Do I really need to take a childbirth class?

This post was originally written for My Nest Well.


Between blogs, books, podcasts, and Youtube videos, do you as an expecting parent really need to spend time — and money — taking a local birthing class? As a Childbirth Educator, I’ve encountered numerous couples who have “read all the things” and “watched all the things,” but when they finally take a class, they gain so much more than they ever expected. Here are three reasons why this rite of parenthood passage shouldn’t be skipped and how to find out which type may work best for you.

Local Touch. The basic information of the stages of labor, pain-coping techniques, and interventions can be found all over the web and in books, but how do you make it all relevant to your specific situation? A local childbirth educator will be savvy on which hospitals have tubs, which offer nitrous oxide, and even how to navigate an overflowing urban Labor & Delivery triage. They fill in the unknowns of the labor process, but they also help to align your expectations with your particular birth place and provider. The goal is to give you the tools to become an active participant with your birth team. 

New Community. The main goal of a birth class may be knowledge of the birth process, but another perk is the discovery of other families that will be having a baby at the same time as you. Nothing bonds people like shared experience, so it’s quite common to meet another parent that you might create a nanny share with, have early “playdates” with, or who you can text in the middle of the night because you know they aren’t sleeping either.

Partner Connection. From choosing a pediatrician, comparing 100 different strollers, creating a registry, decorating a nursery, and working a full-time job, the months preparing for baby are a whirlwind. Almost all childbirth classes are designed for both a pregnant person and their partner, so class is an amazing opportunity to slow down, connect with your partner about your new arrival, your birth options, and how your partner can best support and advocate for you. 

So, which class is right for you?

Hospital Childbirth Class. A birth class at the hospital you’re delivering at is a natural first stop for most for its convenience and familiarity, but these classes tend to have limitations. They’re often crowded and taught by staff that isn’t encouraged to share all of your options or recent evidence-based findings in an effort to keep things streamlined for larger groups.

Independent Childbirth Class. One of the things I love about teaching in my own cozy space is that I attract a diverse set of families with a range of birth places. Some attendees birth in big city hospitals, others in smaller hospitals, and other in birth centers or at home. Families get to learn so much about various options from each other. 

Branded Childbirth Class. I have been trained by Lamaze International and Childbirth Education Association of Metropolitan NY (CEAMNY), both of which celebrate that there is no “one right way” to give birth. For example, a medicated birth is honored just as much as a non-medicated birth is. Instead, they focus on evidence-based techniques, shared decision making, informed consent/refusal, and creating the birth experience that works best for you. Birthing Within treats birth as a profound rite of passage, focusing on experiencing it as a journey. The Bradley Method, a 12-week series, is “husband coached” and emphasizes a natural, unmedicated birth. Hypnobirthing, a method intended to foster a peaceful birth experience, focuses on reducing fear, staying calm, and breathing through labor.

There really are so many options out there for everyone. Before signing up for any of these classes, consult with like-minded friends who have given birth recently. Reach out to potential instructors about class size, room setup (comfy couches or back jacks on the floor?), and if they are open to diversity and different family structures. The most important thing is that you go in with an open mind, ready to learn all you can about how to make your own birth experience as empowering and joyful as it can be. 



This was originally written for Tranquilo Mat by Hilary and appeared on their Blog February 8th, 2018

Nursing a Newborn: 3 Tips to Help You Survive Those 'Witching Hour' Fussy Evenings With Baby


For many first time parents, the first two weeks of life with a newborn can be a bit of a blur. Then, just as you feel like you might be slightly more confident in your new role, the “witching hours” hit.

Most parents know that newborns need to eat 8-12 times a day, but don’t be fooled into thinking that these feedings will be organized or spaced out into any pattern in the beginning. Around week 3, many newborns start to have “fussy” evenings where they are clingy, cranky, and seem to want to nurse on and off for hours. This pattern is referred to as “cluster feeding,” and there is disagreement on what causes it. Some say it’s developmental, others say that baby is filling up on the fattier hind milk before sleep. But it helps to be clear on what it isn’t.


