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.

Aww, how *sweet*!

If this doesn’t make you go into emotional sugar-shock… there’s just something wrong with you!

Deaf baby hears his mother’s voice for the first time, after a cochlear implant.

Hope for pregnant women with heart disease

I just read this article and thought it was amazing. Often, women with pulmonary hypertension are advised not to get pregnant, and if they do get pregnant (or if they only find out that they have pulmonary hypertension while pregnant, which is unfortunately a common time for diagnosis), they are advised to undergo an abortion immediately. Why? Apparently after giving birth, the body can’t handle the fluid overload, so women frequently die. About 50-60% of women so affected die in the top health centers — with the best medicine and the best care, a greater than 50% mortality rate! Yet one doctor has a 0% mortality rate, out of 40 women. Doesn’t sound like coincidence to me!

The treatment sounds so simple, so obvious, when it’s explained: basically, since it’s the fluid overload with a term birth that overwhelms the heart and kills the woman, she is given a C-section at 35-36 weeks (less fluid build-up than at term), and then hospitalized for several days afterward while they draw fluid off with medicine and diuretics — nine liters — that’s almost two and a half gallons!

For many women with this condition, being advised to have an abortion is a horrendous decision — an unchoice. This doctor may give them hope.

The Vulnerability of Men

That’s the name of a post on circumcision, written from a man’s perspective as to why circumcised men want their sons to be circumcised. If the father of your baby is circumcised, he will probably want your son to be circumcised. Why?

Men who have been circumcised have an extremely difficult dilemma. For them to acknowledge that the practice is unnecessary and harmful means that they must acknowledge a painful personal reality.

You really need to read the whole article (preferably, before you bring the topic up the first time, so that you can bring it up in the way most likely to bring positive results). But this totally makes sense. As I was reading this article, I was nodding my head in agreement at the whole thing, because it reminded me of “the talk” my husband and I had — or rather, “the talks” because we discussed it more than once, just as in this article.  Men don’t want to have it thrown in their faces that there’s something “wrong” with their penises; and for a woman to want her sons to remain intact implies (to the men, whether women mean it this way or not) that there is something wrong with being circumcised. Therefore, for cut men to accept that, it requires them to accept that there is something wrong with them. Ouch. Far easier to retreat into the various fallacies and myths surrounding circumcision, rather than accept that they were subjected to a painful and unnecessary procedure when they couldn’t consent. And, after all, since most men don’t remember it, they assuage any qualms about it by saying that their sons won’t remember it either, and will get all the “benefits” of circumcision, like “looking like his dad!”

Women and men are different in so many ways. Is it sexist to say that? Perhaps; but it’s also accurate. We women need to learn how to communicate in our female way, in such a way that we can reach our men. Want to learn how to do it? Read the rest of the article. 🙂

I like the way this guy thinks

After answering why he doesn’t like and thinks we shouldn’t say, “Breast is best,” (because it puts formula-feeding as the norm), he goes on to answer the following question:

Q. Okay, breast is normal. But surely infant formula is second-best isn’t it?
A. No, the second-best feeding option is obviously other breast milk, for example expressed milk from a child’s own mother or milk from another mother in good health, whether directly from the breast or a human-milk bank. And if there is no breast milk, infant formula, which we should never forget began as a crisis commodity for emergency use only, is the least-bad alternative.
To put this alimentary aberration into perspective, consider routine use of infant formula as the feeding equivalent of emergency devices on airplanes – for example overhead oxygen masks and under-the-seat life jackets – suddenly transformed into everyday must-have fashion accessories. Infant formula pitched as somehow suitable for routine non-emergency use is immediately denatured, thereby forfeiting its only claim to legitimacy – as a life-sustaining crisis commodity.
But no matter how appropriate infant formula might be when infants are denied access to breast milk, feeding an inert pediatric fast-food based on the milk of an alien species remains a deviation from the biological norm for the young of our species. I invite you to reflect on this not-so-rhetorical question: At what point should society begin to regard a routine deviation from the biological norm as deviant behavior?

Why not to have an ultrasound

Some things serendipitously fall into my lap. I had been thinking about writing a post like this for a while, and then today found someone who said it even better than I did (plus has done the research that I haven’t done!) — Ultrasound and Fury: One Mother’s Ordeal.

