obstetrician will hand the baby to a nurse or pediatrician who now will have the primary responsibility of taking care of the baby. The days of holding a baby upside down and spanking its booty until it cries are long gone, but we do try and stimulate the baby to cry…this will be its first breath. (I personally think popping their little butt to start off life may be what’s missing in the discipline of today’s youth and we should blame pediatricians for all the out of control teenagers). If the baby has passed stool prior to being born you will hear the term meconium stained fluid. (Meconium is a fancy medical word for black baby poop). If the amniotic fluid is meconium stained they will try and suction the baby’s throat below the level of the vocal cords prior to it crying and taking its first breath. Your OB/Gyn may do this when the baby’s head comes out. After the baby takes its first breath there will be a flurry of activity where they are rapidly drying the baby off in what looks kind of a rough way. They are trying to dry the baby as quickly as possible, because the baby is losing a lot of heat while wet and therefore a bunch of energy. At the same time, they are stimulating it to cry. If the baby does not start crying with the rubbing they will flick the bottom of their feet. (We may have given up on spanking but we’re still annoying). They will also try to get a little hat on the baby to cover its head and get it under a warmer as soon as possible. In amongst the drying and warming up they will be listening to heart sounds and the baby’s lungs to make sure everything sounds good. They will also assess APGAR scores at one and five minutes after birth. This is a score given in five different categories; each receives a score of zero to two. The five categories are then added together to get an APGAR score. These scores are a way for medical personnel to communicate to each other what the baby looked like at these times. The scores are used to give an idea of how well or how poorly the baby looked and responded at specific times right after birth. The first of the two shots given is a Vitamin K shot; an essential vitamin babies may be deficient in that allows blood to clot and thus keep them from bleeding excessively. The second shot would be a Hepatitis B shot if you had given them permission to start this vaccine series while in the hospital. They will probably at the time they are giving shots put some ointment into the baby’s eyes. This is to prevent any possibility of the baby getting an infection in the eyes, which is a cause of blindness in babies.

While the baby is in the nursery the nurses do a much more thorough assessment and get the baby’s vital signs. They may take the baby’s length, weight, and head measurements or they may have done them in the room after they were born. They will get the baby’s footprint for its birth certificate and give it a bath. After the baby’s bath they will keep it under a warmer to get it warm and will keep it until it can maintain its temperature. Most hospitals have gone to mother baby rooms, which mean the mother and baby will stay together throughout the hospital stay, and as soon as the baby is doing well they are taken back to Mom’s room for her to feed. After that the babies will spend most of their time in the room with Mom and Dad so they can take care of their little tyke. Just a little warning for Dad; those chairs that convert to a bed for you to sleep on were invented by a woman who evidently just had a very bad birthing experience. They were especially designed to cause pain everywhere, tempting you with the idea of blissful sleep only to cruelly prevent it happening.

Depending on the type of delivery you have, you may stay between 24 hours to three to four days in the hospital. You will probably have lots of visitors, take some naps, and get some help from nurses and doctors and then go home where everything changes when you are all alone.

Here are a couple of little tips for your time in the hospital that you might not have known. If they open something for your baby but do not use it all—diapers, wipes, ointment or the like—take it home with you. You were charged for the whole container not just what you used. By law you have the right to stay 48 hours in the hospital for a vaginal delivery and 72 hours for an uncomplicated cesarean section. Hospitals sometimes try and rush you out; do not let them if you are not ready to go. Everyone who talks to you in the hospital is not an expert. Lactation consultants sometimes are pushy and only see one side of things and this could be a side that does not always agree with how you need to live your life. Nurses sometimes give advice based on their experience and not necessarily based on scientific facts. If you have questions it is best to ask your doctors.

Here’s a funny little anecdote from the hospital when my oldest boy was born, showing you crazy things even happen to pediatricians. I was on call when his mom went into the hospital and I am known for not exactly dressing the part of a normal doctor. I had on a pair of blue jeans, a t-shirt and tennis shoes and was wearing a motorcycle jacket with Wildman written across the back and a Tasmanian devil. I kept getting paged while we were in the hospital room so I would go to the corner where I could get reception on my cell phone and return the calls. One nurse, who saw me go to the corner a couple of times, turned to me angrily and said, “You can stop dealing drugs long enough for your baby to be born.” I pointed out I was a doctor and on call. Another nurse pointed out that mommy was also a doctor and worked in the hospital. The first nurse apologized and we did not see her anymore.