Skin-to-Skin Contact Following a Cesarean: Fight for It – It’s Your Right

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This piece is about the importance of mothers staying with their babies after birth and of experiencing immediate skin-to-skin contact, even if a C-section is warranted. In my case, I was holding out for a vaginal birth but ended up with a c-section. This is the story about how I was able to get skin-to-skin contact following a C-section despite my first doctor telling me that it would not be possible.

As I’ve mentioned in a previous post on the birth of my child, the first OB that I sought care under was mandating that I have a cesarean at 36 weeks, mostly due to CYA policies. Not knowing any better I originally went along with her decision.

However, one day I was talking over my situation with a well-published neuroscientist who had recently had a child of his own. He was appalled that my doctor would recommend a c-section at 36 weeks. He suggested that I start researching my options immediately. His opposition to the C-section was not just medically-based. He felt that C-sections could have negative side effects on a mother’s emotional well being and he was worried about the lack of skin-to-skin contact. He stated that skin-to-skin contact (which might not be available with a cesarean) following the birth of the child was a crucial element in mother-child bonding, to nursing, and important for the health and well being of the child.

What is Skin-to-Skin Contact?
When a baby is born vaginally, he or she is ideally taken from the birth canal and placed on the mother’s belly immediately following the delivery. The babe is covered with a blanket to keep her warm. Babies lay on their mothers and begin to regulate their body’s temperatures in synch with their mother. They exhibit pre-feeding behavior and start to learn to latch on and nurse. In some research studies, scientists have filmed the babies as they literally army-crawl up their mother’s chest to reach the breast where they can start breastfeeding! It may take an hour but they make it and with any luck they latch on and start to nurse. This is skin-to-skin contact at its best. The mother and baby are united skin-to-skin immediately following birth.

Of course, there may be times when the mother is what they call “medically unavailable.” In these cases, skin-to-skin contact with Dad or another caregiver has been proven to be equally as beneficial to baby.

Why is skin-to-skin contact so good for your baby?

  1. The sooner the baby starts nursing, the more likely it is that the baby will successfully nurse and will latch on well. With skin-to-skin contact it is also more likely that the baby will nurse exclusively for a longer period of time. During the first few minutes of life the baby is not eating per se but is practicing the act of nursing and demonstrating pre-feeding behaviors. These behaviors are crucial to long term successful breastfeeding.
  2. Skin-to-skin contact with the mother (or even a father or substitute caregiver) helps the baby to regulate its temperature more quickly and without the use of a warmer. Many babies are put into a warmer directly following birth. Research shows that skin-to-skin contact is more effective in regulating the temperature of the new born than swaddling or being put in warmer. Research also shows that when a baby’s temperature drops, the mother’s temperature rises to compensate for the loss of body heat in the baby. The mother’s body is designed to regulate her baby’s temperature. She literally becomes her baby’s thermostat.
  3. With skin-to-skin contact babies breathing rates and heart rates are more stable and the baby’s blood sugar is higher.
  4. Babies who have skin-to-skin contact cry less than babies who are placed beside the mother/father in a bassinet. This is true even for babies that receive skin-to-skin contact from their fathers when the mother is medically unavailable. The infants become calmer faster and reach a drowsy state faster than babies who are put in a warming cot next to the parent’s bed. If you are medically unavailable ask the doctors and nurses to allow you or your husband or partner or family member to provide skin-to-skin contact or create a lang in advance so that your birth partner or doula can make this happen. This is better than no skin-to-skin contact and can have beneficial effects on the well-being of the infant.
  5. Babies born prematurely recover more quickly when they have skin-to-skin contact. Skin-to-skin contact is being promoted more and more in NICU’s (neonatal intensive care units) to help babies who are born prematurely to thrive. Skin-to-skin contact can reduce the infant’s need for hospital-supplied oxygen.
  6. Can you still have skin-to-skin contact if you are having a C-section?
    When I found out how important skin-to-skin contact was for the baby, I immediately wanted this for my child and me despite the fact that I was scheduling a c-section. I approached my OB about it which led to many conversations, discussions and tears. I brought in research articles supporting my desire and outlining the importance of skin-to-skin contact. The OB responded “Don’t worry. There’s plenty of time for bonding later.”

