An update -Skin to Skin in the Operating Theatre 

On Thursday I was working and looking at statistics for skin to skin contact – I check these at the end or towards the end of every month 

My dream is 100% skin to skin but reality bites and that’s not always possible – however I see the positive in the fact that women and families are more aware of skin to skin and that every day all health care professionals across the NHS are making a difference one woman and one newborn at a time . Their care and love spread the effect and importance of skin to skin on a global level.

Onto Dr Nils Bergman the man who almost 10  years ago taught me the word “Paradigm” -so as Nils would probably say ” instead of celebrating the high percentage of skin to skin lets flip the paradigm and ‘question  , dig , investigate’ the babies and mothers that didn’t get skin to skin contact”   – what happened ? “Maternal choice” “Theatre too cold ” or were there undocumented reasons like “pressure of work” “staff unaware” “mother not sure of benefits” “wants to bottle feed”  “paperwork too important” 

Skin to skin contact for women who have a caesarean is easy to implement yet difficult to monitor. It’s all a bit “retrospective” when what’s needed is a pro-active approach – women should be well – informed about all the new benefits that skin to skin brings such as “an increased ability to parent ” “acidosis correction ”  “reduction of pph” “reduced pain of mother & newborn” 

Theatre staff should be debriefed on the immeasurable ‘stuff’ like the woman’s heart overflowing with love , the tenderness that is shown , the noise in theatre turning into silence for the mother and child as they provide a two way comfort for each other . These things  slip away unnoticed by some  staff and it’s so sad that some are impervious to what’s actually happening . A life is beginning -a relationship is starting –  a caesarean birth is not a ‘procedure’ but an amazing event bringing a child into this world to be protected valued and rejoiced. 

So I’ll say this – let us all  talk about love and birth as a partnership – let’s know why skin to skin must happen and promote it more , let’s be ready for it ,prepare women for skin to skin , stand by them , give women the ability to believe in what skin to skin does by enabling women and newborns to experience skin to skin at birth by caesarean. 

My key pointers to start skin to skin at a birth by caesarean are 

1.The baby belongs with its own mother – & cannot be owned by the staff that are present – the newborn is not a hindrance to our work in the operating theatre we are there because of it – we work for the newborn 

2. Prepare the woman by keeping one of her arms out of her theatre gown and tucking it under her arm – an off the shoulder look which has a special purpose = gives space to the newborn . Place the stickers for the ECG connectors on the woman’s back – ask the anaesthetist for support and explain why. 

3. Explain to the woman and her partner that their baby must be prone to maximise full skin to skin contact which will maintain their child’s blood sugar,  prevent the mobilisation of brown fat and assist thermoregulation  

4. Explain thoroughly that skin to skin at Caesarean section is not always fabulously comfortable , that the woman might not be able to see her newborn but that YOU and the rest of the TEAM are there to support her and that her child is gaining so much from the contact that she will look back on it and be happy that it did take place 

5. Skin to skin in the operating theatre is everyone’s role – if it’s not happening and you are standing idly by then you are as responsible as the other staff on theatre . Women and their partners do not want to cause a fuss and 80% will not ask for  skin to skin contact , so as health professional we must mention skin to skin contact 

💡Your role is to teach others and help others to teach others – women , staff , families💡 

Start by looking at reasons why skin to skin did not take place – then move forwards – we can all improve what we do every day by our own approach and also by collaboration and communication within the TEAM and by including the WOMAN and her PARTNER and / or FAMILY MEMBER – #KeepGoing