Ep 127: Golden Hour: First moments with your new baby

The time immediately following birth, where you can snuggle skin-to-skin with your baby is often called the golden hour.  It’s an important time because having uninterrupted close contact with your baby can lead to better stress response of mom and baby, better immune function for baby, promotes bonding of mom and baby, can help with uterine contractions, and so much more.  But, if you are birthing in a hospital, it can take some effort and planning on your part and conversations with your provider in order to achieve your desired golden hour experience.  

That first hour alone with your baby is golden!  Check out this episode to learn more about why it’s important and how to advocate for yourself in what you want that golden hour experience to look and feel like. 

Resources mentioned:

Episode 11:  Birth Plan

Episode 102: Newborn terms ep

Transcript

Dr. Shannon (00:02.475)
Hello, hello, you are listening to the Aligned Birth Podcast. You have both hosts of the show here today. I am Dr. Shannon, prenatal chiropractor, Dula Rachel is here as well. And we are chatting about the golden hour. That's our birthday topic for the day. I hope you have heard of this word before or this phrase, golden hour. But I'll be honest. I, with my pregnancies 13, 14, 10 years ago,

I don't think I was too aware of it. And so that's why, that's a big reason why we want to talk about it today because we're going to talk about what is the golden hour, why it's important to honor the golden hour and then some ways to achieve it and some things that go on during the golden hour. So the golden hour, it's that first hour of life where you, after baby is born, where you really want to have like that uninterrupted time with baby.

Yes, there's going to be differences between if you're birthing at a hospital versus if you're birthing at home as far as achieving that uninterrupted time, but there are amazing benefits for mom and baby. And there's ways to achieve this in the hospital that can be very beneficial as well. And so you can achieve this wonderful and amazing golden hour. So I'm excited to chat with Rachel about it today because I think I'm going to learn some new things as well. So.

Welcome to the show today, my friend.

Rachael Hutchins (01:51.938)
Hello?

Dr. Shannon (01:53.107)
Hello.

Rachael Hutchins (01:56.042)
Was there a big long pause there? Okay, I don't know what happened. I will edit that out. My you froze.

Dr. Shannon (01:57.983)
There was a big long pause.

Dr. Shannon (02:04.788)
Yeah.

Oh, I froze. I was like, I'm just sitting here. You were moving. We could just edit out the pause. That's fine.

Rachael Hutchins (02:13.546)
Wonderful. Yeah, edit out the pause. You got the intro in. So I'm gonna cut out this part and pick up. Did you just kick it to me like normal?

Dr. Shannon (02:20.753)
Okay.

Yeah, I just said, so happy to have you on the show today, Rachel. Yeah.

Rachael Hutchins (02:27.434)
Okay. Hi Dr. Shannon. How are you?

Dr. Shannon (02:32.115)
I am good. Good to see you. And we get to see each other because we do, we do YouTube now and so we have our videos, so this is always fun.

Rachael Hutchins (02:34.914)
Good to see you.

Rachael Hutchins (02:38.814)
I know we have the video. I'm so excited to talk with you today about this. I love this topic. I love this conversation. And like you said, it's one of those things I think we probably are so used to talking about that we might assume everyone's familiar with it, but you shared your personal experience of like that wasn't on your radar. And so we're here to talk about the golden hour today, what it is, why it's important, like what it might look like and kind of how to achieve it. And hopefully again, we're all about kind of sharing that information so that you can be

you know, take what resonates with you and hopefully sort of shift things to meet your needs and hopefully have a better overall experience. So yeah, that golden hour is that first one to three hours right after the baby's born and it is a critical time for mom and baby. And there are many, many benefits to it, right? And there are many evidence-based benefits to having an uninterrupted first hour of life.

But please know that if you're not able to have that uninterrupted first hour, that it's not the end all be all, right? We don't wanna get too tied up in being stressed out.

Dr. Shannon (03:45.891)
Right. Because I know both of mine were different. Like I did not, there was no way possible for me to have that with my first, I had that emergency cesarean and I was going one way, my baby was going the other way, my husband didn't know where to go. So there was that aspect of it. And then second time around was a lot different. And I think one thing I didn't realize, I guess, looking at now is I want people to understand that you have a say. It doesn't have to be all these things that are happening to you or happening to your baby.

certain instances and that's one thing we want to talk about today because yes, there's the benefits of it why you want to have Maybe these thoughts and conversations during pregnancy so that you're prepared for that golden hour aspect of things So yes, there's gonna be times where You're unable to have this ideal situation in your head. That's okay

Rachael Hutchins (04:36.586)
Right, and it's all about protecting what you can protect in the golden hour. Just like with the birth plan, that element of flexibility, it's still very important to explore your options, learn about what happens during this time, and make a flexible plan that meets your needs and your preferences and aligns with the things that you want for you and your baby in this time. And then adjusting accordingly if intervention is needed or learning how to determine what interventions are actually needed and learning how to advocate.

Dr. Shannon (04:40.392)
Mm-hmm.

