Before Baby Arrives: What to Do and When

Not everything is equally urgent—so here’s the checklist by pregnancy week. Wherever this says “you both,” it applies just the same if you’re on your own—what changes then is explained in a separate box further down. Your timeline might look like this:

• By week 12: Choose your OB-GYN or midwife; if you want a birth center or home birth, ask right away. Check what your health plan covers for pregnancy and birth. If your work is physically demanding or involves chemicals, sick people, or animals, talk to your employer early—many employers must make reasonable accommodations for pregnant workers, but only once they know.

• Weeks 13–20: Tour hospitals, and look into a childbirth class and a postpartum exercise class. Money tight? Check whether you qualify for Medicaid, and call 211 for local help with things like food and diapers. Unmarried: ask your hospital about the form to establish paternity.

• Weeks 21–28: Choose your baby’s pediatrician, plan your leave with your employer and check your state’s paid leave rules, ask daycares about waitlists, and order a stroller and crib. At the start of the last trimester: get the whooping cough vaccine.

• Weeks 29–34: Take your class, both talk to HR about which leave you qualify for and what paperwork they need, apply for paid leave if your state has it, pack your paperwork folder, and take an infant first-aid class.

• From week 35: Install the rear-facing infant car seat, pack your hospital bag, and finalize your plan for when labor starts. Confirm your leave dates with your employer now, too.

A lot can wait, though: the nursery, because your baby will sleep in your room during the first year; a high chair; toys; and a closet full of clothes. You don’t need breathing sensor mats or smart socks—there’s no evidence they prevent sudden infant death syndrome. A lot can be bought secondhand; just look especially carefully at the mattress and infant car seat.

What you need from day 1—ideally all set by about week 36:

• a safe sleep space with a new, firm mattress and two sleep sacks

• a rear-facing infant car seat—even if you don’t own a car, for the ride home and any taxi or rideshare

• a stroller or a baby carrier

• newborn-size diapers, a changing mat, burp cloths

• five to seven bodysuits and sleepers in newborn and 0–3 months sizes, plus one hat for outdoors

• a digital thermometer

• for you: postpartum pads, mesh underwear, nursing bras, and breast pads

• if you’re formula feeding: a few bottles, a bottle brush, and infant formula

Sort this out as soon as you know you’re pregnant: in the US, most families don’t get home visits after the birth, so it helps to know now who you’ll call.

Your OB-GYN or midwife handles your prenatal care and your postpartum care, which should wrap up with a full checkup by 12 weeks. Your baby’s first checkup is usually at 3 to 5 days old at the pediatrician’s office. Your health plan covers much of this—check what’s in network. Here’s how to do it:

1. 1

   Choose your baby’s pediatrician before the birth—many offices offer a prenatal visit. Check that the office is in your health plan’s network and who answers after hours.

2. 2

   Contact several offices at once—better five than one. Say your due date, whether this is your first child, what kind of support you’re hoping for, and how to reach you.

3. 3

   Look up a lactation consultant (IBCLC) near you now; your health plan may cover it.

Nobody coming to your home? That’s normal in the US. Here’s who to call in the first weeks:

• Weight, feeding, umbilical cord, jaundice: pediatrician’s office. Call right after the birth to book the checkup at 3 to 5 days old.

• Your healing—stitches, scar, postpartum bleeding, breasts: your OB-GYN or midwife.

• Breastfeeding: the hospital’s lactation consultants, breastfeeding support groups such as La Leche League, and IBCLC lactation consultants (your health plan may cover it).

• Mood: your OB-GYN, midwife, or primary care doctor. In the US, you can also call or text the National Maternal Mental Health Hotline at 1-833-852-6262, any time.

• Everyday help: ask family and friends for concrete help. Some communities offer free home visiting programs for new parents; your pediatrician or local health department can tell you what’s available.

Some hospitals also have patient navigators or postpartum clinics—ask about that when you tour.

Birth hospital, birth center, or home birth—the key is where you feel safe. Birth centers and home-birth midwives only have a small number of spots, so ask right at the beginning, including what your health plan covers and what you’d pay yourself. If you’re expecting twins, at risk of preterm birth, or have a health condition that could affect the birth, plan with your OB-GYN for a hospital that also cares for premature babies. These questions are worth asking at tours and info sessions:

• What paperwork do you need from us before the birth?

• Will my baby stay undisturbed on my skin after birth, including after a C-section?

• Do you offer 24-hour rooming-in and breastfeeding support on the ward, and what do you provide for the first days?

