Standard Newborn Procedures at Birth

Standard Newborn Procedures

When writing your birth plan, it's not just about the labor and birth itself! It is also helpful to have a think about those first few hours and days after birth, and whether or not you have a preference about some of the routine newborn procedures that happen right after the birth.

If you decide to opt out of any of these standard policies, it is helpful to have had a clear conversation with your OB, midwife, and the pediatrician or neonatologist about the benefits and risks of accepting or declining. Doing your research ahead of time will help you to feel confident and ready to have that conversation!

Here are the routine procedures that all newborns born in the hospital encounter. To learn more about recommendations for skin-to-skin, rooming-in and timing and setting of newborn procedures, check out the AAP's recommendations. {If you are having a homebirth, your doula can help you understand what your options and choices are for many of these routine hospital care procedures}:

Cord Clamping

All newborn babies need to detach from their placenta and umbilical cord! It used to be that this happened right away at the birth, but a lot of research points to the benefit of waiting for at least a few minutes, or until the cord stops pulsing. Most of the area hospitals in Dayton and Cincinnati and providers do "Delayed Cord Clamping." where they wait around 3 minutes to cut the cord. 

Weight & Height Measurement

At some point after birth your baby will be weighed and measured. This usually happens within the first two hours. Most of the Dayton and Cincinnati area hospitals will wait to do these measurements until after the first "golden hour," when they try to keep you and the baby skin-to-skin. There is a lot of research to demonstrate the numerous benefits of keeping mom and baby undisturbed and skin-to-skin for at least one hour if both are healthy and stable during a normal delivery. There are a few hospitals, however, that routinely take the newborn immediately at birth for a few moments to take these measurements, so it is worth asking. 

Vitamin K Injection

Vitamin K helps blood to clot properly, and babies are born deficient in this vitamin. It is standard procedure for hospitals to give newborns an injection of Vitamin K at birth to prevent a rare, but serious, bleeding condition. This one is typically very strongly encouraged. This can be done with the baby in your arms or even nursing if desired.

Erythromycin Eye Ointment

This antibiotic eye ointment is given to prevent blindness. The most common reason a newborn would contract blindness after birth would be exposure to the sexually transmitted diseases gonorrhea and chlamydia. It is also possible, although not common, that other bacteria could cause an infection. This can be done with the baby in your arms or even nursing if desired.

Hepatitis B Vaccine

This is the first vaccine on the CDC schedule given to all new babies to prevent Hepatitis B. Hepatitis B is transmitted sexually or through blood contact. This can be done with the baby in your arms or even nursing if desired.

Other Testing & Screening

  • Suctioning: No longer standard at most hospitals, occasionally a newborn will need to have their airway suctioned with a small bulb syringe at birth to help clear mucous for breathing. This only happens when there is an indication. This can often be done while the baby is still in your arms right at the birth.
  • Metabolic Testing: A simple blood test using a small sample of blood from a heel prick is sent to the laboratory to screen for 36 rare but serious disorders and diseases. You often will not hear the results unless something comes back that needs to be investigated and treated. This test is mandated in Ohio, and can be done in your room.
  • Hearing Screening: This non-invasive, 5 minute test checks the hearing of your newborn so that follow-up screening or treatment can happen early if needed. Basically, it just looks like a pair of headphones on your baby hooked up to a monitor! Most of the Cincinnati and Dayton hospitals will do this screening at the bedside in your room. This test is also mandated in Ohio.
  • Heart Screening: A pulse-oximetry screening is performed on all new babies to screen for heart defects. This screening is noninvasive, and involves simply placing sensors on the baby's foot for a few minutes, which can be done at the bedside. This test is mandated in the state of Ohio.
  • Glucose Testing: Most newborns do not routinely have glucose testing, which involves a small prick of blood from the heel to check blood sugar levels. Only babies that are showing symptoms or fit certain criteria are tested. Reasons your baby might be checked are:
    • You have diabetes or gestational diabetes.
    • Your baby is extremely large or extremely small for gestational age.
    • Your baby is showing physical symptoms.
    • Your baby was born premature or ill.