adapted from The first hour following birth: Don't wake the mother! by Micheal Odent
"The hour following birth is undoubtedly one of the most critical phases in the life of human beings. It is not by chance that all human groups have routinely disturbed the physiological processes in this short period of time, via beliefs and rituals. Our cultural milieus are, to a great extent, shaped at the very beginning of the mother-newborn interactions."
The first hour following birth may be looked at from many kinds of perspectives. From the obstetrical model to the midwifery model. From a medical-centered process to a woman-centered. From an allopathic view to a holistic view.
They are all important aspects as we consider what ways can best support optimal growth and development for the motherbaby. Depending on where you decide to have your baby, the first several hours can look very different. As a mother prepares for her birth she can consider how and where births can impact her baby’s experience and will ensure the best start to life. There are many integrations that are happening at the moment of birth and over the first moments, hours and days.
Baby needs to breath. As the transition from womb to world happens, a baby moves from fetal circulation, through the placenta, to newborn circulation, through the lungs. It can take a several minutes for this transition to be fully complete. As a baby is birthed there is a series of reflexes that are done to prepare for the first breath. The lungs at the time of birth are not filled with air but have fluid that needs to be expelled and then the process of filling with air can begin. Most babies can do this just fine on their own, some may need a little bit of support to do so. This time is meant for the mother and baby to reconnect. A mother will reach for her baby and stimulate the baby to begin to breath. These moments should be protected, with intervention only happening if needed.
The hormones in the mother continue to work synergistically through the birth process and the moments following birth. Oxytocin is at an all time high at the moment of birth. It helps to contract the uterus and helps to get the milk ejection reflex going. We can encourage oxytocin to remain high at birth by keeping the birth space warm. Mom and baby should be skin to skin immediately so all they must do is gaze into each others eye and fall in love. By allowing this to happen, prolactin, which is called the "mothering hormone", creates bonding and a gradual change in milk from colosturm to a full milk supply. The mother and baby both release endorphins at birth which cause a feeling of well being and relaxation. The hormones of adrenaline, which during the birth process should be suppressed are increasingly released in the last few contractions of pushing. This causes mom to be alert and have more energy in order to protect her baby and causes the baby to adapt to his new environment, be alert and find his way to the breast.
Attachment begins at birth. There is a short and crucial period immediately after birth that will never be repeated. This is the moment that a mother looks and then reaches for her baby. She begins to touch, and stroke and the birth gaze happens when baby and mother look into each others’ eyes. Often this moment is disturbed due to various interventions that have happened during the birth and routine ‘management’ of the third stage of labour. If a separation happens a mother and baby should be supported to re-connect as soon as possible as this is where healing can happen for both.
The baby will find the breast. Lactation begins at birth. A baby can find the breast and the mother will instinctively know how to hold her baby. By given them time and space they can take this time to figure it out. Just as there is a blueprint for the birth process to unfold, there is also a blueprint for breastfeeding to unfold. There is no immediate rush for baby to suckle. The baby and mother can take time to breath together and often all a mother needs to do is support her baby as he finds his way to the breast and begins the breastfeeding process.
The baby can adapt to his/her new environment. A baby in the womb receives nutrients from the mother through the placenta. After birth, as all baby’s blood is transferred back from the placenta, the placenta is released from the womb and the baby begins to receive nourishment from the mother, through the breasts. The remarkable newborn can adapt to this change is given the time to complete the needed sequence of events. The amazing thing is even if the biological process was interrupted, a baby can adapt, and given support can reconnect and reattach to his mother.
The work of seeding the microbiome begins at birth. At birth baby has moved from a relatively germ-free environment. As baby is born through the birth canal they are washed with bacteria from the mother and that will begin to prime their immune system. Within the first hour there are millions of germs covering his mucous membranes. The baby's body is inundated with whatever is in the environment he is in and from whoever is touching him. The mother and baby share the same antibodies which is why it is important for baby to be skin to skin immediately. Colostrum can help establish an ideal gut flora. This will impact the baby for a lifetime, setting up healthy gut flora and protective immune properties. Mothers skin and breastmilk contain important stem cells to begin the process of building a healthy microbiome for the baby.
Warming up. In the womb that baby is kept at a constant and perfect temperature. At birth, the baby is thrust into a whole new environment. The birth environment should be warm for the mother and the baby, this will help as the mother and baby adapt to the new changes. Being skin to skin helps baby adapt to the new temperatures as their own thermoregulation takes time to mature. Having baby on the mother with no materials in between (they do not need hats on) will help regulate breathing, temperature, blood sugar and heart rate.
What would your baby like in that first hour? Sometimes we need to put ourselves in someone else's shoes, or in this case, womb. Think about how you would like to be welcomed into a new space or a new environment. What sounds or feelings would make you feel safe? How can we create a place to welcome our most precious new baby?
Which way up? Baby's have to adapt to gravity. during the first hour they learn about equilibrium and which way is up. They can make their way up but as yet can not move backwards. This is so they are able to crawl to the breast and latch on. When a mother is laying down, laying back or on her side a baby feels more secure.
Mothers come from many different cultures and backgrounds. A mothers beliefs should be respected and by honoring what her own rituals are, will help her connect with her baby, family, and community. However, in all cultures there are many ways that the first hour is disturbed. It may be to cut the cord immediately, bathing, rubbing, swaddling, and even not feeding colostrum. We have to consider that what may be a cultural norm in our community is not necessarily what is best for the baby.
Obstetrical management can be very invasive in the first moments of life. In our culture the question for obstetrics is often "how can we manage the third stage?". The separation of mother and baby is common, whether it is to perform routine tests or to remove them to a separate room for ‘observation’. We have known for many years that this separation is detrimental to both the mother and the baby. The research supports this. There are many people now who are trying to encourage more study of the negative effects of labour management on moms and babies and are pushing for changes in the way a new baby and a mother are viewed.
The midwifery approach can help the mother and baby have a gentle start. Authentic midwives work to ensure that the birth is encouraged to be as least disturbed as possible. They work to promote an ideal environment for baby to be born into, protecting both the mother and baby. Across the world this form of midwifery is in jeopardy, as a more medicalized approach is used. There is a rise in birth companions supporting women through birth. Having this personal and individualized support can be very beneficial to help protect mothers and babies in the first moments and hours after birth.
Politics in the birthing room. The effects of labour and birth has on the long-term health of a population is often overlooked. How a women births can have long term consequences on her, her baby, and the community. It is important to keep in mind that the world of childbirth is very much about politics, money, and power. Birth really is a big business. The overuse of pharmaceuticals and medical interventions makes money, can influence policy and creates a divide between women and the medical community. As the rates of inductions and caesarean sections continue to rise there is more risk to the mother and baby. Along with these increases we are also seeing an increase in PTSD and depression in women postpartum. It is an imperative that we continue to encourage and support the normal physiology-biology of the birthing woman. It is women themselves who will continue to find ways create the pregnancy, birth and postpartum experiences that are best for them and their babies.
By learning more about all the aspects of birth hand how it can impact the mother and baby you can do your best to give your baby a good start to life. We live in an age and a culture where accessing information is easier than ever. Look for information and knowledge centered around the mother-baby. Find classes, groups and wise-women in your community that will help support you on this journey. Know that you are not alone and there are many families who are looking for ways to be create health and wellbeing.
You are welcome to reach out to me if you have any questions or are looking for direction.
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