Rachael Hutchins (05:06.654)
um for more time if that's available or delaying things if that's available um and then protecting the things that are there's like lots of things that happen in that first bit of time after baby's here so um what can you can what can you protect um like if you need a cesarean like there is a there is a delay between when baby is born and they get skin to skin with mom that's just the nature because you're having major abdominal surgery um but getting

advocating to have that happen as soon as possible, asking for support from the nurses, kind of getting the ball rolling and knowing kind of how to navigate that so that you can do the best you can and know that that's the best you can do in certain situations and that everything doesn't, you're not failing or your baby's not going to be irreparably, is that the word, irreparably damaged. Shannon, words are hard today.

Dr. Shannon (05:37.887)
Mm-hmm.

Dr. Shannon (05:59.869)
I think that's a word. Damaged. Words have been difficult. That's okay. I don't know why it doesn't sound irreparably. Permanently non-reversibly. I'm always like, I'm gonna pick a different word.

Rachael Hutchins (06:04.496)
irreparably?

Rachael Hutchins (06:11.913)
Um, yeah.

Rachael Hutchins (06:18.594)
Yeah, and so I want you to be motivated. I want people to be motivated by the benefits of protecting the golden hour and not doing things out of fear of what might happen if they don't get the golden hour or if things intervention is needed. So we're going to talk about why right? So the benefits to the golden hour. It promotes attachment between mom and baby oxytocin boost right and

Dr. Shannon (06:26.098)
Mm-hmm.

Dr. Shannon (06:29.404)
Right.

Dr. Shannon (06:39.172)
Mm-hmm.

Dr. Shannon (06:45.793)
Mm-hmm.

Rachael Hutchins (06:48.106)
When you are skin to skin with your baby immediately after the birth, there's a transfer of hormones and connection. You're smelling your baby, you're feeling your baby, they're wiggling on your tummy, maybe they're trying to feed, stimulates oxytocin. Looking into your baby's eyes stimulates oxytocin and that is laying the foundation for the mother-baby bonding when you have that time to sort of imprint on each other. Also...

Dr. Shannon (07:03.275)
Mm-hmm.

Dr. Shannon (07:10.536)
Mm-hmm, that dyad. Mm-hmm.

Rachael Hutchins (07:16.286)
regulates baby's bodily functions. This is one of the coolest things about protecting the golden hour, having the immediate and uninterrupted skin to skin is that. So we have all these tools and okay, backing up here. This really is, I would say more geared towards hospital birth. In all the home births I have attended this, like the newborn golden hour.

Dr. Shannon (07:35.476)
Mm-hmm.

Rachael Hutchins (07:41.346)
is vastly protected for the most part and really uninterrupted and less true and less intervention is needed. I still encourage having a conversation with your home birth midwife about what they do, what you can expect, your options and all that but how we're going to talk about it here is really in regards to hospital birth. So what I was going to say is in the hospital setting there's all these tools and equipment and things and staff to support a new baby and mom right after the birth

Dr. Shannon (07:43.817)
Mm-hmm.

Dr. Shannon (08:07.077)
Mm-hmm.

Rachael Hutchins (08:11.318)
these providers in this safe place to give birth for the most part. However, with these tools like the warmer, we have the warmer and we have the mom baby nurse and they like baby has to go over there to get checked out. Or we have like all these we need to suction so we can't suction on mom. So we're going to go suction over on the warmer, like away from the way the hospital set up doesn't promote like keeping mom and baby together because there's staff, there's protocol, there's machines, there's things right.

Dr. Shannon (08:41.034)
Exactly.

Rachael Hutchins (08:41.234)
And so knowing that your body and the vast majority of situations or circumstances, your body, skin to skin with your baby is all they need. It regulates their respiratory, their breathing, their body temperature. So if they're saying baby isn't holding their temperature, really advocate for good quality skin to skin and give it a chance. And then if baby's not holding temperature then maybe they do need the warmer.

But more times than not, they just need to be in good quality, like skin to skin with a warm blanket over mom and baby. And their glucose levels helps stabilize their glucose levels, helps promote uterine contractions because again, oxytocin being skin to skin, your uterus is going to contract. So all these bodily functions that are happening just by being skin to skin immediately after the birth is going to protect mom and baby. It's designed that way.

Dr. Shannon (09:27.748)
Exitosin.

Rachael Hutchins (09:38.934)
It's not designed to be pulled apart, separated unnecessarily. This also can reduce the stress levels for mom and baby due to the oxytocin. And this is improves better breastfeeding outcomes, if that's what you're planning to do. Helps boost baby's immune system. So they have so when baby is brought skin to skin with mom and.

Dr. Shannon (09:42.087)
Removed. Mm-hmm. Exactly.

Rachael Hutchins (10:08.122)
left alone, they have vernis on their skin and they have amniotic fluid on their skin and those serve important roles. So like wiping them off or cleaning them up immediately can interfere with their immune system and then getting skin to skin with mom possibly initiating that first feeding as soon as possible is that next layer to boosting their immune support. They're going to get mom's germs which are good for baby breast milk or colostrum which helps

Dr. Shannon (10:36.378)
Mm-hmm.

