Skin-to-Skin in the O.R. after a C-section

Being born vaginally is good for babies, in part because it colonizes them with the mother’s good bacteria, setting them on the road to health; a C-section bypasses this normal process and may be part of the reason why babies born by Cesarean have higher rates of things like asthma. But putting the baby skin-to-skin with the mom, especially after a Cesarean, can restore some of this good colonization; otherwise, the baby will be colonized only with hospital bacteria. Skin-to-skin contact is also beneficial in facilitating breastfeeding. Typically, when babies are born, they have an innate ability and desire to get to the breast and self-attach; wrapping babies up in a blanket like a burrito prevents this. All too often, whether the baby is born vaginally or by C-section, babies are only briefly shown to the mom right after birth, and then are taken across the room for the newborn assessment and procedures, before finally being returned to their mothers securely swaddled in a hospital blanket. Then, many times, babies are taken to the nursery soon after birth for a bath, then kept in the nursery under the warmer for a few hours to warm back up, and then finally taken back to their mothers… just in time for them to fall asleep for a few hours. But it doesn’t have to be that way. Healthy babies can — and should — be placed skin-to-skin with their mothers immediately after birth, even with a C-section.

Update: Here’s a video showing skin-to-skin after a C-section


If you had a C-section, were you able to have your baby put skin-to-skin in the operating room? Did you even know that was a possibility? If you are a nurse or midwife, do you ever put babies skin-to-skin on their moms, even if they have a C-section?

Weigh in on this topic on the Breastfeeding with Comfort and Joy fan page [currently, it's the most recent post, dated May 28]. Laura Keegan, the author of Breastfeeding with Comfort and Joy, will be giving Grand Rounds in June/July, so will have the opportunity to talk about this important topic to attending physicians, L&D nurses, and residents in OB, pediatrics, and family practice. She would love to have input from women about their experiences with skin-to-skin contact (or the lack thereof) after both vaginal and Cesarean births, to pass along to the doctors, nurses, and doctors-in-training. What did it mean to you to be able to hold your baby with nothing between you, and just a blanket put over both of you? What did it mean to you to be denied this? Please comment on the fan page post, and also spread the word (blog, share on facebook, Tweet about it, etc.), so that doctors and nurses can find out from you and other women what they otherwise might not hear.

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15 Responses

  1. When my baby was born by c-section she was able to be held skin to skin with my husband fairly quickly. He had taken off his own shirt to wear the scrubs and tore the scrub shirt open to hold her. Of course it wasn’t immediately after she emerged. The cord was clamped too quickly and nurses rubbed her roughly with towels before he could get his hands on her.

    Once I was in the recovery area she was handed to me for more skin to skin. She started nursing soon after and nursed while I was wheeled to my hospital room.

  2. When my daughter was born by c-section a little less than a year ago, I worked very hard to lay out a “mom-baby friendly” c-section plan, should it become necessary. (And when she not able to turn from breech to vertex after numerous attempts, it was becoming clear that a c-section would likely be happening.) I really wanted skin-to-skin the OR and my OB supported that, but let me know that ultimately that would be up to the anesthesiologist.

    I did not get to hold her skin-to-skin, which is frustrating to me as I look back and I wish I would’ve pushed harder for that, as there was NO reason I she couldn’t have been put directly on my skin. BUT, her cord-clamping was delayed–something that was also very important to me. And I was able to hold her just a couple minutes after her cord was clamped. I had my doula with me in the OR and I requested the briefest of evaluations of our baby. She was quickly brought right to my arms (I requested the drape be placed low enough so I’d have room to hold her). When I started trembling later in the repair process, my doula held her right next to me.

    I did not have much skin-to-skin with her in the recovery room b/c I was vomiting profusely and in severe pain. While my memory of our time in the OR is clear, my memory of my time in recovery is vague. My husband and doula held her a lot. I had previously planned with my doula that even if, God-forbid, I had to have general anesthesia, she would help initiate putting her to my breast. After about 40 minutes in recovery, during a window of time where my pain was briefly under control, we got her to latch on and nurse several times.

