9 Stages Following Birth

Question 1

What are the advantages of skin to skin contact?

Answer 1

*Regulates heart rate
* Regulates breathing
* Regulate temperature
* Increases oxytocin
* Instinctive behaviour
* Bonding
* Starts to develop the microbiome
* Culminates in a successful breastfeed

Question 2

What are some barriers to achieving an uninterrupted golden hour?

Answer 2

*suturing i.e. use of entonox
*Surgery
-something wrong with mum/baby
-GA
-People around (surgeons choice, may feel pressured not to provide)
*PPH
*Resusitation of baby
*May not be safe to hold baby i.e. use of certain medicine diamorphine and pethidine (effect both mum and baby)
*parent choice

Question 3

When and who identified and published the 9 stages

Answer 3

Windstorm in 1992 after an observational study of newborn behaviour in skin-to-skin contact with their mothers immediately after birth.

Question 4

What are some of the variations in the 9 stages between person?

Answer 4

The stages are not necessarily sequential and are disturbed if the skin to skin contact is interrupted
Also there is variation in the timings of these stages.

Question 5

What are the 9 stages?

Answer 5

Birth cry
Relaxation
Awakening
Activity
Crawling
Resting
Familiarisation
Suckling
Sleeping

Question 6

What is meant by the birth cry and what time frame is this expected within?

Answer 6

Less than 2 minutes following birth. Initially cry briefly-very instinctive.
Could be more gradual with a ‘gentle’ birth when the cord is still intact.

Question 7

What is the purpose of this birth cry?

Answer 7

Inflate lungs and pushes most of the fluid from the lungs.

Question 8

What happens in the relaxation stage and what are the generalised timings?

Answer 8

Baby relaxes after birth cry and the shock of birth. Display very little movement as they recover from birth.
1-3 minutes after birth.

Question 9

What happens in the awakening stage and what are the generalised timings?

Answer 9

Start to wake up, open their eyes.
Can show response to their mother’s voice
The mother/baby relationship continues…..
3-8 minutes after birth.

Question 10

What happens in the activity stage and what are the generalised timings for this?

Answer 10

Begin to move, initially little movements, perhaps arms, shoulders and head
8-35 minutes ater birth.

Question 11

What happens in the crawling stage and what are the generalised timings for this?

Answer 11

Movements increase and the baby draws up its knees and appears to move or crawl towards the breast.
35-45 minutes after birth.

Question 12

What happens in the resting stage?

Answer 12

Once they have found the breast, they can rest for a while.
(this can be mistaken as baby not wanting to feed or not being hungry)
Babies can rest at any point during the process.

Question 13

What happens in the familiarisation stage and what are the generalised timings for this?

Answer 13

Baby gets familiar with the breast.
Nuzzling, smelling, licking around the area
This stage can take sine time
45-60 minutes post birth
(RESIST THE TEMPTATION TO HELP THE BABY ATTACH TO THE BREAST. They an work it out themselves.)

Question 14

What happens in the suckling stage?

Answer 14

Finally baby self attaches and begins to feed.
Mother and baby may need a little help (or not!) at this stage.
Don’t touch a women’s breasts.

Question 15

What happens in the sleeping stage?

Answer 15

Baby sleeps after its first breastfeed
Ideally skin to skin continues with the mother in her own bed or for transfer to post-natal ward
Do not disturb!
…this can last for hours…