Rachael Hutchins (10:37.97)
you know, germs and helps promote a solid immune system. All of that's happening when there's nothing interfere when we're not interfering with it or it's happening more optimally when we don't interfere with it and that's going to help your baby have a stronger immune system. So yeah, those are some of the benefits. Did I miss any?

Dr. Shannon (10:49.515)
Mm-hmm.

Dr. Shannon (10:56.663)
I know and promotes the uterine contractions. So I feel like you had said that though, but I can't remember if you did but Because again, oxytocin. Yeah, maybe in there. So yeah, but a lot of that is due to oxytocin too. So um And those are just some of the benefits we wanted to go over of like why This is important and why you Why I don't want to shit on you, but why you should think about this pre natally

Rachael Hutchins (11:03.638)
Yeah, I think under bodily functions.

Dr. Shannon (11:25.423)
And again, too, I guess I just didn't know that, I guess I just followed the rules when I was doing the hospital birth. And so it was kind of like, okay, this is what's done. And it's so cool now to see families start to advocate for themselves and to say, okay, no, I really wanna honor this, give me this hour. And it can make a leaps and bounds difference in how mom processes birth and how baby processes birth. Now, all this to say,

that if these things don't happen, you know, and if you can't immediately snuggle, it's not like, oh, it's all doomed. Your stress levels are gonna be crazy. You're not gonna be able to breastfeed those types of things. So, because I've talked about that before on other episodes with my birth was very different with my first. And so you can still accomplish that. It just, it might just be a little bit later, but if we can honor that golden hour, it would be really, really good. Mm-hmm.

Rachael Hutchins (12:17.41)
Yeah, you're just trying to get like a good start. You're just trying to get the best start possible. Um, and it, yes, it is not the end all be all if it doesn't happen. Um, but I think it's important to talk about too, the reality of our, of the traditional medical birthing location, which is the hospital, um, it's different in all locations, like every hospital is slightly different and I think a lot of birthers feel like I'm giving birth in the hospital, things don't happen unless they're safe.

for mom and baby. And I do think the overall goal is safety for mom and baby. I do believe that is the goal, but that doesn't mean all the practices align perfectly with what we know to be evidence-based because it's still a hospital system. They're still trying to help many, many people. There's a big part of it, yeah. And in lots, they're managing just lots of different people and scenarios and circumstances. So...

Dr. Shannon (13:00.462)
Mm-hmm.

Dr. Shannon (13:04.867)
It's just risk management is a really big part of what they're thinking.

Dr. Shannon (13:13.183)
Mm-hmm.

Rachael Hutchins (13:15.806)
giving grace where grace is due, but understanding that this doesn't just happen by default. Some hospitals are more mother-baby friendly, so that's a great term that you can use and look up, like is my hospital mother-baby friendly? That means they have met an actual certain set of standards that are more aligned with what we're going to talk about here.

Dr. Shannon (13:22.034)
Mm-hmm.

Dr. Shannon (13:30.948)
Mm-hmm.

Rachael Hutchins (13:38.346)
then if they're not mother-baby friendly. But then some people say they're mother-baby friendly, but then they're not actually. So that's where you have to kind of use your advocacy tools and ask questions and not assume that certain things are gonna happen. And that some hospitals are better than others. Like I work at some hospitals where we really have to advocate for these things. And then I work at some hospitals that this is standard of care, right?

Dr. Shannon (13:52.777)
Mm-hmm.

Dr. Shannon (13:58.323)
This is the norm, I know. So that's why you gotta look at this beforehand and take that into account. And that's why this is gonna be important for when you are going through and creating your birth plan or your birth preferences list because these things can go on there. So we're gonna go through the like what typically happens in the first one to three hours after birth. And then there's gonna be things in your nuggets where if you want to add in these things into that.

birth preferences list, then these are good things to add in there. There might be some terms. We're not going to go through and explain all the terms because we literally did a four-part series of all kinds of different terms, like prenatal terms, postpartum terms, pregnancy terms, perinatal. I don't even know what we had. We had four different episodes, but we did one that was on the newborn terms. It was episode 102. We'll link that in the show notes. So that's going to go through more specifically of what some of these words are.

Rachael Hutchins (14:41.49)
labor, newborn.

Dr. Shannon (14:55.579)
and a lot more in depth, but we do want to highlight some of the things of what to expect that way you can make an impact in your birth plan.

Rachael Hutchins (15:05.886)
Yeah, so just going to walk you through like a quote unquote typical scenario in the hospital setting. Mom is born and I say typical. I use that usually. I would say like what happens in that first one to three hours and then kind of talking about the areas that we want to protect. Right. So.

Dr. Shannon (15:21.891)
Mm-hmm. Assuming that birth was uncomplicated, you know? Yes.