    Thank you for posting this. I am continually shaking me head at how few women know what their options are during a c-section.

    • Worse yet, I had a client who thought she had arranged with her doctor for skin to skin in the OR with her perfectly healthy (but breech) baby. But it did not happen. The look on her face when she told me this nearly broke my heart.

  3. I’d like to be able to post these comments on the f/b page I was talking about (or better yet, for you to leave the comments yourselves). Will that be okay with you both?

  4. I posted a link to this post on my blog. I love this video, thanks so much for sharing it. I see no reason why this couldn’t be SOP at all hospitals, but I know that it isn’t the norm at mine. Le sigh.

  5. [...] Skin to Skin immediately after birth is an extremely important part of the continuum of the nurturing of pregnancy, the process of birth and the transition of nurturing from inside mom to outside mom. This is the natural habitat where baby should transition and begin his own regulations of breathing, heart rate, temperature etc… This is recognized by the AAP in their changes to the Neonatal Resuscitation Algorithm back in 2000. The recommendation was to keep baby with mom and provide all initial evaluations and steps with baby on moms chest for all healthy babies!  We all know that babies have an inborn innate ability to self attach and nurse right after birth. These recommendations are not just for vaginal births. Kathy Petersen has a beautiful description of the importance of StS after a Cesarean birth on her Woman to Woman Childbirth Education blog in her 5/30/10 post Skin-to-Skin in the O.R. after a C-section. [...]

  6. change is a very difficult proces, and in cases such as skin-to-skin after a c-section there may be a longer process in gettig this practice changed to allow skin-to-skin. women are going to have to be very vocal and stand their ground in wanting this practice to become a standard of care. recent changes have allowed the infant to remain in the surgery room for the immediate newborn interventions. a very big step for our hospital. it has taken a few monthso fo discussion in order to have this changed. getting the infant skin-to-skin is the next chagne process we are working on. we have already gotten many of the nurses to change attitudes about the importance of promotion of early colonization of the moms normal flora with the infants as a standard of care. takes time. on another note: if we are supportive in the cultural wishes of each client/patient then we will have better outcomes whether we area ble to do all the ‘best prctices’ or not. keep trying.

  7. [...] you to Woman to Woman CBE for this excellent trailer for Breast is Best. Can’t wait to see the film! This trailer points out that even moms who have cesareans [...]

  8. [...] at Woman to Woman Childbirth Education asks, “If you had a C-section, were you able to have your baby put skin-to-skin in the [...]

  9. [...] Natural c-section?? I am really going to try and push for this with my consultant…. it's looking likely I will need a c-section due to a multitude of physical issues…so if it has to be that way then this in an ideal world woiuld be what I would want…what do you think?? http://www.guardian.co.uk/society/20…icineandhealth http://womantowomancbe.wordpress.com…r-a-c-section/ [...]

  10. [...] Today, 01:02 AM   #1   Stolen this from another site but thought it was very interesting so i had to share… http://www.guardian.co.uk/society/20…icineandhealth http://womantowomancbe.wordpress.com…r-a-c-section/ [...]

  11. I am currently working to get the hospital where I am a Labor and Delivery nurse to shift how we manange cesarean birth. Because we are a small community hospital OB does not have our own OR and we are essentially guests in the OR. We do a wonderful job of skin to skin after vaginal birth but not with cesearan birth. My goal is to move toward allowing skin to skin in the OR as well as breastfeeding in the PACU. I am getting a lot of push back from the OR and PACU staff (including anestheia) and would love some wise words from staff at hosptials that have been successful in implementing this change in procedure.

  12. I am so happy to find this link. I am an old doula with grown daughters. I myself had two terrible cesareans that are sad and painful to remember 30 years later. I want so much better for my clients. I currently have a client who is at high risk for a cesarean. I will send her this link. She can decide for herself what is right for her. If one must have a cesarean it should be a humane cesarean — for mother, baby and birth partner.

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