February 10, 2012
Small Steps in the Right Direction
The longer I work in labor and delivery, the more I see that there is a need for things to change, especially regarding c-sections. (No, this isnt a post about how there are too many c-sections...that's whole huge post and discussion for another day. Yes, avoiding c-sections altogehter is the best answer, but until we get to that point, there are still many c-sections being done and we need to manage things better until we get to that point) I'll admit, since 4 of my 3 kids were born by c/s, 2 of them preterm and one emergency, it hits a nerve for me. Why is it routine to take babies born by c-section away from their mothers? In certain cases, obviously there isn't a choice, either the mom is too sick or the baby is too sick. What about those non-emergent cases, like a failure to progress, scheduled repeat, or a repeat c-section in labor, or the like? It seems routine that the the baby is born in the OR, taken to a warmer where most the time the pediatrician is in attendance. Baby is held up to mom so she can see her baby, then Dad goes with the nursery nurse, pediatrician and baby to the nursery and the mom is left alone with strangers while they finish the surgery. The baby has already been evaluated and is fine, but stil they go to the nursery. Why? Had my last baby been term, I had already stated that he would not have left the OR. I knew he would be given a good once over by the pediatrician and nursery nurse, so I saw no reason why he should leave. He could hang out in Husbands arms until they were through with me, Husband would give me the baby and I would be wheeled out of the OR into recovery with Caleb skin-to-skin. But, that bonding wasn't able to happen until I was in recovery because he was 34 weeks. And this is where a lot of c-section moms start having trouble. Here they are, sometimes they feel like their body has failed them because they need a c-section. So their baby is delivered through their abdomen, they will have a longer recovery and the baby is taken away from them. They may seem "fine" during the short 2-3 day hospital stay because they have their baby and they do all the typical things new mothers do. But it's not until after they are discharged that the emotional turmoil begins for some. They start to realize they missed out on those first moments. They weren't able to hold their baby for 1-2 hours, in some cases, even longer. Here they carried and loved this child, labored and they are the last to hold the baby. Some women even feel like it was their "punishment" for not being able to deliver vaginally. And these feelings start spinning out of control and when they try to talk about these feelings to others, they are brushed off. "Well, you got a healthy baby. Why are you so upset/sad/angry?". Yes, the most important thing is a healthy mom and a healthy baby, but the birth experience is also very important. I know even for myself, when I tried to talk about my unsettled feelings about Calebs birth, some people look at me like I'm nuts, that I should let it go, "it's been a year plus, just move on". The thing is it's not that easy. Yes, I'm very thankful he was delivered healthy, considering his early gestation, and he is an absolute joy. But, I am still unhappy with the lack of respect I was shown in the day and hours leading up to his birth and during. I was almost denied the option of having Husband there. What would have happened if I hadn't worked in OB? Would I have thought to say "no, if the baby and I are fine I want to wait"? Probably not. That disrespect cut much deeper than the scalpel blade. Those physical scars have healed, but the emotional scars are still a bit tender. But having the opportunity to have Caleb skin-to-skin within an hour of his birth and being able to take him in, to hold him against my chest, eased some of the pain/guilt I was feeling. Ok, back to my main point. Why not keep the baby in the OR with mom? Why can't we keep her child with her, bring him/her to her so she can see, touch and yes, even hold her baby (it is possible) while the docs finish up surgery. Then the baby can go with her to recovery and she will be able to be with her child those first few moments and maybe that will help. I've been doing this lately. I've asked the nursery nurse and pediatrician if the baby can stay in the OR. And I've not met ANY resistance. The results have been awesome. I can't speak to how the moms feel after they are discharged or if it has any effect on possible emotional turmoil they may feel, but in the immediate here and now, they seem happy. They don't lose those first few minutes. They don't watch helplessly as their baby is taken to the nursery even though everything is fine. They get to do skin-to-skin as soon as they are in recovery and guess what? These babies have all nursed great in recovery. Coincidence? Perhaps. It might be a small step in the right direction. Maybe it won't have much impact. Or maybe, just maybe, it will make a world of a difference. It can't hurt to try.