Lamaze International Organization’s Healthy Birth Practice #6: Keeping Mothers and Babies Together After Birth

Amy Romano, a Certified Nurse Midwife, mother of two and multiple venue contributor to Lamaze publications, including the blog Science and Sensibility is a fantastic example of a woman on a mission.  In short, she is working to make improvements to the maternity care system in our country.

Amy recently invited me to participate in a Bloggers Carnival regarding the Lamaze International organization’s sixth Healthy Birth PracticeKeep Mother and Baby Together (following birth): It’s Best for Mother, Baby, and Breastfeeding

This particular topic reminds me of the dozens of conversations I’ve been involved in–with my own students and with childbirth education colleagues of mine– regarding how to maintain mother-baby contact following a cesarean section birth.

The research on this issue is crystal clear:  babies do better in the first minutes, hours and days, the more time they spend in skin-to-skin contact with their mothers.  Their breathing and heart rates remain more stable.  Their body temperatures fluctuate less.  Ditto for their blood sugar levels.  They cry less and they nurse and sleep better, too.

In her wildly successful book, A Thinking Woman’s Guide to a Better Birth, birth activist Henci Goer pulls together data from multiple national and international studies that all report similar findings with newborn decreased APGAR scores, respiratory rate variability and poor oxygenation, in the event of a cesarean birth.  Basically, a baby born by c-section loses out on the pressures associated with a normal, vaginal birth–pressures that result in massaging and squeezing excess amniotic fluid from her lungs, enabling improved air flow and oxygenation.

So, if a baby born by c-section is already three times as likely to suffer breathing difficulties than his vaginal birth equivalent, why would we would make it common practice to separate mom and baby seconds after the birth, when maintaining mother-baby skin-to-skin contact improves the very functions threatened by the cesarean process?  Is it not equally possible for someone (dad/partner/nurse/doula/etc./etc.) to lift away mom’s hospital gown and help hold baby skin-to-skin on mom’s chest while the cesarean procedure is completed, thus helping to stabilize the infant in the moments following his birth?

Another hurdle to maintaining close contact between mom and baby following a cesarean is the question of anesthesia.  Depending on the hospital in which a woman is giving birth, it may be very likely a common practice for the woman to receive an IV sedative following her baby’s birth–forcing her into a “twilight” sleep for the remainder of her surgery, and rendering her groggy (and sometimes violently nauseated) for upwards of two hours thereafter.  With mom cast off into la-la land and baby whisked away to the nursery, some mother-baby duos find themselves separated for upwards of two hours after birth–a critical time when skin-to-skin contact would otherwise facilitate stabilization of baby’s vital signs, mother-baby bonding, initiation of nursing (which, by the way, significantly slows mom’s uterine bleeding) and stabilization of the woman’s birth and post-birth hormonal fluctuations.

In the Lamaze classes I taught up in Bozeman, I got to the point that I encouraged expectant parents to ask for several things in the event a cesarean delivery became imminent:

1.  Request baby be placed on mom’s chest following delivery AS SOON AS POSSIBLE and perform any support measures for baby at that location (yes, the anesthesiologist will have his or her space cramped up at the head of the operating table but they can cope if they really want to).

2.  Request that mom NOT be given a sedative of any sort (she will be entirely numb from nipple line down due to a spinal block, anyway) during or following the surgery.  Encourage other relaxation measures if anxiety surrounding surgery should arise:  relaxation breathing, soft music in the OR, partner and/or doula present near mom’s head at all times…

3.  If separation of mom and baby DOES occur for any reason (newborn needing extra resuscitation measures, etc.) request reunion between mom and baby within no more than 30 MINUTES of birth, and make sure baby goes directly to recovery room with mom, rather than to the nursery.

4.  Request two people accompany mom into operating room, such as her spouse/partner and a doula, midwife, friend or other family member so that there is plenty of emotional support and advocacy for maintaining mother-baby contact following birth.

With the national rate of cesareans creeping upwards of 30%, there are a lot of moms and newborn babes out there who are missing out on important minutes and hours of each others’ time…unless educated consumers LIKE YOU start requesting different practices.

Do me a favor, pass the link to this post along to anyone who will at some point, has, or is about to give birth.  Join the conversation.  Make your voice heard.

