Skin-to-Skin After Cesarean Delivery

 

 

sjmh_csection
First mom at Houston Methodist San Jacinto to experience skin-to-skin contact in the OR

 

As a nurse, I think we all know the benefits of skin-to-skin contact immediately after delivery. But after cesarean delivery?! Yes 😃  With a little bit of work, it can be done. And the patient’s ❤ it!

The resistance:

  • staffing
    • In our old approach, the nursery nurse that “caught” the baby would immediately take the baby back to the nursery.  The baby would be fully assessed, medications and bath would be given, and the baby would be taken back to the mom 4 hours later. (This seems so cruel writing it out on paper!)
    • In our new approach, a newborn transition nurse stays with the baby until the PACU recovery of the mother is completed. Baby stays with mom and dad in the OR and then mother is transferred to recovery room with baby skin-to-skin. When recovery of mom is completed, care of mom and baby (as long as both are stable) is given to a family nurse (that’s what we call couplet care nurses).
  • anesthesiology-
    • One of the first things we did was target one anesthesiologist.  Their buy-in was paramount. Their main concern was that we were not expecting them to take care of mom and baby. We also gave them literature that moms who experienced skin-to-skin in the OR were less likely to need antiemtics and experienced less pain and anxiety.
  • obstetrician –
    • Once we had buy in from one anesthesiologist, we then targeted one physician. Initially, this was tricky. We had to convince them that the baby would not interfere with their sterile field.
  • patient –
    • Once we had a couple of physicians in mind that we thought we could approach with the idea, we targeted a patient that we thought would be interested in the idea in one of our prenatal classes. Once we had the patient picked out, we went to her OB with “this is something that your patient has requested.”

When we were ready to trial this one patient, with our one anesthesiologist, with our one OB physician, we made a really big deal about it.  We called the local paper and they wrote up a great article.  When the mom came out of the OR, all the nurse’s had lined up outside of the OR and were clapping as she made her way to our recovery room with her baby skin-to-skin.  We had balloons and our director bought our unit cake and icecream.  It was great 😃  The physician loved his patient’s response to the experience so much that he started asking that all of his cesarean patients be given the opportunity to utilize skin-to-skin in the OR. Word quickly caught on and more and more physicians wanted to do it.  By then, we were already educating our moms in our prenatal classes to talk to their OBs about skin-to-skin in the OR prior to being admitted into the hospital.

 

I’m going to post some quick links with some good articles, but I’m working on compiling a link with journal articles supporting skin-to-skin in the OR.

http://www.ncbi.nlm.nih.gov/pubmed/21743355

http://www.bestforbabes.org/booby-traps-series-skin-to-skin-in-the-operating-room-after-a-cesarean-birth-is-possible-improves-breastfeeding-rates-could-this-be-the-beginning-of-a-trend/

http://evidencebasedbirth.com/the-evidence-for-skin-to-skin-care-after-a-cesarean/

 

 

Until my next delivery ❤


7 thoughts on “Skin-to-Skin After Cesarean Delivery

  • May 8, 2014 at 10:06 pm
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    I love reading your blog! I’m an LDRP nurse in Pennsylvania. I love my job as if it were my fifth child. When I catch a baby in a section, the mom is the first one to hug the baby. I don’t even do an assessment if babe is pink, breathing clear, and has a good heart rate. I wouldn’t in a vaginal delivery. Mom gets immediate skin-to-skin no matter how the mom/baby chooses to have the birth go. I always tell them, “it’s not my baby…it’s yours…I already have four and got to hold them right away…you earned this”. I love that you feel the same way. Keep writing. Keep advocating. I love every word!

    Reply
  • May 10, 2014 at 12:44 pm
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    I am an OB nurse in Long Island, New York . We are a Baby-friendly hospital at Stony Brook Medicine and have incorporated skin-to-skin for only select c/s deliveries. Usually not enough time to initiate it in the OR but it is our standard of care in our PACU even with bottle-fed babies. We are now delaying first bath to help babies transition easier. Leaving vernix on skin actually has even more benefits!!!

    Reply
    • May 10, 2014 at 12:53 pm
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      That’s great! After all the changes we have made, there has been a lot of resistance to delaying the bath! Lol of all things

      Reply
  • April 26, 2015 at 11:41 am
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    I am scheduled to have a c-section one year and one day after this was posted, and my doctor has already offered me a gentle csection and skin to skin in the OR without me having to even ask. So grateful for the pioneering work that you do! It creates new norms that change the scene across the country. I’m going into this feeling so positive about the surgery.

    Reply
  • April 22, 2016 at 2:39 pm
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    I had a section six months ago and I was the first person to hug my son. I even nursed him on the table! It was wonderful

    Reply

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