In short, her baby girl was diagnosed by three different doctors (including at least one specialist) as having club foot, so they spent the remainder of the pregnancy researching club foot, trying to come to terms with the diagnosis. At birth, the baby was perfectly normal. Other parents and babies aren’t that lucky — aborting babies who turned out to be healthy and normal, or continuing the pregnancy under a deep cloud at a diagnosis more serious than club foot.

There are some benefits of ultrasound — some parents have said that knowing their child’s diagnosis (when it was accurate) prior to birth helped them to prepare for their baby’s condition after birth, or to prepare for a stillbirth or a short life after birth. There are a few conditions that can be diagnosed prior to birth and either fixed prior to birth (extremely rare) or (occasionally) to be ready for immediate surgery or care at birth; however, the research the author cited showed that there was no significant benefit to having ultrasound done routinely, as opposed to it being done when there was reason to suspect something was wrong — such as the baby not seeming to be growing.

Of course, if you’re the parent of a child for whom ultrasound was a benefit, then it’s significant to you. However, if you’re the parent of a child who was wrongly diagnosed by ultrasound, it’s also significant to you.

This also doesn’t take into consideration that there may be harms of ultrasound even when there is no misdiagnosis. I’m convinced that most babies sense that there is something going on when an ultrasound or Doppler is aimed at them, even if it’s supposedly out of the range of hearing. Doppler was used on me during my first pregnancy to find the fetal heart-tones, and my baby ran from it every time — far too consistent for it to be a fluke. I’ve seen recent news about doctors trying to use a blast of ultrasound to render men sterile for 6 months. I’m assuming that this type of ultrasound is not exactly the same as what is used in a typical prenatal appointment — that it’s either stronger, longer, or more directly applied… but it still makes me wonder — if ultrasound can stop men from producing sperm for several months, what else can it do? Just like electricity can be used for good, powering this computer, it can also be used for bad, maiming or killing someone. I wish ultrasound were better studied, to make sure that it was only used for good, and keeping it from harming people as much as possible.

The use of ultrasound scanning during pregnancy is now so widespread it seems almost as banal as taking a patient’s blood pressure. Unlike amniocentesis, it is considered safe, noninvasive and painless for both mother and child. Formal studies indicate that 70 percent of all pregnant women get at least one scan, and the true number is probably higher, said Dr. E. O. Horger 3d, chairman of obstetrics and gynecology at the University of South Carolina School of Medicine in Columbia. If a woman does not request ultrasound, many obstetricians will recommend it, as mine did, ”just to see how things are going.” They make that suggestion even though the American College of Obstetricians and Gynecologists, the American Academy of Family Physicians and other medical organizations advise against the routine use of ultrasound in pregnancy.

All My Babies

If you’ve not seen this documentary you need to. From the description:

Both educational tool and poetic portrait of a black midwife and childbirth in the Deep South.

“This beautiful film is the story of “”Miss Mary”” Coley an African-American midwife more than half a century ago in rural Georgia. Conceived as a demonstration film for “”granny”” midwives its production sponsored by the Georgia Department of Public Health All My Babies quickly transcended its initial purpose. It was used around the world by UNESCO and has become an enduring classic of non-fiction film.

All My Babies was written produced and directed by George C. Stoney in close collaboration with Mrs. Coley as well as with local public health doctors and nurses and shows the preparation for and home delivery of healthy babies in both relatively good and bad rural conditions among black families at that time.

The film is in addition both a deeply respectful portrait of “”Miss Mary”” who is revealed as an inspiring human being and a record of the actual living conditions of her patients.

Selected in 2002 by the Librarian of Congress as a “”culturally historically and artistically significant work”” for permanent preservation in the National Film Registry.”

While there were some moments that made me cringe (like Miss Mary telling a mama it wasn’t “safe” to give birth on the floor and that the bed was “much better”; and her fully and completely cleaning and dressing the baby before letting the mama even see the baby), it is still gives great insight to the culture of the time, and it is obvious that the doctor, nurse, and all the midwives had their hearts in the right place, and did the best they could with what they knew at the time.