Rachael Hutchins (15:26.782)
Yes, that intervention is not necessitated. Um, so baby is born. Yay. Baby's here. Immediate skin to skin, like they are still attached to the umbilical cord. That umbilical cord is still attached to your placenta and your placenta is still inside your uterus. So like you are still attached to your baby. And this is where like delayed cord clamping comes in, um, not rushing that separation process, because as long as baby's still attached, then they have to stay near you. So advocating for delayed cord clamping, which would come.

Dr. Shannon (15:33.619)
Gay.

Dr. Shannon (15:49.316)
Mm-hmm.

Rachael Hutchins (15:56.738)
Next ish, right? So advocating for waiting for white with that umbilical core, delaying until it's done pulsating, regulating between placenta and baby, making sure baby has all the blood they need. Um, and during this time, so baby has come up there, maybe on your abdomen or on your chest. Um, we're waiting on the cord to finish pulsating. Um, without you really being knowing it, your team, your birth team, like the nurse typically is assessing their Apgar.

And this is like a visual thing, it's not a physical test. They're looking at activity, how the baby's moving, their pulse, which they can take their pulse while the baby's on you. Their grimace, so it's a reflex when they pull on their arm or is the arm like kind of coming back. Appearance, their color, and respiration, heart rate, which they will put like, you know, listen to the baby's.

Dr. Shannon (16:24.525)
Mm-hmm.

Dr. Shannon (16:44.444)
Uh-huh.

Rachael Hutchins (16:50.59)
Lungs as well, but this is all happening on you and very quickly and they do an abgar at one minute and at five minutes and typically like Average what the one minute is a little bit lower than the five minute um And also during this time is if it's needed they're going to clear the airways So there's a lot of mucus when a baby is born vaginally and being born vaginally helps squeeze all that

Dr. Shannon (16:58.592)
Mm-hmm.

Dr. Shannon (17:03.272)
Right.

Rachael Hutchins (17:17.322)
a lot of that mucus and a lot of the amniotic fluid out of their lungs, like they get the big squeezes they pass through, but for some, they might still have a little bit of mucus in their throat or in their cheek or in their mouth that's hindering them from being able to get that first big breath. And if they can't get that first big breath or they're struggling to do that, then the nurse or the midwife or doctor might suction either with a bulb syringe, their cheek or their throat if needed.

Dr. Shannon (17:18.533)
Mm-hmm.

Rachael Hutchins (17:44.318)
And if that's persistent, that would be an indication for needing to do deep suction, which they would take the baby over to the warmer and do deep suction. At home, home births just for point of reference, they can do deep suction on mom. And they often do, but it's just a totally different technique and a totally different approach. So knowing kind of like, okay, that's interesting. Right. So clearing of the airways and it's not always necessary. So really advocating for only using that bulb syringe.

Dr. Shannon (18:09.175)
Mm-hmm

Rachael Hutchins (18:15.306)
and suction if it's needed. Temperature, they're gonna take baby's temperature and they're gonna stimulate the baby. So maybe rubbing the baby's back, rubbing their feet, kind of really making sure they're active in the way they need to be active. Either they're responding, they're not. So like if they're rubbing the baby's back, some people are like think they're getting cleaned off and usually it's just the nurse is trying to stimulate. So baby's like skin to skin, like tummy to chest on you and they're maybe rubbing.

Dr. Shannon (18:24.779)
Mm-hmm.

They're responding to stimuli.

Rachael Hutchins (18:42.39)
baby's back or you're there telling you, okay, rub baby's back, talk to baby. Like just helping stimulate, making sure they're responding and pinking up, perking up, kind of getting that first, maybe cry in. Um, they don't always have to be screaming to be good. Um, but just making sure that all those things look good. Um, at the same time happening to you is they're monitoring your bleeding. You're delivering your placenta. You're they're going to check for any tears.

Dr. Shannon (18:45.672)
Mm-hmm.

Dr. Shannon (18:57.784)
Mm-hmm.

Rachael Hutchins (19:11.294)
and they're gonna help clean you up. And if there are tears, they would do any repairs needed and then clean you up. All the while, ideally, baby is on your chest during this time, because that's again gonna help promote oxytocin, uterine contractions, and that helps slow and stop bleeding.

Dr. Shannon (19:22.314)
Mm-hmm. Mmm.

And that octitocin, that's what promotes, that helps deliver the placenta as well. So how long does it, is it typically take for the placenta to be delivered? Like if mom doesn't need any additional, like, you know, fungal massage and those types of things.

Rachael Hutchins (19:31.656)
Placenta.

Rachael Hutchins (19:42.546)
anywhere from like five minutes to 45 minutes. Most people wanna see the placenta come within 45 minutes. So that would be on the long end and they might do some intervention with Pitocin or other things if it's not delivering on its own. So again, baby skin to skin, there's a huge dance of hormones and connection and bonding happening during this time. And it's all happening relatively fast.

Dr. Shannon (19:45.682)
Okay.

