Bringing It Home: Implementing Skin to Skin In Our OR

Cara and Baby Simon

Cara and Baby Simon

By, Sarah Copple, BSN, RNC- MNN

Stepping into the “Skin to Skin in the OR- Don’t Let Triplets Stop You” session at the AWHONN Conference last year, I had no idea what a difference it would make in my nursing or in the experience of my patients and their families.I decided immediately that surely if skin to skin could be done with triplets in the OR, I could implement it in my facility. My nurse manager, Deb Tell had also attended the session and was onboard with making the change.

Upon return to Iowa, I approached two women who were having repeat cesarean sections and taught them each about the benefits of skin to skin care and asked if they would be interested in having this time with their baby in the operating room.  Next, the families and I discussed the potential plan with their obstetrician and once everyone agreed I moved on with laying out the plan to the unit.

The day of the first scheduled C-section with planned skin to skin in the OR came quickly.

That morning I came to work just to help out with this new process.  I talked with the obstetrician again to confirm the logistics and discussed the plan with the anesthesiologist and all the staff involved in the care for Rose and her new baby. Our team recognized that working seamlessly together was the key to success. We made sure to have a backup plan if the baby or Rose (our first mom!) were not stable at the time of delivery or became unstable while skin to skin. We also discussed with the parents that the plan was not a guarantee, but we would try our best to make it happen. We headed back to the operating room and everything went exactly as planned.

Later, Rose described the experience as “magical”.

Rose, Wes and Baby Theo

Rose, Wes and Baby Theo

 “Theo’s birth experience was quite a memorable experience. It was as natural as a cold, sterile surgery could be. Rather than being whisked away, weighed, cleaned, dressed, and given meds, Theo was put onto my chest, right in front of the blue curtain.  It was so instinctive as his crying immediately stopped, he snuggled right in, and started rooting around to nurse. I hardly remember any of this process because I was so focused on my new son so close to me.

I wish I was more eloquent with my words to describe the overwhelming flood of emotions I felt at that moment.  I was able to have the skin-to-skin experience that has always been reserved only for vaginal births and got to do something that I never thought I’d be able to do.”

Then it was time for C-section number two with mom Cara. Immediately after delivery I carried her baby straight from the Cara’s abdomen to the head of her bed as I was drying and stimulating him. I placed him on her chest and placed dry blankets and a hat on him. He was able to remain there for 25 minutes. She was amazed with the experience!

Cara and Nurse Sara

Cara and Nurse Sara

“It was awesome; I never expected to get that opportunity.  I lost track of time, I was zoned in on him forgetting that I was in a surgery room. It was just all about having a baby.  This time I was not worried about bleeding, surgery or other things that concerned me the last two c-sections, I was just focused on my new baby.”

Kurt explained how important it was for his wife to get the opportunity to hold their son prior to coming out of recovery

“Our other two c-section births gave me the chance to have first contact with our children.  I felt better that my wife, as a mom, got the opportunity to hold our son first.  I understood that she was sad that she did not get the chance to hold our first two children until we were in recovery.” 

We started with a few patients and the word has quickly spread to others on how great of an experience it is, it even made the local news!

Since then, we have been working on staff education and creating an official procedure for our maternity center. I have given my first webinar “Skin to Skin Following a C-section” for Blank Children’s Hospital Advocacy and Outreach Program to nurses across the state of Iowa and a few from Illinois.

“If I had to tell women who were having a repeat cesarean about this, I would say go for it.  I would say that is was such a positive experience and just a little extra work to coordinate with the doctors, nurses and anesthesiologists is definitely worth it. I had such a positive experience.  Holding my son on my chest afterward is even hard to put into words because it was such a magical time and it made the experience a wonderful one” said Rose.

Hearing how awesome this experience is from our patients makes it worth standing up against adversity and the discomfort of trying something new.

I am hopeful that our patient’s comments and the positive experiences we have had will help to further motivate our team members to be supportive of this awesome change, truly putting women and families at the center of the care we provide.

Copple_Sarah 2015_RGB (2)Sarah Copple is a Unit Based Educator and Staff Nurse at Methodist at UnityPoint Health – Des Moines in Iowa. She is married with three beautiful children and enjoys being active outdoors (including riding bikes and running half marathons).

 

 
Resources
Leading Nursing Journal Finds Mothers and Babies Benefit from Skin-to-Skin Contact after Cesarean Birth

Learn more about what you can learn at the 2017 AWHONN Convention.

8 thoughts on “Bringing It Home: Implementing Skin to Skin In Our OR

  1. Sue gehlsen says:

    Sarah is an awesome nurse and a champion for moms and babies! Her work speaks for itself, she’s one who stays current and is a leader among her peers!

  2. kim Steakley says:

    We have been doing skin to skin in our ORs for about 2 years and our babies stay with the parents through the whole recovery period. Every parent I have ever talked to loved it

  3. Stephanie Trusty says:

    Congratulations to Sarah, Deb and the wonderful nursing staff at Unity Point Iowa Methodist Medical Center for making this clinical practice change. This intervention helps both the mother and the infant.

    Thanks AWHONN for inspiring all of us.

  4. Mary Holley says:

    I think it’s a great idea. I was an OB nurse for 34+ years. This had not been implemented in the hospital I worked at, as of the time I left there, a little over a year ago. but it wouldn’t surprise me if it has been by now, or if it does in the near future, because we have a lactation consultant that is VERY much a patient advocate for this kind of thing.

    I’m not sure I see why it has to be such a big deal, though. Meaning, why it has to take so much work, and effort to make it happen. I’ve attended many, MANY c-sections as the nursery nurse, and it seems to me, that as long as the baby is stable, of course, as they said, all you have to do is PUT THE BABY ON MOM’S CHEST! Doesn’t seem difficult to me, at all. Even the drapes and IV poles really aren’t THAT much in the way. You just DO it. 🙂

  5. Luanne Jelm-eickholtz says:

    I’d like to know if there was an additional staff member standing at the head of the bed to keep mom and baby safe. We are getting the naysayers that say anesthesia will not take on that responsibility. I don’t think it is a big deal, but think it is a staffing issue and cultural change

    • Brenda Drury says:

      In our facility, the nursery nurse or nurse responsible for care of the baby stays at the head of the bed. Just this past weekend I was in a csection with a very anxious Mom. The anesethiologist was awesome in assisting me to get baby placed skin to skin! He had previously, very recently been less than 100% engaged in skin to skin in the OR. I thanked him after and his reply was, “of course-it’s so good for both Mom and baby!” Seeing is believing. It’s one of those,” why have we not been doing it this way forever” kind of things!

  6. Cindy humphry says:

    I would like to know exactly this is done safely so I can do this well of taking baby to mom for skin to skin.
    Cindy Humphry RN MN BirthCenter staff Mad River Com Hosp! Arcata, Calif

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