When a new mom’s newborn begins cluster feeding so early in their breastfeeding journey, they may blame their milk supply. A clingy baby who is nursing frequently will leave mom’s breasts feeling soft and “empty,” leading mom to believe that baby must not be getting enough milk. But if baby is gaining weight and making lots of wet/soiled diapers, there is nothing to worry about.

Research shows that fully “emptying” the breasts can actually help produce more milk. And don’t be tricked by the pump; even if you can’t pump any milk out at this time, your more efficient baby often is getting something. In these delicate first weeks of nursing, we don’t want to confuse the “supply and demand” system of milk production by adding in a supplement if we don’t need it. Many parents get confused by the baby’s strong reflex to suck: “when I offered her a few ounces from a bottle after nursing, she sucked them right down! She must have been hungry!” Newborn babies are wired to suck. Breasts, pacifiers, fingers, bottles–if you put them in their mouth, they will probably suck it. This is not a great indication that baby is hungry.

Even exclusively formula fed newborns go through “the witching hours.” It’s also often confused for reflux or colic because babies can be fretful and fussy, but it’s rarely either of these things. Knowing what it’s not can help you get through this stage with less anxiety.


These fussy evenings can last for hours and are inconveniently located when you might be trying to start dinner, and wind down and connect with a partner that has gone back to work.

Nursing can be physically and emotionally demanding, so this isn’t a great time for multi-tasking. Make use of a slow cooker and prep dinner during an early afternoon nap. Take a shower in the morning and don’t plan on having guests or heading out during your baby’s fussy hours. As you get closer to your baby’s usual fussy time, make sure you have had a good snack, grab a glass of water (and maybe a glass of wine), and settle in with a good Netflix series or Nook while your little one is cluster feeding. This is only temporary; in a couple weeks, the “witching hours” will be a thing of the past, but until then it is best to work with them, rather than fight again them.


The witching hours are most frequently experienced somewhere between 5pm and midnight. But it’s a good idea to start laying the groundwork for a consistent routine now. Decide what you think a good “bedtime” might be; a good indicator is 90 minutes – 2 hours from baby’s evening nap. So if she had a nap from 4:45-5:30, then 7pm might be a place to start. When “bedtime” comes, bring baby to the room they sleep in, darken the room as much as possible, turn on a white noise machine, and consider swaddling them. This may not put an end to the frequent nursing or fussiness yet, but it helps to reduce overstimulation and can start to create new sleep associations. The good news is that when baby does settle after the witching hours they usually have their longest stretch of sleep. It will still be some time before they will sleep through the night, so when they wake to nurse, keep the room very dark and minimize stimulation (diaper changes, talking); this will help her to realize that night is for sleeping, nursing, and going right back to sleep. Even if she’s not settling till 9 or 10, knowing that there is a goal and having a clear separation of day and night routine will help everyone feel less overwhelmed.

You can expect this phase to pass and see more settled evenings usually after baby is 8-9 weeks old. Sometimes knowing that this is a normal phase that will soon be a memory can make it easier for everyone while you are going through it.

Watch Hilary chatting LIVE about surviving those ‘witching hour’ evenings with baby:


Don’t leave the hospital without these 4 support systems in place

Childbirth Educator and Certified Lactation Consultant Hilary Baxendale helps you make the transition home from the hospital as smooth as possible. Assemble the contact information for these 4 people to build a stellar support team before you need it.


Bringing home your newborn is one of the most exciting, and nerve wracking, moments in any new parents life. “You’re letting me walk out of here with this helpless ball of adorable? Are you sure?!”

They’re sure. Most parents bumble through the first diaper changes or YouTube how to give a sponge bath with enough success to keep everyone involved alive and well. But sometimes you need extra assistance from a seasoned professional.

Have these 4 support systems on speed dial before leaving the hospital, just in case. Because searching online for help while bleary eyed at 3am is just as productive as it seems.

  1. Postpartum Doula

Hiring a postpartum doula may be the single most important thing to make the transition from hospital to home go smoothly, and many new parents don’t even know what one is! Unlike a baby nurse, a postpartum doula takes care of the family, not just the baby. Usually trained in breastfeeding counseling and newborn care, a postpartum doula can help you with latching, swaddling and routines. Most will also unobtrusively make a healthy meal, do a load of laundry, and then quietly sneak out leaving the place cleaner than when they came. Think of a postpartum doula as the perfect mother-in-law without the unsolicited “advice.” Hired by the hour, day, or even overnight.