Dr. Shannon (19:50.64)
Mm-hmm.

Dr. Shannon (19:57.328)
Okay.

Rachael Hutchins (20:10.614)
In a hospital setting at this point, there's a lot of people in the room. So, you know, the midwife has showed up. Usually you have your main nurse. There'll be a second nurse that comes in as you're, you know, when you're really getting closer to delivering, then there's usually one or two baby nurses. If you had any kind of meconium in your amniotic fluid, when your water broke, there's a, they'll bring in NICU, which is like, um, one or two from them. Just in case. So

Dr. Shannon (20:10.643)
Mm-hmm.

Dr. Shannon (20:14.776)
Yeah. There's a lot.

Dr. Shannon (20:35.291)
More people. Yeah.

Rachael Hutchins (20:38.878)
I say all that to say it gets rowdy. Like, and you're wanting a calm, peaceful environment, most people. And so we like to talk about it so you're prepared for what's gonna happen. And again, choosing.

Dr. Shannon (20:42.932)
Mm-hmm.

Dr. Shannon (20:48.839)
Yeah, because even in my head right now, I'm like, that would be so good to like watch a hospital birth video If someone's got what you know, if you see one and then that way you can see what to expect at that afterwards I mean because yeah, it sounds like there's like a party going on

Rachael Hutchins (21:04.85)
Yeah, and I would say most moms are, I feel like dads are usually like, what's happening? Why are there so many people here? And mom is like in post labor land, you know, intoxicated by her baby, intoxicated by hormones for the vast majority. Cause I usually try and get in their ear and be like, just so you know, so and so is here, just so you know, a couple more people just showed up. This is their purpose. Like, so they're not overwhelmed. So they know what's going on. And a lot of times they are.

Dr. Shannon (21:16.235)
Oh yeah.

Dr. Shannon (21:27.989)
Mm-hmm.

Dr. Shannon (21:31.899)
Mm-hmm.

Rachael Hutchins (21:32.93)
they're not fully aware of it all, which is a good thing. Like, right, you know, you're focused on your baby. So if baby's with you, you're more focused on baby. And I always encourage like smell your baby, kiss your baby. If you wanna get real crazy, lick your baby. Like there's just a lot to be said with that immediate time together while all this other stuff is happening, right? So also during this time, you wanna initiate that first feeding.

Dr. Shannon (21:35.395)
Yeah. Yeah, yeah, yeah. I remember that with my second.

Dr. Shannon (21:57.108)
Mm-hmm.

Rachael Hutchins (22:02.562)
So after all these other things have happened, things are starting to settle down and baby is starting to like hunt and peck on your chest, getting a little wiggly, maybe birdie mouth, maybe they're smacking their lips. These are signs they're ready to feed, initiate that first feeding. So getting that going too is gonna boost oxytocin, which is again gonna help with what you need in that moment, which is uterine contractions to help with either placenta or bleeding. And...

Dr. Shannon (22:10.419)
Mm-hmm.

Dr. Shannon (22:28.959)
Mm-hmm.

Rachael Hutchins (22:30.994)
it's going to stimulate the prolactin to like get your body ready to produce the milk. It's sending the signal. We are ready to go here and also getting colostrum. So colostrum is your first milk. So when you are doing that first feeding, you don't have like straight up regular milk ready to go.

Dr. Shannon (22:46.663)
Right. It does not look like how it would when if you're pumping like way later. Mm-hmm. It's a small amount. Mm-hmm.

Rachael Hutchins (22:50.318)
how you envision it right it's like the tiniest amount remember half a teaspoon half a teaspoon per feeding tummy size is like a cherry and colostrum is really thick but it is highly nutritious it lines their gut it boosts immunity you know it's got everything they need in it it's the perfect milk for your baby so do not be concerned if you're not gushing milk at this stage your baby is getting just what they need and reminders of like the quantities that they need is very little

Dr. Shannon (23:02.196)
Mm-hmm.

Dr. Shannon (23:17.663)
Mm-hmm.

Rachael Hutchins (23:17.794)
But getting that going at this point is really good for baby's blood sugars so that we can keep mom and baby together. What else? OK, so after the one to three hours and after you've had that first feeding. So that's really important that you have before the next step set of things. You've got that first feeding in. So if they're coming in wanting to move on to the next thing,

Dr. Shannon (23:34.271)
Mm-hmm.

Rachael Hutchins (23:46.622)
successfully latched I would like more time. Anything that's happening next is not emergent and can be delayed like without rush. So get that first feeding in, settle down, bond. Like that's why I say one to three hours because we've talked about the golden hour it is the first hour but really like if you can go like three hours of like pure bonding before the next set of things because they're not necessary for

Dr. Shannon (23:49.797)
Mm-hmm.

Dr. Shannon (23:54.795)
Yeah.

Dr. Shannon (24:09.323)
Mm-hmm.

