Booby Traps Series: One mom’s experience with skin-to-skin in the operating room

by Tanya Lieberman, IBCLC | December 8, 2011 3:10 pm

This post is the 26th in a series on Booby Traps made possible by the generous support of Motherlove Herbal Company.

Following up on last week’s post on skin-to-skin after a cesarean, I’m very happy to share this interview with my friend and lactation consultant Joanna, who welcomed her second baby last year at a California hospital.  I trained to become a lactation consultant with Joanna, who now works as a lactation consultant in the San Francisco Bay Area.

Joanna, who had an unmedicated birth with her first son, was expecting to have a similar birth with her second baby.  Late in her pregnancy the baby’s position was breech, and after a version attempt resulted in the baby’s heart rate dropping, it became clear that she would have to birth by cesarean.

Joanna is well versed in the power of early skin-to-skin contact, and was able to arrange a period of skin-to-skin contact in the operating room.

1)  Why was it important to you to hold your baby skin-to-skin after your cesarean section?

When I met with my midwife and learned that we would need a cesarean, my emotions overwhelmed me.  After I was able to briefly compose myself I spouted, “I just want him to be a good feeder.”

Breastfeeding is really important to me, I’m a lactation consultant by day and enjoyed breastfeeding my first for almost two years.  I was very afraid that the cesarean would rob me of that experience.  I was also very afraid that I wouldn’t experience that same intimate time with my second baby that I enjoyed with my first through immediate and ongoing skin-to-skin time and lots of breastfeeding.

2)  How did you approach this with your providers, and how did they respond?

The midwife was awesome and added “skin-to-skin” to the problem list in my chart so the whole team knew it was really important to me.  Then at my pre-op appointment with the obstetrician I again expressed my deep concern/yearning over being able to do skin-to-skin.  She said she couldn’t make any promises because she wouldn’t be attending the delivery but would pass along how passionate I was and encouraged me to remind the team on the day of surgery my wishes.

On the day of the surgery as each provider talked to me in advance, they all said they had read in my chart that I wanted to do skin-to-skin.  They were more supportive than I expected.  I imagined I would be received with rolling eyes and that I would have to fight to get what I wanted, and likely be disappointed.  They all treated me like I had a reasonable request and it was no big deal to accommodate that request.  These positive conversations went on with my labor and delivery nurse, my OB, and the anesthesia team.

3)  What happened at your birth?

After my son was delivered he went to the baby warmer in the OR which I could see out of the corner of my eye.  They had him there probably less than 5 minutes; drying him, checking weight, doing a brief newborn exam.  Vaccines, eye drops, bath were on hold.

The nurse attending the baby asked if I was ready and I practically wanted to jump off the table!  Working inpatient lactation I’ve seen moms in the first few hours after c-sections and was prepared to feel awful and experience nausea and vomiting, among other side effects.  The anesthesia team was still by my head checking my vitals, etc.  Leads were all over my chest, and I couldn’t really feel my hands too well from the spinal.

They placed my baby on my chest with his feet almost on my left shoulder and his check on my right breast.  I placed my arms around him.  My husband sat at my left shoulder and also had a hand on the baby’s back for extra support.  We were able to stay skin-to-skin like this for about 10 minutes all the while the OB and team were closing the incision.

Out of nowhere I start feeling really yucky and very panicked. I told them I felt awful and somebody needed to take the baby.  Not seconds after they took him off my chest and had him back on the baby warmer did I throw up.  After that subsided, the baby nurse asked my permission to take the baby to the nursery with my husband and finish the newborn exam, and do the vaccines and eyedrops, with the bath on hold until later.  I consented, as I was still feeling awful and there was no way I could have him on me that point.

Shortly thereafter I was in the recovery room.  I was still feeling terrible, was really pale, had low blood pressure, and was shaking.  I was still feeling the effects quite heavily from the spinal.  My husband came in with the baby.  He was eager to get the first feeding going, anxiously looking at this watch because we were 1-2 hours since delivery.  The nurse was hesitant because I was still feeling and looking so awful.  I stayed in a semi-reclined position and my husband helped the baby get his first latch and then helped place him back skin-to-skin.

4)  What has been the reaction of your providers since your birth?

I was fortunate to know a lactation consultant where I delivered, and I offered to share my personal photos of us doing skin-to-skin in the OR for the hospital’s professional use.  She reported that within a month of when I delivered another c-section mom was able to do skin-to-skin and had subsequent great breastfeeding experience, and the baby had minimal weight loss.  That mom had had a horrible experience breastfeeding her first baby, who never latched.   She did skin-to-skin with her second child, who had a beautiful feeding at 90 minutes of age and was discharged exclusively breastfeeding with 4 percent weight loss!

She reports that they are still having resistance among providers to consistently have c-section moms do skin-to-skin in the OR.  When I last talked to her she said that they will be publishing my photos to be used in a campaign for skin-to-skin in OR.

I wrote thank you notes and sent to the managers of the labor and mother/baby units, thanking them for our experience.  If I can remember some of the details from my thank you note it was that I was treated with respect, and that nobody made me feel like I was asking for something unreasonable.  At a recent multidisciplinary meeting one of the managers read my thank you note aloud.  And, I’m told, one of the quality assurance team members was almost moved to tears.

I cherished that intimate time of getting to know my newborn through skin-to-skin.



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