    2. International Board Certified Lactation Consultant (IBCLC)

As a Childbirth Educator I always recommend that my clients request to be seen by an International Board Certified Lactation Consultant before they leave the hospital. Labor and Delivery Nurses are an awesome resource for new moms, but IBCLCs are true experts in their field and can spot issues with position and latch that make all the difference as you start breastfeeding for the first time. That support shouldn’t end when you leave the hospital because many breastfeeding issues arise as your mature milk “comes in” on day 3 or 4, after you’re already home. Such issues as soreness or milk supply are best dealt with right away, before they turn into more serious problems.

Want to be even more prepared? Take a breastfeeding class before you deliver to get the low down on feeding expectations, troubleshooting issues and when and if you need to pump.

    3. Mental Health Professional

Prenatal anxiety, baby blues, postpartum depression – many women experience one or all of these mood changes during or after pregnancy. If this sounds familiar, know that you are not alone, it’s not your fault, and you can and should receive treatment. Many therapists specialize in the postpartum period and may even hold special support groups in your area. Make a prenatal plan in advance with your partner to talk about expectations and whom you might turn to if you don’t feel like yourself.

    4. New Mom Group

Its been celebrated, and it’s been mocked, but even the most resistant new moms, “I already have friends!” usually find themselves converted. A safe place to commiserate about lack of sleep, frustrations with feedings, and, yes, make a few new friends, a New Mom Group can be a real lifeline to share and explore your new role of “mom,” especially for those without family nearby. The New Mom Group that I lead has led to play dates, weekly walking groups, nanny shares and life long friendships.



Growth and Change…

Pregnancy and parenting are filled with growth and change. Growing our bellies and growing our families while we change our priorities and change what we consider sleeping in (does 8am sound like heaven to just me?!).

My childbirth business is growing and changing too! It took me three years to admit it, but I don’t live in Brooklyn anymore, and Westchester is my home. I wanted my Business name to reflect that, so you will see that my website and Facebook page is now Westchester Birth and Parenting!

I will to continue to bring high quality, non judgmental, evidenced based (and fun!) classes to the families of lower Westchester as they become parents. And I’m excited to announce two new partnerships!

On the Westside of Westchester I have joined Prana Yoga and Meditation and will continue to offer my Childbirth Education and Newborn Care classes at their Full Circle Woman’s Health Studio in Harrison. Joining Prana will also allow easier access for my students to Prana’s other prenatal offerings including prenatal yoga classes, yoga for labor workshops and their Pranabirthing workshop which is a great option for those couples looking to build on the labor coping techniques that they learn in my childbirth class.

full circle

And on Westchester’s Eastside I will be teaching Childbirth Education, Breastfeeding Basics and Childbirth Refresher Workshops at The Hudson Collective shared work and wellness space in Dobbs Ferry. This airy industrial chic location is the perfect place to absorb all the nitty gritty info you need on childbirth and breastfeeding while mingling with other parents-to-be!

hudco space

I’m also looking forward to collaborating with other great local businesses through goodies bags I’ll be distributing to my class attendees this Fall, so stay tuned or contact me if you would like to contribute!

Bringing home Baby? Now what?

Hilary Baxendale Childbirth has expended its services to include assisting families as they transition home from the hospital and begin to navigate parenthood!

IMG_4201 (1)

Hilary is a Certified Lactation Counselor, Childbirth Educator, mother to two young boys and leader of Rivertown Mamas, a local new mom discussion group. She is excited to build on the work she has already done with Westchester moms to include additional postpartum support in their home.

Research shows that moms who are cared for and supported after having a baby are more likely to feel confident, have a lower incidence of postpartum depression and more success with breastfeeding. In fact, a study in the Journal of Obstetric, Gynecologic, & Neonatal Nursing found that trained postpartum support can positively impact a mother’s competence and responsiveness to her baby.

Hilary’s role is educate, provide support and companionship and nurture the new family, the specific duties can vary depending on each family’s needs. For example, she can help parents make sense of the latest research and recommendations on infant care, teach parents ways to soothe a crying baby or help older siblings feel included.