Rachael Hutchins (24:14.758)
the health and well-being of the baby, right? So, but a lot of times they will, the nurse might come over and say, can I borrow your baby? Like just wanna go ahead and get all their stuff done. And they might use the weight as the enticement because everyone always wants to know the weight. And while they go away, then they do all this other stuff. So protecting that time, make sure you get that first feeding in. And then they will ask to take the baby over to the warmer.

Dr. Shannon (24:33.874)
Mm-hmm.

Rachael Hutchins (24:43.126)
And I say the warmer in the hospitals I'm birthing in, it's in the room. It's like just in the little like carve out space of the room. It's like a space for the baby to lay. It weighs them. It has all the tools on it. They would need to take care of baby. And then it's got a warmer on it. So they can lay there completely unclothed and be warm. But this is where they'll get the weight of the baby. They'll measure the baby, get their hand and footprints, revisit their vital signs.

Dr. Shannon (24:51.519)
Mm-hmm.

Dr. Shannon (24:55.349)
Yeah.

Dr. Shannon (25:01.681)
Mm-hmm.

Dr. Shannon (25:11.955)
We'll do the newborn screening, probably the heel prick and everything as well too, typically, I think in that, or is that later?

Rachael Hutchins (25:12.316)
Listen to their heart, get in their pulse.

Rachael Hutchins (25:17.078)
The hill prick in my experience isn't happening until they're on the mom and baby floor or the postpartum floor. Yeah, but that is something that happens, but not typically in this first window. For the places I'm working now, the hill prick you're mentioning is something that they do. So it's worth asking, like, when does this happen based on where you're giving birth? And that is where they're doing that screening for all the metabolic disorders. And that's like a little...

Dr. Shannon (25:21.929)
Oh, not in baby floor. Okay.

Dr. Shannon (25:27.212)
not in that first three hours. Okay.

Dr. Shannon (25:38.46)
Right.

Dr. Shannon (25:43.489)
Mm-hmm.

Rachael Hutchins (25:46.242)
piece of their heel, they, and then they squeeze some blood drops onto like a postcard and then they mill it off. My experience is that's happening on the postpartum floor. While they're got the baby on the warmer, they're also going to do, if you've agreed, you have, you have a say in these eye ointment, which is the erythromycin, the drops in the eyes, vitamin K injection and the hepatitis B vaccine. They're going to do all that in this first assessment of baby.

Dr. Shannon (25:49.251)
to get some blood on it.

Rachael Hutchins (26:13.662)
And so that's a lot of things happening at once for a baby. So you can delay and say, no, we'll do these when we're on mom and baby or, and I say mom and baby, that's like the postpartum floor. You leave like labor and delivery and you go to another floor. So you can delay to then, because again, it's really not emergent that they get them right away. And you can, you know, accept or decline those three things. Um, then they're going to clean up the baby, but not bathe the baby. Like if they're goopy.

Dr. Shannon (26:16.555)
Mm-hmm.

Dr. Shannon (26:23.148)
Mm-hmm.

Dr. Shannon (26:35.231)
Mm-hmm.

Rachael Hutchins (26:42.87)
which babies can be goopy, you know, they got vernix or they've got meconium or whatever, poop if they pooped on themselves, they get them kind of cleaned up but they're not giving them a bath. And they'll diaper and swaddle them and bring them back to you. Which is when you will then immediately unswaddle them, unswaddle that magnificent swaddle. It's like a little bundle. And I think there's great satisfaction in for nurses just to be like, here you go. And then the nurse, you know, leaves. I'm like, okay, let's undo the baby.

Dr. Shannon (26:45.04)
Mm-hmm.

Dr. Shannon (26:58.171)
Yes, I know. They give you this like little bundle. Yeah, a little burrito. Yeah.

Uh... Heheheheh...

Rachael Hutchins (27:12.362)
So you unswallow them and get them immediately skin to skin. So optimal skin to skin is baby on your chest or your partner's chest if you're unable to, and then like warm blankets on top of you. So nothing in between baby skin and mom or dad's skin, and then wrap them up, and that's gonna keep baby nice and stable with their temperature.

Dr. Shannon (27:16.115)
Mm-hmm.

Dr. Shannon (27:24.162)
Mm-hmm.

Exactly.

Dr. Shannon (27:32.683)
Exactly. And I think it's important to mention that, you know, maybe you did have emergency cesarean and mom has to go somewhere else or there's lots of other things going on and the baby's doing fine and maybe baby and your partner are together and your partner can do um skin to skin. I mean obviously not the one that gave birth but still so beneficial and again that would be where it's literally skin to skin so

Rachael Hutchins (27:53.355)
Mm-hmm.

Dr. Shannon (28:01.335)
partner would have shirt off but then being you can be like wrapped in a blanket and that sort of thing because that can also and I think if you as mom if you've been through something and knowing that okay your partner maybe you're able to do skin to skin that like that can also bring like calming and stress relief to you as well.

