In the minutes after birth, a rapid sequence of events unfolds for both the baby and the mother. The baby takes its first breath, is dried off and placed on the mother’s chest, and medical staff quietly assess its health. Meanwhile, the mother’s body shifts into recovery mode, delivering the placenta and releasing a surge of hormones that reduce pain and promote bonding. Most of this happens within the first hour, often called the “golden hour,” and the process differs slightly depending on whether the birth was vaginal or surgical.
The Baby’s First Breaths
Inside the womb, a baby’s lungs are filled with fluid and oxygen comes through the umbilical cord. Within seconds of delivery, the sudden exposure to cooler air and physical stimulation triggers the first cry, which forces fluid out of the lungs and pulls air in. This transition from fluid-filled to air-breathing lungs is one of the most dramatic physiological shifts a human body ever makes, and it typically happens on its own without intervention.
Staff will quickly dry the baby with a warm towel, which serves double duty: it prevents heat loss (newborns lose body heat fast) and the rubbing sensation stimulates breathing. If the baby is breathing well and crying, they’re usually placed directly onto the mother’s bare chest within the first minute or two.
Cord Clamping and Cutting
The umbilical cord continues to pulse for a short time after birth, transferring blood from the placenta to the baby. The World Health Organization recommends waiting at least one minute before clamping, and many providers wait until the cord stops pulsing entirely. This delayed clamping allows extra blood flow that improves the baby’s iron stores for up to six months. Early clamping, done within the first 60 seconds, is now less common unless there’s a medical reason to act quickly. After clamping, the cord is cut, which is painless for both mother and baby.
The One-Minute and Five-Minute Checks
At exactly one minute and again at five minutes after birth, staff perform a quick assessment called the Apgar score. Five things are evaluated: breathing effort, heart rate, muscle tone, reflexes, and skin color. Each gets a score of 0, 1, or 2, for a total out of 10. Most healthy newborns score 7 to 10. A lower score at one minute isn’t necessarily alarming, since many babies need a few minutes to adjust. The five-minute score matters more for gauging how well the baby is adapting. This assessment is done right at the mother’s chest and doesn’t require separating the baby.
Skin-to-Skin Contact and the Breast Crawl
Placing the naked baby directly against the mother’s bare chest is now standard practice, and for good reason. A Cochrane review found that skin-to-skin contact in the first hour stabilizes the baby’s body temperature, heart rate, breathing, and blood sugar levels. It also reduces crying and stress. On the mother’s side, the warmth isn’t one-directional: the hormonal surge after birth actually increases blood flow to the mother’s chest wall, warming the skin surface for the baby.
Left undisturbed on the mother’s chest, newborns display a remarkable instinct called the breast crawl. It unfolds in nine distinct stages: the birth cry, a period of relaxation, then awakening, increasing activity, a rest, crawling toward the breast, familiarization with the nipple, sucking, and finally sleeping. The entire sequence can take 30 to 60 minutes. Babies who successfully complete the breast crawl tend to latch earlier (around 51 minutes versus 65 minutes for those who don’t), breastfeed longer during the first feeding, and have higher rates of successful breastfeeding in the first 48 hours. The crawling process exercises the baby’s foraging and sucking instincts, which triggers stronger hormonal responses in the mother that accelerate milk production.
What Happens to the Mother
While the baby is being assessed and placed skin-to-skin, the mother’s body enters the third stage of labor: delivering the placenta. This stage begins the moment the baby is born and takes about five to six minutes on average, though it can range from one minute to much longer. The placenta separates from the uterine wall and is delivered with a few mild contractions that feel far less intense than labor.
At the same time, the mother experiences a massive oxytocin surge, with levels rising three to four times higher than during labor. This hormonal flood does several things at once. It helps the uterus contract to expel the placenta, reduces bleeding, lowers anxiety and pain, and activates reward centers in the brain. This is why many mothers describe an overwhelming sense of relief and euphoria in the moments after birth, even after an exhausting labor. Skin-to-skin contact with the baby reinforces the oxytocin release, creating a feedback loop that supports both bonding and physical recovery.
After the placenta is delivered, a nurse or midwife will periodically press on the lower abdomen to massage the uterus. This feels uncomfortable but serves a critical purpose: it stimulates the uterus to keep contracting and stay firm. The most common cause of heavy bleeding after birth is the uterus failing to contract, and this simple massage helps prevent that by encouraging the release of natural compounds that promote contraction. If there were any tears during delivery, these are repaired during this time as well.
Standard Medications for the Baby
Two routine treatments are given to nearly every newborn within the first few hours. The first is a vitamin K injection, administered in the thigh within six hours of birth. Newborns are born with very low levels of vitamin K, which is essential for blood clotting. Without it, babies are at risk of a rare but potentially fatal bleeding condition that can occur anytime in the first six months of life. The injection is a single dose of 0.5 to 1.0 mg, and oral alternatives are not considered as effective.
The second is an antibiotic eye ointment applied to both eyes shortly after birth. This prevents a type of eye infection that was once a common cause of blindness in newborns. It’s given to all babies regardless of the mother’s health status, because targeted screening alone isn’t reliable enough to catch every case.
Newborn Screening Tests
Within the first 24 to 48 hours, hospital staff perform a heel stick, pricking the baby’s heel to collect a few drops of blood on a special card. This blood is tested for a panel of congenital conditions, things a baby is born with that may not show obvious symptoms right away but benefit enormously from early treatment. The specific conditions screened for vary by state but typically number in the dozens.
A hearing test is also performed before discharge, using one of two quick, painless methods that take five to ten minutes. One measures whether parts of the inner ear respond to sound; the other checks whether the auditory nerve is carrying signals to the brain properly. At least 24 hours after birth, a small sensor is placed on the baby’s hand or foot to measure blood oxygen levels. Low oxygen can indicate a serious heart defect that might not be visible from the outside.
How Cesarean Births Differ
When a baby is born by cesarean section, the same immediate assessments and treatments happen, but the timeline and setting are different. The baby may need a bit more help clearing fluid from the lungs, since it doesn’t get the squeezing effect of passing through the birth canal. Babies born by cesarean are admitted to the neonatal intensive care unit more often and may have more breathing difficulties in the first hours.
Many hospitals now support skin-to-skin contact in the operating room, placing the baby on the mother’s chest while the surgical team finishes closing the incision. However, mobility limitations can make this more challenging. Breastfeeding initiation is sometimes delayed because the mother is lying flat and may have limited arm movement. Recovery from a cesarean takes six to eight weeks to feel close to normal, compared with two to four weeks for a vaginal birth, and the risk of serious maternal complications is about three times higher. Mothers who deliver surgically typically stay in the hospital longer and resume normal activities more slowly due to lifting restrictions and incision care.