Transforming the Cesarean Section Experience
Not long ago, a woman who delivered her child by cesarean section (C-section), a surgical procedure, felt disconnected from the bonding experience described by couples whose child was delivered vaginally. Instead of dad or a partner cutting the umbilical cord, or mom bonding skin-to-skin with her newborn, C-section babies were whisked away to the nursery.
“Typically, C-sections were treated more like a surgery instead of a delivery experience,” says obstetrician-gynecologist Amy DePuy, MD, with LVPG Obstetrics and Gynecology. “Now, as safety allows, we are making sure we provide a patient- and family-centered experience in the operating room (OR) that is as close to the regular delivery room as possible.”
Describing your ideal C-section experience
In preparation for delivery, maternal preferences are discussed and selected around 32 weeks gestation. As part of that conversation, options for C-section also are included. This helps ensure patient (mom) and family have a voice in the delivery experience they would like to have, whether a C-section is planned or is medically indicated during labor.
“When I speak with a patient who had a C-section several years earlier, I try to emphasize differences in the experience between then and what we do today. Typically, the patient and family are very excited to hear we do things differently now,” DePuy says.
C-section experience: Then…and now
To improve the mother-baby-partner experience, thought was given to what a traditional delivery is like: you can select music that you like for the delivery; you can see your baby right after delivery; you can hear his or her first cries; your partner can cut the umbilical cord; after baby is cleaned and assessed, mom can begin skin-to-skin contact and breastfeeding.
With support of colleagues in labor and delivery at Lehigh Valley Hospital (LVH)–Cedar Crest and LVH–Muhlenberg, maternal preferences and other practices are being implemented, like:
Lowering the drape to allow mom and dad to see baby’s delivery and first cry. (This a patient choice on the maternal preference list.)
Keeping delivery room conversations to a minimum so first cries can be heard.
Allowing the father or partner to trim baby’s cord on the infant warmer. (This cannot occur on the sterile field – the surgical area of the mother’s abdomen.)
Making every effort to keep mom and baby together after delivery.
“Previously, after the baby was delivered and assessed, the baby was taken to the nursery or neonatal intensive care unit (NICU) and the father or partner typically went with the baby. Mom was barely able to see her baby let alone hold the baby, and she was left in the OR by herself while surgeons completed the C-section – but that has changed,” DePuy says.
Baby nurse means bonding time for family
A new team member in the delivery room is a baby nurse, who is provided for every baby born in the OR at LVH–Cedar Crest and LVH–Muhlenberg. This is a nurse who is assigned only to the newborn – even if a NICU care team is present for delivery – so baby and the father or partner remain in the OR with mom until the C-section is complete. “This allows the family to start bonding right away, giving mom and dad/partner the opportunity to start skin-to-skin or allowing mom, with support of the baby nurse, to start breastfeeding while surgeons finish the C-section,” DePuy says.
The family leaves the OR together and travels to the recovery room – again keeping the family unit together. “Some people call this a ‘gentle C-section,’ but it has nothing to do with the surgical procedure. It has everything to do with the delivery experience,” says DePuy. “This gentler experience is what new parents want so they can begin the process of bonding immediately after birth, whether that birth was surgical or not.”
After over a year of gentler, patient-centered C-sections, DePuy is convinced it is the way to go. “As a surgeon, it is gratifying to offer this patient-centered and family-centered C-section experience to couples,” DePuy says. “Whether they want calm music during delivery or rock music; whether they want to cut the baby’s cord or to begin breastfeeding immediately, we are dedicated to deliver a birth experience they will cherish.”
CTA: Learn more about pregnancy and birth – your before and after experience – at LVHN. Visit LVHN.org/welcomebaby.