Hilary also helps screen women for postpartum anxiety and postpartum depression, which affects one in seven moms, or she can simply offer emotional support when hormones and emotions tend to run high. Unlike a family member, who may offer up unsolicited advice, Hilary offers moms evidence-based information but never judges the family’s choices or tells them how to parent.

Services include helping new mothers, newborns and families during the first six months with:

  • Infant feeding (including breastfeeding support, bottle-feeding guidance, pumping support)
  • Giving baby’s first bath
  • Mother-care (cesarean recovery, perineal tear care, emotional support)
  • Newborn development and care recommendations
  • Soothing techniques
  • Newborn sleep education and tips
  • Accompanying parents to doctor visits or first outings
  • Discussing childcare options and going back to work.
  • Help with older children adjusting to their new role.

Bringing home a new baby is a joyous event but it can be stressful for new and experienced families alike. Having a support system however, can make all the difference.

To book any of Hilary’s services email her at

Hilary’s customizable one-time new parent support workshop runs 2 hours and is $250.

Rivertown Mamas new mom discussion group is held every Thursday 10:30-12, at Hilary’s home at 68 Prince Street in Hastings-on-Hudson. It is drop-in (although they can RSVP if they want on Meet-up) and is pay-as-you-wish ($20 suggested).

Hilary offers in-home CLC visits for $150 (visit is approximately 1.5-2hrs)



My Working Motherhood Journey

The folks over at Mitera Collection where I can sometimes be found blogging in their postpartum life series (see here), asked me if they could interview me about my journey from NYC worker bee to becoming a Mother/Childbirth Educator/Lactation Consultant/Ice Cream taste tester. Ok. The last one is made-up, but how cool would that be??

See the full article in much nicer font and with pretty pictures here

Or read on 🙂


For most of us, pregnancy, child birth and becoming a parent are truly life changing experiences. For some, it is also a career altering experience. After the birth of her first son, Hilary Baxendale, a Mitera blog contributing writer (have read this funniest post by her in our My Postpartum Life series?) left the fashion industry and become a Birth Educator and a Lactation Counselor. On the first day of her training to become a Birth Educator, she thought to herself “Do I belong here? I’m not the “yogi/crunchy/earth mama” that I pictured when I thought of a childbirth educator.” But she knew that “…all kinds of New Yorkers are giving birth everyday” and she hopes her clients can relate to her and her teaching style.

Here is her inspirational story of ‘working motherhood journey’.

Read on…

1.Who is in your family?
I am Hilary Baxendale and am happily married to Gareth, Senior Account Executive (men’s) for VINCE.
We have two boys Henry, 3 Archie, 12 months.

2. Can you tell me a bit more about yourself
I am 33 and I work as a Childbirth Educator and Certified Lactation Counselor. I also lead a New Mom Discussion Group and teach Intro to Breastfeeding and Newborn Care. My family recently moved from Park Slope, Brooklyn to Hastings-on-Hudson in Westchester. The suburbs! Gulp.

I’m very passionate about my family obviously, but I’m passionate about other people’s families too, and giving them the best start possible. The way our country is set up, there is little emphasis on helping couples make the transition into parenthood (short maternity leaves, hardly any paternal leave, no follow-up care, no home visits, etc). I love working with couples and guiding them into parenthood in my classes and support groups, but also giving them permission to make mistakes. Because trust me, NONE of us knows exactly what we are doing!

My other non-motherhood and non-career-related interests are… well, I used to read lots of books. Remember those moms? Now I read facebook posts and the occasional blog. Ha! I also love to bake. My three year old is all about the process (mixing, pouring, measuring, counting) and I’m all about the eating. So it works out pretty well.

My Background

3. Where did you grow up and how did you end up in New York?
I grew up in Rhode Island, went to college in Boston and moved to NYC right out of school. I found a tiny studio on the UES, one of those mini fridge, barely room for a full size bed deals, and loved it! I met my husband (who had recently moved to NYC from England) about a year after getting to the city and knew from our first date that he was the one. He was, and still is, the most authentic, honest, hard working and ridiculously handsome man I’d ever met. And the accent didn’t hurt either! We were married in 2009 and decided to start a family soon after that. Our first son Henry was born 2 days after Gareth’s 30th birthday in 2011 and Archie came along soon after. I always joke that being new parents is a young mans game (even though I see parents of all ages doing an amazing job everyday!). We are in the thick of things right now with two young boys, but I just try and remember the mantra “The days are long, but the years are short”. I know its true, but damn those days can be loooong.