• Is the hospital certified as “baby-friendly”?

• Who examines our baby before we go home, and how long do families usually stay?

Ask your hospital what to bring—usually your ID, your insurance card, and any paperwork it asks for—and talk through your birth plan with your OB-GYN or midwife if you want. A few lines are enough: who’ll be with you, what pain relief you’d consider—such as an epidural—your wishes around skin-to-skin contact, cord clamping, first latch, and what matters to you if a C-section becomes necessary. A birth plan isn’t an order form: if things go differently, the team will still quickly know what’s important to you.

It’s best to take a childbirth class in the last trimester, but book it early so it definitely finishes before your due date. Many hospitals and community centers offer classes; ask whether your health plan covers any of the cost. Look into a postpartum exercise class at the same time: these usually start six to eight weeks after the birth—again, ask about costs before you book.

Sort out the logistics by about week 36:

• Who takes the older child or the dog? Choose two people, in case the first one can’t be reached at night or the baby comes early.

• How will you get there? Do one practice run: where will you park at night, and which entrance is open? Don’t count on a taxi or rideshare having an infant car seat—bring your own.

• Who will you call? The numbers for labor and delivery, your support person, and your backup care are saved in your phone and written on paper.

• The hospital bag is packed by the door: photo IDs, insurance cards, your pregnancy records, any paperwork your hospital asks for, comfortable clothes, postpartum pads, snacks, charging cable, and something for the baby to wear.

The first newborn exam happens in the hospital, the next checkup is usually at 3 to 5 days old at the pediatrician’s office, and the next one at 1 month. Call pediatric practices near you during pregnancy—many offer a prenatal visit—and ask:

• Are you accepting newborns, are you in our health plan’s network, and when should we call after the birth?

• How early should we book the 1-month checkup?

• Do you offer newborn appointments separately from sick visits?

• Who should we contact for urgent concerns outside office hours?

If every office says no, call your health plan and ask for pediatricians in your network who are taking new patients.

If you’re planning a birth center birth or a home birth, clarify in advance who will handle what: vitamin K (in the US, as a shot right after birth), the checkup at 3 to 5 days, the blood sample for newborn screening between 36 and 72 hours of life, the hearing test, and pulse oximetry screening for hidden heart defects. Read the parent information about these now, so you don’t have to decide under pressure later.

Three quick things to do now for emergencies:

1. 1

   Save the numbers for your pediatrician’s office and its after-hours line, labor and delivery, your OB-GYN or midwife, and 911.

2. 2

   Find the nearest ER, and check whether there’s a children’s hospital or a pediatric urgent care near you.

3. 3

   Buy a digital thermometer and put an emergency card on the fridge: your address, your baby’s name and date of birth, the most important phone numbers, and Poison Help: 1-800-222-1222.

An infant first-aid class is worth it for parents and grandparents alike.

In short: in the US, there’s no federal paid maternity leave. What you get depends on your state and your employer—so both of you should talk to your employers early.

There’s no deadline for telling your employer you’re pregnant, but many protections only help once your employer knows. Under the Pregnant Workers Fairness Act, employers with 15 or more employees must make reasonable accommodations for pregnancy, recovery from the birth, and breastfeeding.

There’s no legal maternity protection period before and after the birth. Under the FMLA, you can take up to 12 weeks of unpaid, job-protected leave within 12 months of the birth—if your employer has at least 50 employees within 75 miles and you’ve worked there for 12 months and 1,250 hours. Many people don’t qualify.

Whether any of your leave is paid depends on your state and your employer. As of 2026, 12 states plus DC pay paid family leave through a payroll program, and some states also pay through temporary disability insurance, such as California. Ask HR and your state’s program how and when to apply, and after the birth, send them the proof they ask for.

Both parents can take FMLA leave, even if you’re not married. Talk to your employer early about how much leave you want, whether any of it is paid, and what paperwork HR needs; keep their replies in writing. Here’s what that could look like with a due date of March 15:

• In January, ask HR which leave you qualify for and whether any of it is paid.

• Your partner does the same—FMLA covers fathers and partners, too.

• After the birth on March 15, FMLA leave for your baby has to be used by the following March, so plan who takes which weeks. The easiest option is to agree on a plan before the birth.

A short email is enough to start: “Our baby is due on March 15. I’d like to plan my leave. Which leave do I qualify for, and what do you need from me?” Whether your partner gets paid days off around the birth depends on the employer and state—ask early.

