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Family Centered C-Section

Posted on April 5, 2013 by admin | Posted in Pregnancy

So we as ob/gyn’s have been doing C-sections the same way for a long time.  Well things are about to change in the way I perform C-sections.  There has been plenty of evidence to show that immediate (just after delivery) skin-to-skin contact is beneficial for mother-baby bonding, improving breastfeeding, decreasing infant crying, etc.  However, this is never done at C-sections.  The baby is always taken away from the mother and they “re-unite” once the mother gets back to her postpartum room, which can be over 2 hours after she delivers!  So in situations where the mother and baby is stable, why not allow the baby to go skin-to-skin during C-section while the doctor is finishing the closure.  Not only does the baby go directly to the mother’s chest but the mother is able to see the baby be delivered through her skin incision. Don’t worry no mommy intestines are seen!! Just the baby being delivered, similar to when she delivers vaginally.

This idea of “family-centered” or “mother/baby-centered” or “natural” cesarean deliveries has been widely documented and practiced in England.  They are always a few years ahead of us when it relates to patient focused issues in maternity.  In 2008, there was a paper published in the British Journal of ObGyn, that describes this practice of C-sections.  They had delivered over 100 women by C-section in this manner and showed it improves maternal satisfaction, bonding, and breastfeeding.

Another aspect of this delivery is to allow for the baby to slowly come through the skin the uterine and skin incision.  The reason for this is that, although not proven, it may decrease the amount of fluid in the baby’s lung after delivery.  Baby’s born after vaginal delivery in general have less fluid in their lung compared to baby’s born by C-section. This fluid can cause the baby to be in the nursery longer due to a process called transient tachypnea of the newborn (TTN).  As the name implies, it is transient and not detrimental. However, TTN often does not allow for the baby to be with the family because they have to be monitored in the nursery.

I recommend you look at the following video that comes from England.  http://www.youtube.com/watch?v=m5RIcaK98Yg

 

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