4. Tell us about your pregnancy experience in New York as a busy working city woman.
Being pregnant in New York was always a bit of an adventure. In the beginning when you are nauseous and need a seat on the subway the most, no one knows! But I did find that someone was always willing to help me drag my stroller and toddler up the stairs when I was pregnant with my second. New Yorkers are much more helpful than we get credit for.

Once I was out of that awkward “I just had a big lunch” phase and actually looked pregnant, I enjoyed showing my bump off! I wore a lot of my pre-pregnancy clothes in creative ways (hair elastic in the button holes, layers, etc) and filled in with maternity pieces where I had to. I would have loved to have something like Mitera that didn’t look like a “maternity dress” and worked for nursing too. Maternity clothes are getting so much better, but nursing tops? Awful. Most moms I know need to get half naked to pump at work, so Mitera is really filling a need here.

“Most moms I know need to get half naked
to pump at work,
so Mitera is really filling a need here.”

5. Can you share your birth story/stories?
With my first pregnancy I read a ton of birth books, watched “the business of being born” and thought “I got this”. I made the mistake of not asking my practitioner enough about how birth is often managed in a big NYC hospital. I had a typical experience; induction at 41 weeks pregnant, medically managed labor, difficult delivery and out the door two days later. I had a healthy baby and a vaginal birth, but still felt disappointed, and knew the process could have been so much better. That’s when I sort of got obsessed with birth and dove into becoming a childbirth educator. My first day of training I thought, do I belong here? I’m not the “yogi/crunchy/earth mama” that I pictured when I thought of a childbirth educator. But all kinds of New Yorkers are giving birth everyday and I hope my clients can relate to me and my teaching style.

6. How was your postpartum life after you brought your baby home?
I had worked with children for years before I got pregnant so I think some things came easy to me. But no matter how much time you have spent with other people’s newborns, sleep depravation and breastfeeding are a whole new ball game! Breastfeeding especially was such a profound experience for me. I had big babies, 8lbs 6oz and 9lbs 12oz, so I felt really proud and amazed that my body was creating this perfect food that was all they needed to keep them healthy and give them their adorable rolls and chubby cheeks. But they ate a lot! It felt like a full-time job in the beginning, but I got really good at breastfeeding in the sling or ergo so then off we went into the world! I always tell my moms in my classes to get out of the house as soon as they feel ready. Going from a working professional to a new mom that may not have any family nearby can be very isolating. But that’s the good thing about New York, there is always a café nearby with a stroller or two in it. Meeting “mom friends” is a bit like dating, but ask for her number! Make a plan to meet for a coffee (or a glass of wine!), it’s so important to have someone to talk to that is going through the same things as you. Trust me, your childless co-worker doesn’t care how many times your baby was up last night or what color her poops is.

6. Tell me more about your life with your baby!
The majority of the classes I teach are in the evenings and on weekends (because the pregnant couples are still working). So I’m lucky in that I get to be there with my kids during the day and go on the play dates and do all the school drop-offs. But then as the day is winding down I pass off to my Husband or a babysitter and head off to work (just as the couch is calling!). If I didn’t really love what I do it would be impossible. But teaching those classes is really important work to me and Citybirths, where I teach, makes it easy. I work with such amazing women who all have the same goal of giving couples the knowledge to start out as parents with an empowered and positive experience. What’s better than that?!

It’s also important for to me to put on the heels and the shirt that doesn’t have food on it and hell, maybe even eyeliner, and remember that I’m more than just someone’s mom.

“It’s also important for to me to put on the heels and the shirt that doesn’t have food on it and hell, maybe even eyeliner, and remember that I’m more than just someone’s mom.”

