Care of the newborn infant during the third stage of labor

Abstract

The third stage of labor begins after delivery of the infant and ends with the completed delivery of the placenta and its attached membranes, being a unique period in the transition from fetal to extrauterine physiology. The care of the newborn during this period needs updated knowledge since while the placenta persists attached coexisting with bidirectional umbilical flow, several changes interact to achieve neonatal circulatory and ventilatory autonomy. Consequently, the healthcare team must find the optimum moment to clamp the cord being important for terms and preterms. An engorged and pulsating cord, a sign of vitality, should be used in the clinical evaluation of the newborn added to other signs of physiological changes as the skin blue to pink during the first minutes of extrauterine life. Other aspects must be considered as transference of iron, cooling prevention, respiratory support as needed, and microbiota. In this sense the setting for maintaining together the mother and the baby needs redesigning the delivery room and the healthcare-team work.