On New Year’s Eve in 2007, Michelle Tsai explained how doctors determine the exact time of birth—and whether expectant mothers can try to hold out until the clocks strikes midnight. The article is reprinted below.
The first babies to be born in 2008 will have a chance to win savings bonds and other goodies from local businesses, not to mention get their wrinkly mugs in the paper. With so much on the line, how do doctors determine a baby’s official time of birth?
They wait until the entire baby—from head to feet—has completely exited the mother’s body. Usually, the newborn’s head comes out first, and takes the most time to deliver. After the head has emerged, the mother can deliver the rest of the baby’s body in another few seconds, or in some cases, about a minute. In a Caesarean section, the baby is born when it’s lifted out of the mother’s body. At that moment, a nurse will write down and maybe also call out the time of birth, usually to the nearest minute. The nurse might refer to the time displayed on a fetal monitor nearby or simply consult the clock on the wall. The time goes into the mother’s and baby’s health records and also on the baby’s birth certificate.
A minute after the official time of birth, nurses examine the baby to determine its “Apgar score,” a representation of a newborn’s health. To assign a proper score, they must check the baby’s pulse and breathing, facial and muscle responses, and the pinkness of the skin color. (Nurses repeat the exam at five minutes after the time of birth.) Meanwhile, the obstetrician coaches the new mom to deliver the placenta, which can happen shortly after birth, or up to half an hour later.
Is there any way to make sure you give birth at the stroke of midnight? Not with any certainty. Doctors can try to speed up or slow down a delivery, but they probably wouldn’t do this without a medical reason. One way to make things happen sooner would be to have an elective C-section. These operations take about half an hour, so you might try to convince your doctor to schedule something for 11:30 at night, though that’s pretty unlikely; these procedures tend to take place during the day when lots of staff are around.
During vaginal deliveries, doctors can induce labor or speed it up by giving drugs that make contractions stronger and more frequent. These might be prescribed to a mother who is long past her due date, or whose cervix hasn’t dilated enough. Doctors can also give drugs to slow down labor, for babies who are less than 37 weeks old, or if the mother’s contractions are so fast as to deprive the baby of oxygen. Either way, doctors can’t predict how much medications will actually help.
What if it’s 11:55 p.m. and the baby’s almost out—could a determined mother hold things up to secure the title? She might try, but it’s extremely difficult to do this for more than a few minutes. (Epidurals, which are given ahead of time to relieve pain, remove some of the urge to push.) Some health professionals also say that it’s possible to control labor by encouraging the mother to breathe in a particular way. For instance, it’s hard to push if you pant like you’re blowing out a candle.
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Explainer thanks Pat Allen of Northeast Georgia Medical Center, Phyllis Cohen of Long Island Jewish Medical Center, and George Wendel of U.T. Southwestern Medical School.