My Career

8. Your career – how did you come to do what you do today?
I came to my work as a Birth Educator from a negative hospital experience and my work as a CLC from a positive breastfeeding experience. When you find a passion for something (either negative or positive) I find it propels you towards something that won’t feel like work. I love educating expecting couples because they are so eager to learn everything they can in the few weeks they have left before their baby arrives. But I’d love in the future to do more education on birth and best hospital practices to young women who aren’t even thinking about having a baby yet, maybe in a college setting. The state of maternity care in the US is pretty shocking (c-section rates, unnecessary inductions, separating mom/baby, maternal mortality stats, etc.) compared to other developed countries and if we can make this a health issue that is discussed far before conception it would be amazing. Just think of the hours women spend planning their wedding, and then how many hours they spend researching their birth. A seven-hour class? Maybe a book or two? I want to see women getting passionate about it much earlier.

9. Who are your clients? What do you do in your profession?
My clients are mostly professional New Yorkers. They are educated and are what some in other parts of the country might consider “older” (mid thirties to mid forties average). They have often waited to establish themselves in their relationships and professions before starting a family, but are now so excited and eager to know every detail about becoming parents. I really see a lot of interest from the partners too. Birth and taking care of their newborn is something they are approaching together which is awesome.

10. What are the craziest questions you had from your clients/students? What are pregnant moms most concerned/worried about? What are they excited about?
First time moms are very interested in what labor will feel like and how they will know when they are actually in labor. This is the most natural question because we are always most anxious about the unknown! They are also worried about knowing when to leave for the hospital and getting there “in time”. There are always those outlier stories where the baby is born in a cab, but I try and stress that for first time moms there is usually plenty of time at the hospital, even if they get there in active labor as I suggest. Most of my clients are just excited so about meeting their baby!

11. Do moms struggle with breastfeeding? What have your experiences been as a lactation consultant? What has been the most difficult part and what has been the most rewarding?
The benefits of breastfeeding, both for babies and moms, is on the minds of most first time parents. They want to breastfeed and are eager to get things off to a good start. I always say breastfeeding is beneficial and attainable, but not always easy. Moms may have pictured this beautiful, natural bonding experience (and it can be!), but when the picture in their mind and reality don’t match up they often don’t know where to turn. OBs and Pediatricians are rarely trained in lactation so I can’t stress enough how important it is to have the number of a Lactation Counselor on hand before you give birth. As a Certified Lactation Counselor I visit new moms in their home, asses latch, position and answer questions. But most of all I give reassurance and support. Inviting a stranger into your home in the first few days or weeks after bringing a baby home can be nerve-wracking, but I promise you I expect to find moms in their robe and dirty dishes in the sink! There is nothing more rewarding than watching a new mom get a great latch for the first time. Their shoulders and face relax and they can really start enjoying just staring at this amazing person they made while they nurse.

“There is nothing more rewarding than watching a new mom get a great latch for the first time. Their shoulders and face relax and they can really start enjoying just staring at this amazing person they made while they nurse.”


Thank you so much, Hilary for sharing your life with us. We feel very inspired! You can find more about Hilary in her bio below.

9 Things No One Tells You After the Baby Comes Out…

This post was originally written for Mitera Collection’s Blog and appered there in April 2015. Mitera is an amazing collection of chic maternity and nursing dresses that launched this Spring.

My Postpartum Life: 9 Things No One Tells You About After the Baby Comes Out…

Being pregnant is pretty amazing. Literally billions of women have done this before you but when YOU get pregnant it still feels incredibly special. And incredibly daunting.

Once you see those two pink lines there is only 9 months to get a lot done. What?!?!?!?! If I took a positive pregnancy test I’m probably already at least 4 weeks pregnant? OK, 8 months to get it all done.

You may feel an immediate need to go buy a pregnancy book and “cram” for what the heck is happening in your uterus. You devour the first four or five chapters, then get freaked out and/or bored and hide said pregnancy book.

Or maybe you become obsessed with the registry. So many women do. If you could have the perfect crib mattress and right number of swaddling blankets things will be ok. And if you don’t want 27 yellow baby towels, you should create a registry. This is done online because those big box baby stores will scare the s*it out of you and confirm that you are indeed not financially stable enough to have a baby. Spoiler: you need about 10% of the stuff on the “suggested” registry list (note: there are many articles written about this like this one, this one and this one). But if you find yourself comparing stroller reviews on more than 5 websites at 1 am. Step away from the laptop.