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4 Comments

Filed under Mommy and Motherhood, Kids, From One Mother to Another, pregnancy, family, Childbirth Issues, politics, breastfeeding

4 responses to “Lamaze International Organization’s Healthy Birth Practice #6: Keeping Mothers and Babies Together After Birth

  1. I’m a section mama. The hospital I got sectioned at tells us that they ahve a 30% c-section rate but we figure that’s not including repeat booked cesareans.
    I got to hold my son for about 2 seconds after he was born. He was laid on my chest, all swaddled up. I could touch his cheek with one finger because my other hand had an IV in it and I wasn’t allowed to move it. Then they whisked him away to the special care nursery (standard protocal, not needed as his apgars were both 9/10) and I didn’t see him for an hour. My hubby went with him so I was left alone in the OR then recovery. We weren’t even allowed to bring our camera into the OR.

    I wish doctors and nurses listened to the facts more. Mom and baby need to be together. And most sections don’t need to happen. The actual rate of “necessary” c-sections is about 10-15%. We figure the rate and the hospital where I had my son is about 50%. Sick. And even if you ask, they don’t allow you skin to skin or anything.

    Next time I’m not going to the hospital.

  2. Tessa,
    The angst represented in your story (which I thank you deeply for sharing) represents the emotional outcome that, quite frankly, most obstetricians neither validate nor care about. Citing “what’s best for mom and baby” tends to be a vague and over-used reason for cesarean that frequently runs against current scientific data, but also completely excludes any consideration for the variety of issues brought forth in my post and in your comment. Ask any woman who has undergone an unwanted** cesarean delivery, and she’ll tell you
    the scar left from that mode of delivering her baby runs much deeper than the one across her belly. Do some women prefer cesareans? Strangely, yes. Do a few other women undergo a cesarean and feel ok about? Sure, a few. But the majority of women I’ve encountered who deliver their child(ren) via cesarean experience a lasting sadness and sense of disappointment that they spend the rest of their lives explaining away, making up for or mitigating.

    Why the allopathic medical industry can’t understand the REAL and TRUE emotional/psychological ramifications of the type of practice you describe above, Tessa, just floors me.

    I have never been one to completely denounce cesarean sections, hospital births or doctor-attended birthing experiences. There’s room for all these things and, in some cases, very clear indications for conducting a cesarean birth. The same goes for birthing in vs. out of hospital, with vs. not with a physician, etc. Any home birth midwife worth her salt will corroborate this statement. But our country’s VAST overuse of cesarean section as a form of birth (the World Health Organization states that any cesarean rate above ~ 10-12% puts moms and babies AT GREATER RISK for morbidity/mortality than it does reduce it) has created an epidemic whose long term ramifications, I believe, we have yet to completey understand.

  3. Ellen W

    My older son was a vaginal birth with an induction. After 19 hrs of labor I vowed next time to wait until my body started labor itself. I’m pretty sure I got to hold him soon afterwards and the only time he left the room was to get circumcised the next day. Fast forward 3 1/2 yrs later; the week before my younger son was born (I was at 38 weeks) I start having horrible abdominal pain/heartburn and backaches. I barely sleep half propped up on the couch or recliner and don’t even want to drink. I make two trips to the family birth center and get a prescription for PPI which help some and fluids for dehydration.

    The night before my next dr’s appt, I go into labor. The doctor is doing the final check before I push and I’m excited that I’ve only been in labor for 7 1/2 hours. Baby is breech to everyone’s surprise, so I have an unplanned c-section. I immediately started crying because I was scared to have one. My husband was able to hold him about 15 mns after he was born and I remember stroking his head.

    The next day or so is a blur because they found out I had HELLP syndrome (which I had never heard of and I have a public health background) so I was on magnesium sulfate. I didn’t have any of the risk factors so it caught everyone off guard and frankly I think it scared my OB that it had gone undected. Thankfully the only complication was that I had lots of blood draws to monitor my liver enzyme levels and I was in the hospital for 5 days. Baby was perfectly fine. After I read up on HELLP, I realized how sick I could have become.

    Looking back, the c-section and recovery was not as bad as I thought it would be. Thirteen months later I still have some abdominal muscles that aren’t quite all there. If I was going to have any more children, I would want to try a VBAC but we are happy with two boys. It sometimes bothers me that I am part of the c-section statistics.

  4. Pingback: Healthy Birth Blog Carnival #6: MotherBaby Edition — Giving Birth with Confidence

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