In short: in the US, there’s no monthly child benefit, but you can claim the Child Tax Credit on your tax return—your baby needs a Social Security number for it.

Paid family leave is a state program, so the rules depend on your state: whether it exists, how much it pays, and when you have to apply. Check your state’s rules before the birth. You can prepare almost everything in advance—the key figures are in the box below:

• Plan the weeks—who takes leave when, how much of it is paid, and whether you’ll take it at the same time or one after the other. Examples for 2026: California pays up to 8 weeks, New York up to 12 weeks.

• Federal employees: in the US, they get 12 weeks of paid parental leave.

• Taxes: for 2026, the Child Tax Credit is up to $2,200 per child under 17, of which up to $1,700 is refundable. You and your child both need a Social Security number.

• Documents: keep pay stubs and your leave paperwork together; ask whether you can apply online.

The key figures, as of 2026: there’s no federal paid parental leave in the US. The FMLA gives up to 12 weeks of unpaid, job-protected leave. Paid family leave depends on your state: California pays up to 8 weeks at up to $1,765 a week, and New York up to 12 weeks at up to $1,228.53 a week.

For children with a Social Security number born from 2025 to 2028, there’s also a one-time $1,000 deposit into a so-called Trump Account (IRS Form 4547). The hospital will help you fill out the paperwork for the birth certificate and your baby’s Social Security number; the card arrives by mail after a few weeks.

Money tight? These supports exist. Medicaid and CHIP cover pregnancy, birth, and children in families with lower incomes, depending on your state. If you’re on Medicaid when your baby is born, your baby is automatically covered until their first birthday. Calling 211 connects you with local help with food, diapers, and housing.

And here’s what many people put off: review your insurance policies, think about how you’d be protected if a main earner died, and decide who you would want as guardian—the rules for that depend on your state.

In short: you don’t have to go to a government office. You give your details at the hospital, and the hospital reports the birth to your state’s vital records office.

• Hospital or birth center: they report the birth to the state; you give them your baby’s name and can apply for your baby’s Social Security number at the same time.

• Home birth: the person who attends the birth usually reports it; ask your state’s vital records office how it works and what the deadline is.

Certified copies of the birth certificate come from your state or county vital records office for a fee. Your folder should include your photo IDs, your insurance cards, your pregnancy records, and, if you’re not married, anything about establishing paternity. A trusted person can also handle things after the birth, using a written authorization that you prepare now.

The name: you give your baby’s name for the birth certificate at the hospital. Rules for last names and custody depend on your state, so ask early if you’re unsure.

Your baby’s health insurance

• Employer plan: add your baby within 30 days of the birth; coverage then applies from the day of birth.

• Marketplace plan: add your baby within 60 days; coverage starts on the day of birth.

• Medicaid: if you’re covered by Medicaid when your baby is born, your baby is automatically covered until their first birthday.

In short, if you’re unmarried: the hospital can give you a form to establish paternity, usually right after the birth.

If you’re not married, the father is not automatically the legal father, and rules for custody depend on your state.

• Acknowledgment of paternity: both parents sign a voluntary acknowledgment of paternity, usually right at the hospital; later, it’s also possible through vital records. Bring your photo IDs.

• Custody and medical decisions: only someone with legal custody can consent to treatment for your baby. If your baby has to go to the NICU while the mother is under anesthesia after a C-section, it matters who can decide. The rules depend on your state, so ask about them before the birth.

For the mother herself, you also need a medical information release so the partner can get information about her health, and a power of attorney so they can make decisions for her. The rules depend on your state, so this is worth checking even if you’re married.

If you are two mothers, the rules for who is a legal parent depend on your state. Get legal advice early.

Has the baby already arrived? Most things are still doable, in this order:

1. 1

   Add your baby to your health plan—deadlines are short (often 30 days).

2. 2

   Tell your employer and start the leave you planned—after a preterm birth, ask HR what changes.

3. 3

   If your state has paid family leave, apply as soon as you can.

4. 4

   Call the pediatrician’s office to book the checkup at 3 to 5 days old.

After a medically defined preterm birth, for example under 5.5 lb (2,500 grams), ask your employer and your state’s program what that means for your leave. Everything else can wait.

Newborns sleep around the clock in short stretches, usually 14–18 hours a day; most don’t develop a day-night rhythm until around two months. At first, feeding matters more than hours slept: until birth weight is regained, usually after 10 to 14 days, wake a baby who sleeps longer than about four hours. These rules have been shown to reduce the risk of sudden infant death syndrome—throughout the entire first year, for every sleep:

• Always on the back, even for naps—not on the side, because babies can easily roll from there onto their stomach.