Either way most woman realize around the 7th month mark that this thing really is coming out and you have no idea how (see: hiding pregnancy book) so you sign up for a childbirth class and there will be videos. Of actual BIRTH. But you take it anyway and you even keep your eyes open. Maybe you take the newborn care class too, because rumor has it that once you have the baby you get to (read: have to) take it home and care for it for the next 18-34 years.

With the amount of time and effort you have spent preparing for this baby you’d think there would be no stones left unturned. But in new mom groups and message boards all over the country, someone is sharing a “no one told me about THAT story”. And they tend to focus on what happens immediately AFTER the baby comes out.

Perhaps you never did put that laptop down and you are still adding and deleting things from your registry in the wee hours. Woman give birth everyday, you can just “wing it” right? As a childbirth educator I suggest you don’t, but I’ll let you keep reading too.

So what can you anticipate happening in the first 5 minutes? 5 Hours? 5 days after childbirth?

Read on.
First 5 minutes

1. Cord Clamping
50 years ago dads weren’t with laboring women in the delivery room. But today’s modern parents are “in this together”. Since dad can’t carry the baby, or labor or push, we’ll let him cut the cord! Totally the same thing. A lot of dad’s really do feel excited about their “job” in the delivery room because it makes them feel more involved in this momentous thing their wife just accomplished (they basically just witnessed you being superwoman).

But don’t rush! Studies show that delaying clamping and cutting the cord by at least 1 minute can increase an infants hemoglobin levels and help prevent iron deficiency in the first 3-6 months. Your doctor will clamp the cord before Dad cuts it, so make sure you have a conversation with your doctor BEFORE the baby comes out, letting her know that you want to delay the clamping.

2. Giving “birth” to the Placenta
You’ve labored; you’ve pushed and now finally met your baby. Dad cuts the cord (after 1 minute!) and you’re in skin-to-skin new family bliss. But wait! There’s more! Is that another contraction you feel?! You still need to deliver the placenta (referred to as the third stage of childbirth). Besides making a human, No Big Deal, you also created a whole new organ! The placenta has been delivering oxygen and nutrients to your baby via the umbilical cord and once your baby is delivered the uterus will continue to contract to expel it.

This could take an average of 5-20 minutes (or more) naturally, but doctors are sometimes anxious to deliver the placenta and make sure your uterus is contracting down to its previous size and there is no sign of hemorrhage. They may even “massage” your abdomen or gently pull on the umbilical cord to move things along. This one falls into the category of wide range of experiences. Some woman don’t even notice the delivery of the placenta, others fall in to the “No one said anything about THAT” group. You have been warned.

3. Hospital Procedures
There are plenty of decisions you may need to make during your hospital stay. Shared room or private? Circumcision? And of course officially naming your baby. But two things that usually aren’t up for debate are giving your new baby a Vitamin K injection and antibiotic eye drops.

Vitamin K is given in the rare chance your baby has an undiagnosed clotting disorder and the eye ointment is given to protect your baby’s eyes from possible infections transmitted during birth. Both of these were traditionally done within the first 5-10 minutes after birth. Your baby would be wiped down, weighed, diapered, receive the Vitmain K and eye drops, be swaddled and returned to you. Sometimes in the blur of childbirth this is exactly how it happens. If it is, I encourage you to unwrap your baby and put them skin-to-skin so you can start the bonding process and get ready to start breastfeeding.

Even more optimal would be holding your baby skin-to-skin from the get-go and delaying these procedures for the first hour. You can even ask they be done on your chest. Tell the nurse and pediatrician in the room that that’s what you would prefer and enjoy those first minutes together!

First 5 Hours:

1. Breastfeeding
We all know about the benefits of breastfeeding, and getting it started on the right track. But often I see moms so stressed out about breastfeeding that they are hunched over trying to force a latch in the first 2 minutes! You just pushed out a human lady! Take a minute!

