You have spent months preparing for this day. And then the baby arrives — and nothing fully prepares you for what the first few minutes actually feel like. The room is busy, the nurses are moving fast, and you are running on adrenaline, exhaustion, and something that doesn’t have a name yet.
Knowing what happens in those first moments — and why — gives you something to hold onto when everything else feels like a blur. This is your birth day checklist: the five initial steps of newborn care that happen right after delivery, explained plainly so you know what to expect and what to ask for.
Why the First Minutes After Birth Matter So Much
The transition from womb to world is one of the most significant physiological events a human being ever experiences. Your baby goes from a warm, fluid-filled environment with oxygen delivered through the umbilical cord to breathing air, regulating their own temperature, and processing light, sound, and sensation — all within seconds.
The steps taken immediately after delivery are designed to support that transition as safely and gently as possible. Most of them happen quickly and quietly. Understanding them in advance means you can be present for them rather than confused by them.
Health Canada’s guidelines on newborn care are the primary Canadian reference for standard newborn care practices. They are worth reading before your due date.
Step 1: Skin-to-Skin Contact
The first thing that should happen after a healthy delivery is skin-to-skin contact between you and your baby. Your baby is placed directly on your chest, uncovered except for a warm blanket across their back.
This is not just a sentimental moment. Skin-to-skin contact in the first hour after birth:
- Stabilizes your baby’s body temperature using your own body heat
- Regulates their heart rate and breathing
- Supports blood sugar stabilization
- Triggers the release of oxytocin in both you and your baby, supporting bonding and the initiation of breastfeeding
- Colonizes your baby’s skin with your beneficial bacteria, which supports immune development
In a vaginal delivery without complications, skin-to-skin should begin immediately. In a cesarean section, it can often still happen in the operating room. Ask your care team about this in advance so it is documented in your birth plan.
The first hour of skin-to-skin is sometimes called the golden hour. Routine procedures — weighing, measuring, bathing — can wait. Skin-to-skin cannot be replicated later.
Step 2: Delayed Cord Clamping
Until relatively recently, the umbilical cord was clamped and cut within seconds of delivery. Current evidence — and current Canadian practice guidelines — support waiting.
Delayed cord clamping means waiting at least 60 seconds before clamping the cord, and ideally until the cord stops pulsing on its own. During that time, blood continues to flow from the placenta to your baby — transferring iron-rich blood that supports brain development and reduces the risk of anemia in the first year of life.
The Society of Obstetricians and Gynaecologists of Canada (SOGC) recommends delayed cord clamping for most healthy deliveries, both vaginal and cesarean.
Ask your care provider whether delayed cord clamping is their standard practice. If you want it and it is not routine at your hospital, put it in your birth plan and confirm it again on the day.
Step 3: APGAR Score Assessment
At one minute and five minutes after birth, your baby will be assessed using the APGAR score — a quick evaluation of five physical indicators:
- Appearance (skin colour)
- Pulse (heart rate)
- Grimace (reflex response)
- Activity (muscle tone)
- Respiration (breathing effort)
Each category is scored zero, one, or two. A total score of seven to ten is considered normal and healthy. A lower score at one minute is common and does not indicate a problem — it often simply reflects the adjustment of the first moments. The five-minute score is more clinically significant.
This assessment happens quickly and quietly. You may not even notice it happening. The nurse or midwife will announce the scores, and you can ask what they mean at any point.
Step 4: Warmth, Drying, and Stimulation
Newborns cannot regulate their own body temperature. Within seconds of delivery, your baby’s skin is wet, and that moisture causes rapid heat loss. The care team will dry your baby immediately — which also provides mild stimulation that encourages the first breath and cry.
If your baby is on your chest for skin-to-skin, a warm blanket placed over both of you serves this function. The warmth of your body is more effective at maintaining your baby’s temperature than any warmer.
In situations where skin-to-skin is not immediately possible — such as a baby who needs additional support at birth — your baby will be placed under a radiant warmer while the care team completes their assessment.
A hat is typically placed on your baby’s head promptly, since significant heat loss occurs through the scalp.
Step 5: Vitamin K Injection and Eye Drops
Two routine interventions happen in the first few hours after birth in Canadian hospitals, and both are worth understanding in advance.
Vitamin K is given by injection shortly after birth. Newborns are born with very low levels of vitamin K — a clotting factor — which puts them at risk for a rare but serious bleeding condition called Vitamin K Deficiency Bleeding (VKDB). A single intramuscular injection of vitamin K at birth effectively eliminates this risk. It is recommended for all newborns by Health Canada and is considered standard of care across Canada.
Erythromycin eye ointment is applied to prevent potential eye infection from bacteria that can be present in the birth canal — specifically Neisseria gonorrhoeae and Chlamydia trachomatis, both of which can cause serious eye damage in newborns if untreated. Some parents ask about this one; your care provider can walk you through the current evidence and provincial recommendations for your specific situation.
Both interventions are brief. Neither causes lasting discomfort. And both can be delayed slightly so they do not interrupt the golden hour of skin-to-skin contact — ask your care team to hold routine procedures until after that first hour if possible.
What You Can Do to Prepare
Knowing these five steps before you arrive at the hospital means you can advocate for the experience you want. Write a birth plan. Use specific language — delayed cord clamping, golden hour skin-to-skin, hold routine procedures — and confirm it with your care team on admission.
The steps themselves will be managed by trained professionals. Your job in those first minutes is to be present and let them happen.
If you are still building out your hospital bag, our Labour and Delivery Bag guide walks through everything to pack for birth day — including what most checklists leave out and what Canadian hospitals typically provide.
And if you are thinking ahead to the first weeks at home, our Newborn Essentials guide covers everything you actually need for the first three months — vetted for Canadian safety standards.
→ Read our Labour and Delivery Bag guide — what to pack, what hospitals provide, and what most lists miss.
→ Read our Newborn Essentials guide — everything you need for the first three months, verified for Canadian safety standards.
→ Shop the full Cradle Song Co collection — every product verified for Canadian safety standards.