• Own bed in the parents’ bedroom: a crib, bedside sleeper, or at first a bassinet up to the manufacturer’s weight limit. A bedside sleeper should be attached flush to the parents’ bed, with both mattresses at the same height.

• A firm, flat mattress with no gap to the frame. If you use a secondhand crib, check: slats 1.8 to 2.6 in (4.5 to 6.5 cm) apart, nothing wobbles, no screws are missing, no peeling paint, and no cutouts where the head or arm could get trapped. Buy the mattress new.

• Sleep sack instead of a blanket, and the right size—not one to grow into: the neck and arm openings should be snug enough that your baby can’t slip down inside.

• Nothing else in the bed: no pillow, no blanket, no crib bumper or baby nest, no stuffed animals, no nursing pillow, no pacifier clip.

• Keep it a little cool: about 61–64 °F (16–18 °C). Feel between the shoulder blades: warm and dry is right, sweaty means too warm; cool hands and feet are normal. No hat indoors, and no hot-water bottle in the bed.

• Smoke-free, always, including no e-cigarettes.

• Protective factors: breastfeeding lowers the risk, and so can a pacifier for falling asleep—if you’re breastfeeding, introduce it only once feeding is going well.

The most dangerous situation at three in the morning: never fall asleep with your baby on the couch or in an armchair—the risk there is many times higher than in bed. If your eyes keep closing while feeding, put your baby back in their own bed first or wake your partner. If you fall asleep while breastfeeding in the parents’ bed, make it safe in advance: keep pillows and blankets away from the baby, and make sure there’s no gap to the wall. Never bed-share after alcohol, drugs, or sleep-inducing medication, if anyone smokes, or if you are completely exhausted.

Pass these rules on to anyone caring for your baby—grandparents were often taught side sleeping. Tummy time is only for when your baby is awake and supervised, but then several short times a day.

You’ll need a rear-facing infant car seat from birth, including the ride home from the hospital—and don’t count on a taxi or rideshare having one, so bring your own. Buy the infant car seat by about week 36 and practice using it without pressure:

• Does it fit your car? Check the seat’s vehicle fit guide, and make sure it meets US federal safety standards.

• Always rear-facing, and always in the back seat—in the US, front-seat airbags usually can’t be switched off, so a rear-facing seat never goes in the front.

• Practice installing it once without time pressure: the lap belt goes across the foot end, the shoulder belt around the head end of the seat.

• Harness snug, no thick jacket or snowsuit underneath—in cold weather, the blanket goes over the harness.

• Secondhand only if you know its history: a seat that has been in a crash should not go back in a car.

A certified child passenger safety technician (CPST) can check your installation before the birth.

The postpartum period—ideally six to eight weeks—is for healing and getting to know each other. Newborns usually feed eight to 12 times in 24 hours; anything you organize ahead of time is one less thing to manage afterward:

• Stock up and set things up: fill the freezer with portions you can eat one-handed. Set up a feeding spot with a water bottle and snacks, and a diaper-changing space where everything is within reach—so one hand always stays on the baby.

• Make help specific: write down what other people can take over: shopping, laundry, picking up prescriptions, taking the older child to daycare.

• Manage visitors: anyone who comes washes their hands, doesn’t kiss the baby on the face, and ideally brings food instead of gifts. Anyone with a cold, fever, or a cold sore comes later.

• Vaccine protection: a whooping cough vaccine is recommended in every pregnancy, ideally early in the last trimester. Close contacts should get vaccinated if their last dose was more than 10 years ago, ideally by four weeks before the due date—your baby won’t be vaccinated until 2 months. For RSV, the AAP recommends either an RSV vaccine for you in pregnancy or RSV antibodies for your baby in their first RSV season (if they’re born between October and March, ideally right in the hospital or at the first checkups; otherwise in the fall) if you weren’t vaccinated at least 2 weeks before the birth. Ask your OB-GYN and pediatrician which vaccines are recommended for you.

• Your own follow-up care: make a note now: your OB-GYN or midwife should be in touch within 3 weeks after the birth, and your full postpartum checkup should happen by 12 weeks.

Help at home: in the US, health plans usually don’t pay for household help after the birth. Ask family and friends for concrete help, such as meals, laundry, or an hour so you can sleep. Here’s how:

1. 1

   Set up a meal schedule with friends or neighbors so food arrives in the first weeks.

