April 18, 2012

Skin to skin

A few months ago, my hospital's entire healthcare system implemented a new protocol that I actually really, really like. They want newborns to be placed skin-to-skin for at least 30 minutes after birth, if possible. It doesn't have to be right from the womb to the chest. And moms don't have to have their baby skin-to-skin because some women just aren't comfortable with it. But for most cases, babies now go directly onto moms chest and stay there for 30 minutes or more. I LOVE this!! It's something some of us have been doing anyway, but I do like that the whole system recognizes the benefits of keeping the baby and mom together. It's amazing how wonderful skin-to-skin contact is. If the baby is cold, the mother's body will adjust to raise the baby's temp, will cool if the baby is hot, the baby's heartrate and breathing are regulated, all because of that skin to skin contact. We've noticed APGAR scores are higher. A typical score is 8 & 9 and very rarely are there scores of 10, but lately, even the most conservative nurses are assigning 10's! The only 'problem' with this? I cry sometimes. Ok, ok, so I tear up pretty easy, but I just love it. Maybe it's because that's what I wanted with my kids and I fondly remember holding Caleb skin to skin in the recovery room. Whatever the reason, it's not uncommon for me to have tears in my eyes when moms are holding their sweet new babies on their chest. I think maybe because it's a different reaction when they hold their naked baby on their skin, compared to holding their swaddled baby. One mom, who's first baby was born before viability, was terrified of something going wrong, terrified that something would happen to this baby. She was so afraid, she refused to read anything about pregnancy beyond 22 weeks. She delivered by c-section, I was able to keep baby in the OR with the mom we went back to her labor room to recover (gone are the days of the 'recovery room'!!) She was scared of this baby and didn't know quite how to hold him and was so uptight, so I helped her get her baby skin to skin. Within a minute or two, she was relaxed and didn't let that baby go. It was just beautiful. After I gave him a Leboyer bath(2 hours later), he went back skin to skin and we wheeled out of the labor room to postpartum. I'm not sure that baby spent much time in the cribette! Another mom, who had been very, very sick a few years earlier held her baby skin to skin and the entire family started to cry because at one point, they thought they would lose her...now here she is with her newborn. As usual, I walk out of the room with tears in my eyes. Another mom laboring with her 3rd was open to the idea of skin to skin, but wasn't completely sure but said she'd try it. With the other 2 babies, the old routine was done....baby taken to the warmer, wiped off, meds given, weighed, all that stuff done while mom is taken care of. It wasn't done with any intention of separating them, it's was just how it was done. This time, she delivers a healthy baby who we place immediately skin to skin. She stays that way for a good hour and within 10 minutes, that baby was looking for the breast to nurse. It isn't always possible, sometimes the baby needs help to transition to life outside the womb, or mom isn't stable enough, but for the majority of healthy deliveries, it's been a wonderful change. I just have to keep tissues in my scrub pockets.

11 comments:

Tanashia said...

Stumbled across your blog on Facebook. I am a night shift L&D nurse too....11 yrs! I wish I could get our staff on board with skin-to-skin.

Karen Joy said...

WONDERFUL.

How was the change decided upon? And I'm SO GLAD the APGARS are noticeably improving, because that will help keep the change in place.

Rebecca said...

Love it!! We are very big on STS at our hospital. Our L&D nurses have to document why baby did not go STS. It really makes me sad when I see those delivery room photos of mom holding a bundled up burrito baby who can't get within two inches of her nipple because all the layers of swaddling. I think of how badly that baby must want to feel its mom, and how lovely that mom would probably feel having her baby next to her heart. In postpartum, I am constantly unswaddling "sleepy" babies and placing them on their mother's chests...the mother just melts into her baby, and 15 minutes later baby is rooting and latching!

Nurse Lochia said...

We also have to document if baby was sts greater or less than 30 minutes. If sts isn't done, or is done less than 30 minutes, we have to document why. Im not sure why exactly the change was made. Part of it I think is because of all the research about the benefits of sts, and we are trying to be more mom-baby friendly.

Kristin Meyerhoeffer said...

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Jessica said...

I wish we did that. When I'm "baby catcher", I try to, but with the docs screaming for weights and lengths and fetal fall out in 10 rooms at once, it's not always possible. Breaks my heart. I also love the idea of leboyer baths, again something I do when the unit is nice and slow and I have the time. It should be the standard of care as far as I'm concerned...but as is the nature of nursing...there are always more patients than staff and sometimes the whole process gets rushed.

ittybittybabynurse said...

also stumbled upon your blog and enjoy it! I'm a NICU nurse who is newly transitioning over to the L&D side. I was glad to read this as we struggle in our unit to get everyone on board to do 'kangaroo care' but whenever I can, I seize that opportunity. In fact, not too long ago we got a 25 weeker who they decided to turn off and once they were extubated we placed them on mom to do skin to skin during his last moments. Low and behold this babe came back to us and is now term and ready to go home soon!

K said...

My hospital does sts/initiate breastfeeding as long as mom wants/baby is latched. This is often well over 30 minutes, upwards of 45-60 BUT the nurse OS also supposed to have mom and baby transferred to pp in 1hr. Sets up quite the conflict of interests as they are supposed to please the patients with sts yet turn over those rooms ASAP. Since I had quite a bit of bleeding I wasn't rushed off to pp but even with just me and my healthy baby my nurse was hustling to get us there in just under two hours.

Pietrowski's of North Andover said...

Love this!! Wish I'd had this with my babies!!

Becky K. said...

very cool! Any time hospitals are willing to make changes to make improvements for the moms and babies I am thrilled. I love that you are so sensitive and caring too.

Becky

Moira said...

I love that you have initiated STS in the OR. That is great! We do STS on all of our vaginal deliveries, and I try to do it within the first 15 minutes. For our c-sections patients, if mom is alert enough and not in too much pain we do STS as soon as they get to recovery. I did a paper about the benefits of STS in the OR, and it is SO great!!