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Routine Procedures After Birth

It’s important to plan the time after your baby is born and your preferences for how to spend that time.

Some things you can plan are
• Who announces the baby’s sex and tells everyone his or her name
• When you’d like the baby’s umbilical cord cut and who you’d like to do that
• Information about cord blood donation (if you plan to do this)
• What you plan on doing with the placenta (if you want to take it home and bury it or have the hospital dispose of it)
• What you want the room to be like for the first two hours after birth (dimmed lights, warm, no procedures or measurement unless necessary)
• Who you want to hold the baby skin to skin if you cannot for some reason

Routine procedures after birth that you should think about and possibly include in your birth plan are discussed below.
Medical management of the third stage (inducing the birth of the placenta) happens in many hospitals who have a policy to give you an injection of artificial oxytocin right after baby is born to make the placenta detach faster and control bleeding postpartum.
What are the problems with it?
If bleeding is normal there is no need to rush the birth of the placenta and disturb the you and your baby with an injection.
What are the alternatives?
Your midwife can monitor your bleeding and give you an injection only when she sees that the bleeding is excessive or the placenta is taking longer than one hour to detach and be born. She can react when necessary instead of assuming that there will be a problem. Ensuring a positive environment for the hormonal orchestra, including a dark, warm and calm environment after baby’s birth and plenty of skin to skin and breastfeeding can help your placenta detach and birth physiologically and also keep bleeding to a minimum. However, this is not always possible in a hospital environment.

Immediate clamping and cutting of the umbilical cord is still done in many hospitals. We used to think that a baby’s umbilical cord had to be clamped and cut immediately after birth. Newer research is telling us that this is a problem.
What are the problems with it?
We now know that the placenta, umbilical cord and baby are one unit and that up to one-third of the baby’s blood is contained in the placenta after birth. The umbilical cord continues to pulsate after birth, bringing more of the baby’s blood back into its body, making its adaptation to life outside the womb easier. Studies have also shown that babies whose umbilical cords have been clamped one minute or more after birth have higher blood iron levels at six months of age.
What are the alternatives?
Healthcare providers should wait for the umbilical cord to be white and limp before clamping and cutting it. This can take anywhere between one and five minutes after birth. If the baby needs help after birth, it is often possible to move it together with the placenta with the cord intact.

Cord blood donation is increasingly popular in some countries. Cord blood contains stem cells, which can be stored and used in the case that your baby or another relative becomes sick later on. They can also be used by public blood banks to prepare valuable treatments for people sick with various diseases.
What are the problems with it?
Banking your baby’s cord blood means that your baby is being left without a good portion of its blood. Also, the quality of the cord blood sample may not be good enough for use in medical treatments (sample quality is individual and you don’t know if the sample is acceptable until it gets to the lab). Finally, since cord banking has been possible the number of cord blood samples used has remained very small. There is also increasing evidence that babies who develop illnesses later in life will not be able to use their stored cord blood because the stem cells contain the disease they need treatment for.
What are the alternatives?
Think long and hard about your family’s individual circumstances and medical history before deciding whether or not to store your baby’s cord blood.