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".
"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!
"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.
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.
Previously published on AWHONN Connections.