Changes in the heart at birth
Circulation bypasses the lungs during gestation, but closure of shunt valves in the
heart re-routes blood to the lungs after birth. Charles White (1773) pointed out that
this cannot be expected to happen instantaneously. Circulation to the placenta
should be allowed to continue until the alveoli of the lungs have sufficient blood
supply to begin to receive oxygen in exchange for carbon dioxide.

"Can it possibly be supposed that this
important event, this great change which
takes place in the lungs, the heart, and
the liver, from the state of a foetus, kept
alive by the umbilical cord, to that state
when life cannot be carried on without
respiration, whereby the lungs must be
fully expanded with air, and the whole
mass of blood instead of one fourth part
be circulated through them, the ductus
venosus, foramen ovale, ductus
arteriosus, and the umbilical arteries and
vein must all be closed, and the mode of
circulation in the principal vessels entirely
altered - Is it possible that this wonderful
alteration in the human machine should be
properly brought about in one instant of
time, and at the will of a by-stander?"
White C (1773) A Treatise on the Management
of Pregnant and Lying-In Women. Canton, MA:
Science History Publications, 1987, p 45
Available from:
http://www.shpusa.com/bkindex.html
Charles White (1728-1813)