The road to life. Neonatal transitions to extra-uterine life

The onset of labour and birth initiates profound changes for infants. It is essential to understand these unique aspects of childbirth; doing so will equip midwives with the ability to detect deviations from expected trajectories, take appropriate actions, but most importantly support normal birth transitions. These transitions involve a complex cascade of physiological, anatomical and behavioural changes acting in concert. This article overviews essential knowledge about the early adaptive changes after birth and considers initial cardio-respiratory and metabolic responses to birth, together with how midwives can support the best possible start for infants.