Adriana describes important elements of the “golden hour”- those crucial and magical first moments right after your baby is born- especially for you, the birthing person.
Might parents, parents-to-be, and birthworkers: this is part one of a three-part series on the benefits of the golden hour. Stay tuned!
Right after birth, did you need a minute before meeting your baby? Tell us about your experience during the golden hour on Instagram @birthfulpodcast.
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Related Birthful episodes:
- The Baby’s Birth Experience
- Third Stage of Labor
- [Postpartum] Hemorrhages Explained
- Shaking and the Primal Nature of Birth
- Why You Want to Do Lots of Skin-to-Skin With Your Baby
- 7 Huge Benefits of An Undisturbed First Hour After Birth, BellyBelly
- Providing Evidence-Based Care During the Golden Hour, Nursing for Women’s Health
- The ‘golden hour:’ Giving your newborn the best start, Sanford Health
- The First Hour After Birth: A Baby’s 9 Instinctive Stages, The Magical Hour (Healthy Children Project)
- Step 4: Evidence – Based Care During the Golden Hour, Becoming Baby Friendly in Oklahoma webinar
- Healthy Birth Practice #6: Keep Mother and Baby Together— It’s Best for Mother, Baby, and Breastfeeding, The Journal of Perinatal Education
- Golden hour of neonatal life: Need of the hour, Maternal Health, Neonatology, and Perinatology
- Third stage of labour: delivering placenta and cord clamping, NCT 1st 1000 Days: New Parent Support
- Delivering the placenta, Tommy’s
- Holistic physiological care compared with active management of the third stage of labour for women at low risk of postpartum haemorrhage: A cohort study, Women and Birth
- Retained placenta after vaginal birth: How long should you wait to manually remove the placenta? MDEdge
- Postpartum Hemorrhage, Stanford Children’s Health
- Postpartum Hemorrhage, March of Dimes
- F is for Fundal Massage, Calming Waters Birth Services blog
- Delivery of a Newborn With Meconium-Stained Amniotic Fluid, ACOG Committee Opinion
- Updates to neonatal, pediatric resuscitation guidelines based on new evidence, American Academy of Pediatrics
- Your Baby’s First Cry – What Does It Signify?, First Cry Parenting
- Skin to Skin Contact, UNICEF UK: The Baby Friendly Initiative
- Benefits of Parent-Baby Skin-to-Skin Contact, VeryWell Family
- Kangaroo Mother Care website
- Kangaroo Care, The Cleveland Clinic
- Kangaroo Care, March of Dimes
- Kangaroo mother care started immediately after birth critical for saving lives, new research shows, WHO
- The life-saving benefits of kangaroo care, BBC Future
Why the Golden Hour Matters for You
Hello mighty parents and parents to be. I’m Adriana Lozada, and you’re listening to Birthful. And today, I wanted to hone in on that crucial and magical time right after your baby is born known as the golden hour.
After all that hard work that you’ve done of giving birth, you would think it’d be easy to just chill with your baby and taken in all that just happened and connect with this new member of your family that also just went through a huge transformation, as they transition into the sensorial explosion of being outside the womb, right? It’s so different being outside than inside.
Now, physiologically, there are a fantastic set of really complex processes that need to happen for both of you during this first hour, during this time, that allow for stabilization and bonding and imprinting and the completion of the birth process (because that’s not done until the placenta’s out) and the initiation of breastfeeding, which is also part of the blueprint that your baby follows to fulfill their needs.
Unfortunately, as often happens when birthing in the Western world, these biological imperatives are interrupted by the protocols that happen in all places of birth. So then the trick is figuring out how to integrate things in a way that enables your provider to verify that all is well with you and your baby while keeping your space as undisturbed as possible, because that is the goal.
Also, let me just say that it’s not about what happens during the golden hour exclusively, but what happens before during the birth is also going to impact the golden hour and the postpartum period because, you know, it’s all connected. Now, as I prepared for this episode, I realized that trying to explain the importance of the golden hour and how to navigate it in 10 minutes was a ridiculously lofty goal. So instead, I’m going to split it up into three episodes, and today we’re going to focus on your physiology during that hour.
Then next time we’ll talk about what happens with your baby. And then after that, we’ll focus on how to best support those physiological needs within your place of birth, including how to join forces with your care provider so that your wishes are supported and honored and it’s a team effort.
Okay. So let’s start then with you, and talk about what needs to happen during that first hour after your baby is born.
Broad strokes, there are three big things that happen for you during that time. The first is the neurological integration of the experience, then there’s the claiming of your baby for bonding, imprinting, and initiating the process towards milk production, and parallel to that is the wrapping up of the pregnancy itself through the delivery of the placenta. In terms of the neurology, you have a need to integrate experience. And this may require you to take a minute to sort of come back to the room from that deep internal space you were in, also known as “laborland,” as you went into transition and then birth your baby. Because let’s be real here, you just did an enormous thing.
For some people, this transition is almost immediate, and for others, it can take a few minutes. So if you need a moment or longer before you can switch your attention to your baby, that’s totally fine, totally normal. As Mary Esther Malloy so beautifully put it, and I’m paraphrasing here, you need to exhale the birth before inhaling the baby.
