Regardless of how much prep work you've done, you may not know what you're in for if this is your first baby. Right after birth, there are a number of things happening to you and your baby. In fact, those first 24 hours after delivery are full of activities you probably never thought about.
As soon as your baby has been delivered and the umbilical cord is cut, you have to deliver the placenta. This is what connected the baby to the uterus for oxygen, nutrients, and to get rid of wastes. It can take from a few minutes to a half hour as the placenta separates from the uterine wall. To help deliver the placenta, your health care provider may gently massage your lower abdomen. This helps encourage the uterus to contract, which closes off blood vessels and controls bleeding. If it still doesn't come out, you may also have to help push it out, and in some cases, your doctor or midwife might have to reach inside to remove it by hand. While the removal of the placenta may be painful, it is an important part of the postpartum process. Your provider will look at the placenta carefully once it is delivered to make sure it is normal.
Once the placenta is out, your provider will clean you up and repair any damage that was done - any tearing or an episiotomy. If you had an episiotomy, it will take 10 to 20 minutes to close and a little longer for bigger tears. If the first anesthetic has worn off, you may get an injection of local anesthetic to numb the area before the stitching starts. You may also be given ice packs to help reduce swelling and ease the pain.
After you are all cleaned up, you will be checked regularly and often, especially for the first 24 hours after delivery. Your uterus will be massaged, and you will be monitored for vaginal bleeding, infection, temperature and blood pressure. You will be encouraged to get up out of bed to help with your recovery.
In the meantime, you might be overwhelmed -- and that's normal. Your body has just gone through a dramatic event, and your nine-month odyssey is finally over. Allow yourself time to heal and know that you will feel a flurry of emotions -- ups, downs, good, bad, fear, excitement, and so on. The real adventure is just beginning!