Rachael Hutchins (28:18.538)
Oh yeah, I always remind mommas of like if you're feeling like if there's a lot going on, maybe you're having to be like there's some stitches you need to be repaired. you're coming down from Laborland or your there's some other things going on, if you need a minute I always remind them the next best place is skin to skin with dad so. let's pass them over let's let him do some skin to skin that's great for dad it's great for bonding it's great for baby it's still has many, many benefits and then, when you're ready back to mom. And like I said there's a serian a serian like.

Dr. Shannon (28:29.395)
Mm-hmm.

Dr. Shannon (28:34.055)
Mm-hmm.

Dr. Shannon (28:43.179)
Mm-hmm.

Rachael Hutchins (28:46.638)
front loading and preparing dad to be like, okay, I'm having major surgery. Even if it's on the fly, you've talked about it beforehand. If it ends up, I need a cesarean, like I will have to be in or in the O R being sewn up after the baby's born. And that's like 30 minutes, 45 minutes. You can be with baby. And when you're a baby, be skin to skin, like get them on board with that, because that's the next best place for them to be.

Dr. Shannon (28:55.425)
Mm-hmm.

Dr. Shannon (29:04.444)
Mm-hmm.

Dr. Shannon (29:09.827)
Mm-hmm. Exactly. So, you've got options, you know? It's not end all be all.

Rachael Hutchins (29:21.362)
Yeah, I think the biggest way to achieve this, the things I would recommend to do to achieve it is to know what is happening at your birth location. Ask people who have given birth there, ask your provider questions about what is happening in that first one to three hours after the birth and have these conversations before the birth. Like, how do you support the first few hours after I give birth? How does the hospital staff support the first few hours after birth?

you know, what typically occurs like we just talked about, um, and decide on your preferences before the birth. So you're not overwhelmed because they're going to be like, you got to sign consents for IOI and vitamin K and hepatitis B either consent or decline. And you're going to be like, I have no idea what you're talking about if you haven't explored those options, um, beforehand. So this is all about front loading, prepare before. Yeah.

Dr. Shannon (29:57.102)
Mm-hmm.

Dr. Shannon (30:11.383)
Exactly. This is that prep work. And it's a big part, I think, of what needs to go in that birth plan, that birth preferences list as well too. Because again, too, even if it doesn't all happen as you want, it's that knowledge because then you maybe didn't know all of this stuff happens.

Rachael Hutchins (30:23.838)
Mm-hmm. Yep. Birth planning. Yep.

Dr. Shannon (30:35.547)
in that first hour, the first one to three hours. And so now you do because you're planning and trying to come up with that plan.

Rachael Hutchins (30:45.802)
It can be less overwhelming, less feeling like things are happening to you or the baby without your control. And that matters how you feel, just like it matters while you're giving birth. It matters how you feel after the birth and how you're the care for your newborn. So it's a philosophy across the board. Um, and there's no right or wrong and there's no, you should do this or shouldn't do that. It really is just about the front loading, gaining like knowledge, support and advocacy, um, so that you can navigate it with

Dr. Shannon (30:47.491)
Mm-hmm. To you.

Dr. Shannon (30:57.579)
Mm-hmm.

Rachael Hutchins (31:13.566)
more ease and confidence and that'll leave you feeling better about your birth and hopefully have a great start to motherhood.

Dr. Shannon (31:19.131)
I know with your births, because you had your first in a hospital and then your second was the home birth. What? I feel like you did a good job at your hospital birth though too, as far as like protecting your environment and everything. But did you notice a difference with your golden hour in those two experiences? Yeah.

Rachael Hutchins (31:24.088)
Mm-hmm.

Rachael Hutchins (31:31.501)
Mm-hmm.

Rachael Hutchins (31:37.118)
Yeah, yeah, because the golden hour for my home birth was like, completely uninterrupted. Like they're not doing nothing. You know, like it is, they took, they made sure I was stable, baby was stable, bleeding was under control, moving to the bed and just protected me and the baby. I'm like, they're charting and they're cleaning up and they're getting some food and like letting that first full hour go by before they're even doing.

Dr. Shannon (31:45.131)
Mm-hmm.

Dr. Shannon (31:49.933)
Yeah, yeah.

Dr. Shannon (31:54.367)
Mm-hmm.

Rachael Hutchins (32:06.386)
anything. And they're peeking on the baby, right? So midwives are magical in the way that they, it's not that they're not doing anything. Yeah, they're observing, they're listening, they're, you know, they'll come over and peek in and maybe listen to the heart tones if they need to or they'll, you know, they're doing without doing. Do you know what I'm saying? Like, so I want to have that, I want people to have that confidence that it's not that they're just like,

Dr. Shannon (32:07.538)
Yeah.

Mm-hmm.

They're sneaky. They're like, they're so sneaky. Yeah.

Dr. Shannon (32:31.277)
Mm-hmm.

Rachael Hutchins (32:35.542)
truly doing nothing. They're just, no, it is quite the opposite. Um, and cause Marshall was, had a slow, he was slow to start. Um, and he bought, we borderlined on needing a transfer, but he didn't need resuscitation. He was just like a little quiet and, um, his coloring was a little off, but they were, so they were peeking on him a little bit more, but not like he was just on me, you know.