As part of this integration, you may have what’s called involuntary shaking. And even though that shaking can be really annoying, know that your body is doing some important work, getting rid of stress hormones from the experience. For a deeper dive on this particular subject, I suggest listening to my episode with Lesley Everest called “Shaking and the Primal Nature of Birth.” And I find that this neurological need to integrate the experience also happens for surgical births, not just vaginal births. But in that case, the process tends to be a little bit more drawn out over the first few hours, because the hormonal production flows different depending on what interventions you might have.
So at some point, your focus will be all on your baby. If you’ve had a vaginal birth, then your baby will probably be either placed on your abdomen or your chest, or be close to you so you can be the one to place them on your chest. Ideally, this is happening skin-to-skin, meaning your naked baby on your bare chest.
And this skin-to-skin is a fabulous thing for both of you and a great way to keep your oxytocin flowing because this oxytocin is going to help you attach to your baby. Also during skin-to-skin, your brain releases beta-endorphins, which are analgesic-like hormones that help you feel calm, reinforce the pleasure in interacting with your baby, and encourages you to respond to your baby. Which makes sense, because if it feels good to do it, then you’ll do it more.
This bonding and hormonal flow has been linked to increase maternal confidence and being able to care for babies during the postpartum period and is part of why this initial time with your baby, this golden hour is so important.
Also, connecting with your baby in this way is going to make you calmer, reducing the production of adrenaline, and allowing for the production of prolactin, which is needed for milk production. There is good evidence showing that skin-to-skin during this time increases breastfeeding exclusivity and duration, as well as maternal satisfaction.
Okay, now, remember the placenta? Until it comes out, you are still pregnant. So you also need the flow of oxytocin to help the uterus contract and get the placenta out. A very common concern during this time is getting the placenta to detach while limiting bleeding to avoid postpartum hemorrhaging. And again, here’s where the increase oxytocin is your friend.
So as you take in your baby and gaze into their wide-open eyes that are gazing right back at you and you check out their fingers and the lips and the cute face and comfort them as they maybe give a little cry, all these interactions increase oxytocin and help the placenta to detach and also come out quicker, as well as lessen the risk of hemorrhaging and bleeding in general.
Other good things that will continue to support that oxytocin flow are the same things that we’re working during labor, having a quiet and dim, warm and peaceful environment where you feel safe and supported and not stressed or anxious.
Now, the process of delivering the placenta can get complicated depending on your provider’s approach towards delivering it, but that approach usually falls in one of two camps: either the active management of the third stage of labor, or the more hands-off physiological approach.
Also, depending on what interventions happen during your birth, then that’s going to impact what is needed for the delivery of the placenta. Let me give you an example of this. Research shows that there is a higher risk of having a retained placenta following an induction versus letting labor start on its own. And it seems that the longer a person is exposed to Pitocin, then that risk goes up.
The theory behind this is that when your body produces oxytocin, it does so in pulses or bursts, which allow your body to then quickly metabolize it, so that then the oxytocin receptors are not flooded and the uterus is more receptive to the following pulses of oxytocin over time. When you have Pitocin, that is delivered continuously via your IV, so the receptors may become desensitized, which then makes the uterus less responsive and may increase the risk of hemorrhaging.
Now, of course, this is not the only reason why postpartum hemorrhaging can occur, but it does support the need for a more aggressive management of the third stage of labor if you’ve been exposed to Pitocin for a long time. We’ll talk more about what that active management of the third stage of labor entails in the episode that focuses on the provider procedures during this golden hour, but it’s important to know that depending on how much or how little of a physiological birth you have, that can impact the physiology of the delivery of the placenta and also how those interventions will be something to navigate during the golden hour.
In terms of how quickly providers want to see the placenta delivered, I find that all of them want it to come sooner than later. But in very rough terms, the protocol time limits tend to be up to 30 minutes, if doing active management of the third stage, and up to 60 minutes, if following a physiological approach. Now, that’s broad strokes.
To be honest and regardless of the approach, it can be helpful to expect that your focus is going to be diverted from your baby by your care provider in order to get that placenta out, which is why in that future episode, we’ll also talk about how to come together with your provider to help minimize disruptions during this golden hour.
For the time being though, plan on lots of continuous skin-to-skin, focusing on connecting with your fresh new baby, and just losing yourself in their gaze and their adorable little sounds and just how cute they are.
You can connect with Birthful on Instagram @birthfulpodcast. And to learn more about Birthful and my birth and postpartum preparation classes, go to birthful.com.
Birthful was created by me, Adriana Lozada. This episode was produced by LWC Studios: Paulina Velasco, Jen Chien, and Kojin Tashiro.
Thank you for listening to and sharing Birthful. Be sure to follow us on Apple Podcast, Goodpods, Amazon Music, Spotify, and everywhere you listen, and come back for more ways to inform your intuition.
Lozada, Adriana, host. “Birthful: Why the Golden Hour Matters for You.” Birthful, Birthful, March 2, 2022. Birthful.com.
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