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Births, skin to skin contact

Posted Aug 05 2008 9:16am

Time for a birth post for the birth junkies out there, I suppose.

Last evening, I had a lovely multip having her 4th baby. She really wasn't having much discomfort at all with her contractions, but once she hit a certain point in her dilation, she wanted her epidural. After all, she had an epidural with her other children, and she expected it again. However, things don't always go as planned. When anesthesia finally graced us with their presence, and I sat her up for the epidural placement, she started doing the "sitting on one butt-cheek" dance of labor. Experienced nurses know what this means. I told anesthesia - "she's pushing", and we laid her back down. Sure enough, the head was sitting right there on her perineum. Needless to say, she never did get that epidural, and I think she was a little pissed about it afterwards. She ended up having a very nice, controlled delivery, no lacerations. Of course, we had a new crew of residents and students show up, and I'm gloved up, ready to catch the baby in case they're not gowned and gloved and at the ready.

By the way, I did not end up catching this baby. Too bad, I would have loved to have caught #15 in my record of catches. :::smiles:::

Mom wasn't into the touchy-feely of skin to skin contact after the birth, so baby only had a few minutes of skin to skin. I'm ok with that. At least it was "some" skin to skin time. That's been my goal lately: get more skin to skin contact between babies and moms after the birth, for as long as they'll do it. I've noticed better bonding, stable blood sugars, happy/quiet/content babies, stable (or increased, if it starts out low) baby temps, more breastfeeding initiation.

Oh yes....did I mention I'm also on the interdepartmental committee to improve our services to be more mother-baby friendly? This includes more skin to skin time with mom and baby, increasing the initiation rates of breastfeeding, and improving outcomes overall. We're trying to have a paradigm shift from the "whisk the baby to the warmer" to "all baby care on mom's chest". It's not for everyone - I know that - we have a large population of women who don't want to touch an icky-birth goo covered baby, and want us to weigh the baby right away so they can call their 1001 friends and family to share the good news. However, we do also have a good number of women who WANT more skin to skin time, and have a good initial bonding experience with their babies. We're trying to get out of the "what's best for the hospital staff" mode, to the "what's best for moms and babies" mode.

Sigh. It's going to be hard to change some of the nurses who have been around for years and years, and have done things "their way" for so long. Itty bitty steps. One at a time.

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