Dr. Shannon (32:35.667)
They just left you high and dry. Yeah, no, no.

Dr. Shannon (32:52.432)
Mm-hmm.

Rachael Hutchins (33:02.118)
Swaddled not swaddled up but covered up and skin to skin with me and I was working on feeding and all of that and they Were just I think peaking on him a little bit more Because of that. So again, they were just acutely aware and paying a lot of attention while giving space For and then like there's no I mean they're not doing They're not doing my own it or vitamin K or by a hep B vitamin K is we did like an oral vitamin K So yeah, I think it's

Dr. Shannon (33:09.387)
Mm-hmm.

Dr. Shannon (33:17.544)
Yeah.

Dr. Shannon (33:27.933)
Mm-hmm. You can do an oral one. Mm-hmm.

Rachael Hutchins (33:32.23)
really hard to compare, but definitely different in a really good way.

Dr. Shannon (33:34.631)
Mm-hmm.

Yeah. But it's good to, I mean, you know, it's good to have that knowledge base. There's so much that I use or talk about in the office from a standpoint of like, oh, well, it could be like this if we do these things. I'm like, what just happened over here? So a lot of my experiences are like, whoa, it could be totally different. Yeah. Let's get some things in place beforehand. Let's do some work.

Rachael Hutchins (33:51.182)
I'm sorry.

Rachael Hutchins (33:59.726)
could go this way.

Dr. Shannon (34:07.207)
beforehand so we can we can impact that so that's all good.

Rachael Hutchins (34:11.086)
Yeah, and it's there's all kinds of perspectives and yeah, there's no right or wrong and in the hospital even hindsight I had a lot of preparation and advocacy, but I got caught up in Like I post-birth like that things did sort of just happen That you know before you know it babies on the warmer and I was like in such labor land that I was just like, okay My dad had brought me some food. I was starving. So I ate and you know, it was a lot of things were still protected But also a lot of things just sort of happened which is the part that it

Dr. Shannon (34:15.081)
Mm-mm.

Dr. Shannon (34:25.105)
Mm-hmm.

Dr. Shannon (34:39.067)
Yeah, I guess I would say Mm-hmm Yeah, no, I feel that too because my births were so different. So I had that V back with my second I remember I was in such labor land because I had the V back and I remember I'm just I was like This is awesome to where I don't really remember I don't remember like a lot of like post birth skin to skin, but I was still so freakin happy. So it was like

Rachael Hutchins (34:40.774)
leaves you feeling a little bit like I could have done better there.

Rachael Hutchins (34:51.796)
Yeah!

Dr. Shannon (35:05.211)
And I remember, I do remember seeing like Baby on the Warmer and just kind of like watching all the things they were doing, but it wasn't like a, oh, I wish Baby was over here. I was more like, I just had my feedback. This is great. And I think they were like doing the stitches and stuff like that. So, you know, like it was interesting, but even after that, the first Assyrian, I was, it's kind of the after the fact where you're like, oh, I kind of hate that I missed that, but I was so freaking tired that I couldn't even function.

Rachael Hutchins (35:15.15)
I see a lot of that.

I see a lot of that, yeah.

Dr. Shannon (35:34.447)
So it was like, I just needed rest. So it was, you know, there's those things that happen too. Sometimes, but you don't. Yeah. But it's interesting.

Rachael Hutchins (35:34.817)
Yeah.

Rachael Hutchins (35:40.434)
Right, yes, all versions, all scenarios, and you can't fully prepare or predict. It's just a general awareness. And then I think when you have some awareness, it helps you to accept some of the things that did come up, because you at least understand. I see a lot of the trauma and disappointment coming when they just don't understand what happened or things. Yeah, yeah.

Dr. Shannon (35:52.799)
Mm-hmm.

Mm-hmm.

Dr. Shannon (35:59.615)
Mm-hmm. And yeah, so I think, you know, one other nugget too to add to this is, okay, yes, it's important to do the research for your birth preferences list, but then also I think watching videos, watching a video of a cesarean birth, watching a video of a home birth and watching a video of just a normal physiological hospital birth and seeing what goes on afterwards could be so eye-opening and enlightening as well too. It could really make a difference. So.

Rachael Hutchins (36:13.814)
Mm-hmm.

Rachael Hutchins (36:20.174)
Mm-hmm.

Rachael Hutchins (36:27.83)
Absolutely. I'm always encouraging watching real birth and we have such access to it now. Kind of familiarizing yourself with what it looks like. Cause again, most people haven't done this before, right? Or they had, you know, one or two times in their life for the most part. So, so yeah, we will add some of the things that we talked about here in the show notes. Thank you guys for listening and tune in next week for a brand new episode.

Dr. Shannon (36:33.321)
Mm-hmm.

Dr. Shannon (36:38.671)
Exactly.

Dr. Shannon (36:43.078)
Mm-hmm.