The first hour after birth: skin-to-skin, the cord and the placenta

The first hour after the birth is full of small decisions. Here’s what skin-to-skin does, when the cord is cut, and the two ways the placenta can be delivered.

Skin-to-skin

The NHS says that when your baby is born you’ll be encouraged to have skin-to-skin contact as soon as possible. It says your baby can hear your heartbeat and voice, which helps to calm them. It also says skin-to-skin helps regulate their temperature, breathing and heart rate, supports bonding and breastfeeding, and helps build immunity to infections. The NHS says that if your baby needs special care, the maternity team will help you gently touch your baby until they’re well enough for skin-to-skin. See premature birth: what to expect.

You can put your wishes in your birth plan. Ask your team about skin-to-skin if you’re having a caesarean.

Cutting the cord

NICE says the cord shouldn’t be clamped earlier than 1 minute after the birth unless there is a concern about the cord or your baby’s heartbeat, and you can ask for a longer wait. The NHS describes two approaches in the third stage of labour:

Active management: you’re given an oxytocin injection in the thigh during or soon after the birth. The cord is clamped and cut 1 to 5 minutes after the birth (sooner if there are concerns). The placenta usually comes out within 30 minutes.
Physiological management: no injection. The cord is cut once it has stopped pulsing, usually 2 to 4 minutes after the birth. The placenta can take up to an hour to separate, though pushing it out usually takes only a few minutes.

If you choose physiological management and the placenta doesn’t come away, or you’re bleeding heavily, the NHS says you’ll be advised to switch to active management. The NHS suggests talking this through with your midwife during pregnancy.

The placenta

The placenta comes out after your baby, usually with some more contractions. If you have particular wishes about it, tell your midwife in advance.

Checks and next steps

If you want your baby to have vitamin K, see vitamin K for newborns. In the following days, your baby will be offered the newborn blood spot test.

When to get help

Tell your midwife straight away if you’re bleeding heavily or feel faint after the birth.

Questions people ask

Can I still have skin-to-skin if I have a caesarean?

Ask your team. Many units support it, and you can include it in your birth plan.

Is it my choice how the placenta is delivered?

The NHS describes both options, so talk it over with your midwife. They will advise you to switch to active management if there are concerns.

Can my partner cut the cord?

Ask your team in advance.

What if my baby needs to go to special care?

The NHS says the maternity team will help you gently touch your baby until they’re well enough for skin-to-skin.