She explained that the operating room was not designed for skin-to-skin contact; that there was a drape that came up to the mother’s neck which would prevent skin-to-skin contact; and that additional staff would be necessary to help me have skin-to-skin contact with my baby. She explained that there was a sterile field that could not be crossed and that having the baby on my chest could compromise the integrity of the sterile field. She also maintained that the possibility of skin-to-skin contact would depend on who would be available at the hospital on the day of my surgery and although she could try, no promises could be made.

This news led me to an all out search for a hospital that would allow skin-to-skin contact following a c-section.

Usual Practice
Until recently, usual practice involves separating the baby from the mother as soon as the baby is surgically removed from the mother. The mother is shown the baby over the drape, the baby is then weighed and treated and swaddled and placed under the warmer. That baby is taken to the mother’s room until the mother is finished being stitched up and returns to her room after a stay in the recovery room. The baby and mother are reunited in the mother’s room with the mother only have briefly viewed her baby.

Advocate for Yourself
After determining that skin-to-skin contact was a must-have for me in the case of a cesarean, I contacted three hospitals and asked them about their OR procedures with a c-section and whether I would be able to have the skin-to-skin contact I desired.

The doctors and nurses that I spoke with were all supportive of skin-to-skin contact. I recall one doctor saying that it would be against hospital policy but that rules were made to be broken. This same group of hospitals were changing their delivery practices and training their staff on the importance of in-room boarding (meaning the baby stays with the mother for as much time as possible rather than going to the nursery).

Be Persistent
I finally found an OB who was willing to honor my desire for skin-to-skin contact. The last thing he said to the accompanying nurse before I went into the operating room was “Make sure she gets her skin-to-skin contact.”

The idea of having my baby whisked away from me after the surgery that brought her into the world was devastating to me. I knew that this could not be right. I had carried this baby for nine months and they were going to show her to me over a drape and then take her away. How could this be healthy for the infant and the child?

Obviously, allowing skin-to-skin contact is not an insurmountable request. The obstetrician that I switched to at 28 weeks was Dr. Hartung of Hudson Hospital. He did not hesitate to honor my wishes. He ended up being my greatest advocate and allowing me to get my birthing desires met.

I want to thank Nurse Jessica and Dr. Hartung for providing me with the best birth possible with my cesarean and for helping me get the skin-to-skin contact with my baby that I so desired.

In the meantime, if you are planning a C-section, ask about the possibility of skin-to-skin contact. If the doctor refuses, stand your ground. If the doctor continues to resist, call other hospitals and find a doctor that will honor your wishes.

And, of course, remember that most births do not go as one plans. Even in cases where skin-to-skin contact doesn’t occur due to uncontrollable circumstances, the baby will still thrive and bond with his or her mother. And just because one doesn’t have skin-to-skin contact right away does not mean that breastfeeding isn’t possible. What in theory is the BEST for our baby doesn’t always match with the reality of mothering. We can only take what we know to be best and do with that what we can.

Things to Think About:

As a society, how can we advocate for change among OB’s such that they are open and willing to the idea and practive of skin-to-skin contact even in the case a planned or unplanned C-section?

How can mothers advocate for themselves with OB care such that they can get the type of birth experience that they desire?

How can we be proactive in attempting to create change at the hospital level?

What can we do in our own community to educate OB’s and hospitals about the importance keeping babies united with their mothers especially during the first few hours following birth?

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33 comments

  1. I was frightened into have an unnecessary c-section 3 weeks before my due date. As for skin contact after my son was born, I don’t know how that would have been possible. I was screaming in pain as the stitched me up, and then unconscious. After I woke up, he was with me in my hospital room, and slept in a plastic bassinet next to me. Certainly I held him and made attempts to breastfeed him, but mostly I felt like crap.

  2. That sounds like a horrible experience. Why were you screaming in pain? Why were you unconscious? Obviously every person’s experience is different and every mother does what she is capable of doing in the moment. I’m sure you did what you could do.

