S2S as the Standard That Should Be

I wrote a two-parter a while back on cesareans, not (for once) on how to avoid them or about the epidemic in its societal context, but instead about how, if one did become necessary, to make the absolute best of the situation. One post focused on birth plans, and the other on a doula's role when birth becomes surgical. Check them out if you haven't read them - I won't rehash here, but suffice it to say that there is MUCH that can be improved on, for both mother and child.

Needless to say, I was thrilled to see this post by veteran OB Nurse 35 Years, on one of the most potent factors: S2S - Skin to Skin Contact Minutes After C/S in the OR. YES. (And she links to the same excellent breastfeeding video I just shared, hooray!) Skin to skin is vital, whenever an emergency doesn't preclude it, due to so many things, like its positive effect on breastfeeding initiation, regulates temperature, reduces crying, the fact that it functions, itself, as an analgesic for healthy babes, and the simple profundity of, yes, bonding. Check her bad self out:

Why is it so hard for the doctors and nurses to get on board? Most of them understand the word “bonding”. But what many don’t realize is that it took a long time for the actual concept to take hold, to allow “time” for bonding to occur. It sounds silly but many times if the baby and mother are still together after 2 hours…the nurses call that “extended bonding”. I have been doing this for over 35 years now and the changes from the 70′s to now are fascinating and frustrating at the same time. To understand the process of change, we have to sometimes remember where we’ve been.

I wrote about Medical Science vs Natural Childbirth a year ago because I feel history IS important to help us move forward. Often it is about control… but many times nurses and doctors are simply task oriented/ focused and not patient centered. They want to complete all their procedures and charting and move on to the next task. I understand this, there is always a lot to do and document. I work there too! The environment provided to us, the health-care workers, is one in which regulations are abundant and staffing is not always optimal. Flexibility is needed. I know there is a way. This culture just has to change. And it happens in small little doses.

SO–> Skin to Skin immediately after a C/S? I have been told by coworkers, doctors and anesthesia:

“It’s impossible, “

“It can’t be done”

“There’s not enough room”

“This patient (the mom) is in the middle of major surgery!”

“The baby needs to be under the warmer, it’s too cold in the OR.”

Really? Seriously? Watch Me………

And she then goes on to describe various barriers in the OR and how she has learned to cope with them. She closes with a final scenario, with a potent moral to the story:

The baby was crying and pink when born and without thinking about it, the doctor, nurses and myself had him on the baby unit drying him. Mom went panicky! “Give him to me, give him to me! He has to be ON me! You just took him OUT of me, now he HAS TO BE ON ME!” She was literally trying to sit up. Anesthesia was drawing up meds for her (that was his answer). I said “OK here he comes!”. So I didn’t ask anyone’s permission this time….. just held that naked baby in one hand, snapped open her gown with the other and helped him move in. I asked for a warm blanket and looked up to see the other nurse and doctor staring at me. I said “Seriously… she’s exactly right, he does belong ON her!” Anesthesia saw the immediate transformation of his frantic patient to one with calm maternal bliss, admiration and cooing. He was then helpful to let her other hand out. This little boy stayed with mom, breastfed before he was 15 min old and went to the PACU with mom. She was so incredibly happy. I never got to see her after that since it was near the end of my shift and I wasn’t on shift the next few days. I saw that she exclusively breastfed in the hospital and without complication went home on day 3. At least part of her birth experience went according to plan!

If she hadn’t have been so vocal about what she wanted, so adamant… she would not have experienced what she did.

SPEAK UP AMERICA…. MAKE IT HAPPEN

Right on. Keep fighting for this, OB Nurse! We all know cesareans ARE sometimes necessary. There is no question about that - and thank God we have that available to us. But there is no reason that immediate skin to skin contact, and no routine separation of mother and baby, should not be THE standard of practice in all cases except when medically necessary. Make it happen indeed.