Look at your baby. Kiss your partner. Kiss your baby. Repeat. Make sure baby is skin-to-skin and just breathe. Sometime in the next 30-45min you may notice your baby “head butting” your chest. This is the time to gently bring baby’s nose to your nipple and offer your breast. Your nurse should be able to help with latch. Make sure you are assessed by a Board Certified Lactation Consultant sometime during your hospital stay and go home with their phone number so you can head off any issues before they start.

2. Using the bathroom
After giving birth the thought of anything else exiting “down there” can be a little terrifying. Even the thought of peeing can make you cringe. But sooner or later nature will need to take its course, don’t put it off! It will just make it worse. Even if you have stitches, they were made to withstand the pressure. Drink LOTS of water, as a bonus it’s a good habit to get into while breastfeeding. Make sure you take the colace they will give you at the hospital and have some at home too. This should help keep things “comfortable”. Use the squirt bottle for rinsing afterward and keep some cold witch hazel pads handy for calming swelling and irritation.

And in the toilet there will be blood, more than you think (discussed in our previous post). It’s totally normal and will start to decrease as your uterus shrinks down. I know, the last paragraph made you reconsider what you have gotten yourself into. But I promise, if you follow these tips it will all “come out” ok. I couldn’t resist…

3. Keeping mom/baby together
When your mother gave birth she may recall sending you to “the nursery” while she recovered. Babies would be returned every 3 hours or so for feeding and then brought back to the nursery. This practice is starting to disappear. We know now that keeping mom and baby together is best, and many hospitals are working on earning their “baby friendly” designation from WHO which includes encouraging 24 hour rooming in. Keeping baby close helps promote breastfeeding (which should be done “on demand” not on a three hour schedule) and bonding.

For this reason it’s also best to turn down baby’s first bath at the hospital. A bath can cool down baby’s core temperature, causing her to be kept under warming lights until it comes back up and prolonging the separation from you. How silly! You know what’s the perfect warmer? Mom’s chest. Wiping baby down and having the first bath at home is what I recommend to all my clients.

First 5 Days:

1. Milk Coming in
Even before you gave birth your body was making baby’s first milk, colostrum. This nutrient dense powerhouse is what baby will receive in those first days at the hospital. But when your placenta was expelled it signaled to your body to start making mature breast milk, which should be noticeable around day 2-4. Some women feel a heavy “full” feeling in their breasts and may start leaking between feedings. Others feel as though their chest has been replaced with a recently augmented starlet’s (as discussed in our previous post). Sorry Hubby, these aren’t for you!

To keep those rock hard boobs comfortable make sure you are breastfeeding OFTEN and emptying one side before moving to the next. If your breasts are so engorged that baby is having trouble latching, hand express a little milk into a cloth to soften things up first. In between feedings try cool compresses. Pretty soon things will start calming down and you can start wearing shirts again. Until then you may want to limit visitors.

2. Healing “down there”
After giving birth your baby will be seen at the pediatrician’s office the day after you get home, a week after that and the week after that. You, the one with the stitches and the non-existent pelvic floor? See ya in 6 weeks!

If you tore during delivery try and take a look at your stitches with a hand mirror before going home. Yes, I said that. But that way you can keep an eye on things back at home to make sure everything is healing ok. Take it SLOW. My first day home with my firstborn I attempted to walk to the bagel store 5 blocks away. We needed to take a cab home. Don’t overdue it and things will heal much faster than you anticipate. That being said, contact a pelvic floor specialist if things just don’t feel “right”. Yes, there is physical therapy for your pelvic floor, don’t knock it and your bladder control and sex life will thank you.

3. Hormones
Baby Blues. Weepy. Emotional. Whatever you call it, it can sometimes catch us off guard. You were so excited to become a mom, so why can’t you stop crying? Besides the physical and emotional experience of birth just barely out of your rearview mirror, your hormones are adjusting from being pregnant to caring and nourishing a newborn. It takes a little while to feel like you again. I famously had a complete breakdown because no one had brought me any soup during week one. If you still don’t feel like yourself after the first few weeks, it may be a sign that things are more serious. While much less common, it’s OK to feel like you can’t get out of this fog by yourself. Ask for help. Tell your OB, your partner, your neighbor, just tell someone. And partners? Be patient, be kind and make her some damn soup.