2. 2

   Ask before the birth—people help more easily when they know exactly what’s needed.

3. 3

   If you’d rather pay for help, ask about the total cost first—prices vary a lot.

4. 4

   If relatives come to help, such as a grandmother or sister, agree on who handles what so you can rest.

If your family lives far away or you’ll be alone a lot, some communities offer free home visiting programs for new parents; your pediatrician or local health department can tell you what’s available. Calling 211 connects you with local help, and contacts from your class, family centers and baby groups, neighbors, and delivery services can help, too. If your partner is going back to work after two weeks, decide now who handles which part of the night and who can be reached during the day.

Many women decide during pregnancy how they want to feed their baby, and many families end up doing both. It’s your choice, and you don’t have to justify it to anyone. Still, it helps to read up beforehand—in the first few days, there’s hardly any headspace for that.

Getting breastfeeding off to a good start in five steps

1. 1

   Undisturbed skin-to-skin contact right after birth until the first latch—ask for this even after a C-section. Your baby’s face should stay clear the whole time.

2. 2

   Feed on demand, usually eight to 12 times in 24 hours in the first days, including at night. Frequent feeding gets milk production going.

3. 3

   Respond early: lip-smacking, hand-to-mouth movements, and rooting show hunger; crying is a late sign.

4. 4

   A good latch means: mouth wide open, chin against the breast, rounded cheeks, and you can hear swallowing. If it hurts beyond the first few seconds, break the latch with your little finger in the corner of your baby’s mouth and latch again.

5. 5

   Long feeding stretches in the evening are normal and not a sign that your milk isn’t enough.

Your baby is getting enough if, from day 4, they have yellowish stools several times a day and, from day 5, at least six heavy wet diapers in 24 hours, and if they regain their birth weight after 10 to 14 days. Around 7% weight loss in the first few days is common; from about 10%, someone should take a look. The same is true for formula-fed babies.

If supplementation is needed, breastfeeding is not lost: give your own milk first and keep putting your baby to the breast or expressing milk. By hand, it works like this: place your thumb and index finger a few centimeters behind the nipple, outside the dark areola, press gently together, release, repeat in a rhythm, and catch the drops with a spoon.

Plan breastfeeding support ahead of time if you’ve had breast surgery, have diabetes, are expecting multiples, or didn’t make enough milk with a previous child. Don’t buy a pump just in case: your health insurance has to cover a breast pump—ask your plan which one and when you can get it. Help is available through lactation consultants at the hospital, IBCLC lactation consultants (your health plan may cover it), and breastfeeding support groups such as La Leche League; going once during pregnancy lets you see latching in real life.

If you’re bottle-feeding, infant formula is enough for the whole first year. Feed on demand just as you would with breastfeeding: baby semi-upright in your arms, pause for burping, and don’t pressure your baby to finish the bottle. Bottle-feeding builds closeness too—with calm, skin contact, and eye contact. How to prepare it safely is in the box below.

What you talk through calmly now, you won’t have to negotiate later between diapers and crying. Set aside one evening with no phones:

• Who takes care of which items on this checklist—and who keeps groceries and the kitchen running while you heal?

• Who takes leave when, and how much of it will be paid?

• How much visiting feels good to you—and who says no when it gets too much?

• What will you do if one of you is still crying every day after two weeks, or can’t sleep even when there’s a chance to—who will you call then?

Split the nights: so each of you gets several hours of sleep in one stretch, set a fixed handoff in the middle of the night. Whoever has the second half goes to bed early, ideally in another room, so they don’t hear the first half. If you’re breastfeeding, your partner handles everything on their shift except the actual feed: diapering, bringing the baby to you, burping, and settling the baby back down. At first, it’s better not to replace night feeds with bottles, because they support milk production. If you’re on your own, sleep when your baby sleeps, and accept every hour of daytime help you can get.

Agree on a code phrase for “I need a break right now” that applies without debate, and use the morning handoff for two honest sentences: how much you slept and what you need today. Fathers can also hit a low mood after the birth.

If you remember just five things: choose your OB-GYN or midwife and your baby’s pediatrician early. Talk to your employers about leave well before the due date and check your state’s paid leave rules. Add your baby to your health plan soon after the birth—often within 30 days. Get your baby’s Social Security number for the Child Tax Credit. Install the rear-facing infant car seat by about week 36. Everything else can wait.