  3. I was screaming because being sewn back together was very uncomfortable. I was unconscious because after my son was out of my body they gave me medication that put me under. A c-section is major surgery, and recovery can take several months.

  4. Wow! That is very different from my experience. I didn’t feel anything when they were stitching me back up and they didn’t give me any medication for me to be put under. I had a spinal. I’m sure the experience is different from woman to woman. I can empathize with the long recovery. A c-section was no fun. My stitches got infected and my bedroom was on the second floor of my house. I was also alone many nights because I am a single mom.

  5. Sheryl – Thanks for your feedback on my post. I don’t want my essay to sound like this is the only way for people to go. Also, I guess I wasn’t clear that I had had a c-section too. I’ve made some changes to try and correct these misunderstandings.

  6. Don’t get me wrong, I loved my baby and bonded with him as soon as he was born. I just meant that, for me, their was no opportunity for skin to skin contact right after birth.

  7. Oh, I have no doubt that you bonded with your baby…I’m just so surprised that the stitching up part hurt so much. Didn’t they numb you from the waist down? The only part for me that I found so uncomfortable was when they were pushing her out. It felt like my chest was going to explode. I didn’t even notice the stitching me up part. I think I was chatting away with the doctor. Were there other things going on with you medically? Why did they give you medicine to knock you out afterwards? Because you were in pain?

  8. I had a lot of discomfort during the whole surgery, and especially unpleasant was the sensation that I could not breathe. They said it was because the anesthesia went up as high as my neck, instead of just my abdomen. As far as knocking me out afterward, I think that is often done. After all, surgery is usually done with the patient unconscious. During a c-section a woman is awake during delivery so that the baby doesn’t get too drugged. But after the baby is out, they can use the full dose of anesthesia.

    1. That is NOT common! My husband is an anesthetist and that does not sound right. You should not feel anything and they probably knocked you out because you were panicking. I wonder if they put the spinal up too high too and that is why you were numb to your neck. That is a horrible experience! I have had 2 C-sections with zero pain during and I could move my arms, just numb chest down. That is scary.

  9. After five days of trying to naturally birth in a hospital, I was convinced C-section was the best option. Shaking and trembling I was brought into the surgery ward. Luckily we had an open minded OBGYN on staff and she allowed my husband and my birthing assistant in the room. After the baby was born she we were able to view her and then she was put in a bassinet, I believe and taken to the room. My husband was there as well as my birthing assistant and surely either one of them could have held her. We did have our daughter sleep with me in the bed and began nursing right away so in our case very little was lost. However I would say we both noticed her need for skin to skin contact even after she was one. Our daughter is very attached to us as we practiced attachment parenting throughout her life. Thank you for writing about such an important issue and helping mothers and fathers advocate for skin to skin contact.

    1. Thanks for sharing your story. The hospitals have a general protocol they follow and I think as moms we need to be as proactive as possible. Kids really do like skin-to-skin contact even as they get older, don’t they? It helps them to feel soothed, as Sheryl said, and connected.

  10. As I think more about it, my son still does have the need for skin to skin contact. He is 3, and likes to put his arms in my sleeves, or under my shirt onto my back, and just hang out there. It soothes him.

  11. Thanks for the post. I know this is from a USA point of view and they do things differently there.. But it seems to me what these situations need, much like a ‘normal’ birth, is a midwife! All midwives know all of this, and the Ob is a doctor trained to deal with surgery, emergencies etc. I think everyone should have a midwife whatever their birth is planned to be, natural, drug, home, c-sections etc etc. Also, look for a ‘Baby Friendly’ hospital. They know about skin to skin and giving a baby straight to you etc.

  12. Absolutely! There are many, many midwives in the U.S. and many women are choosing to devlier at home. This is becoming more common. Some midwives here work in doctor’s offices and some do not. In my case, however, I was giving birth as a VBAC and many practices require an MD to do the care as opposed to a midwife in the case of a uterine rupture. One woman I know did have her VBACs with a birthing center but there was a hospital across the street in case she were to have a uterine rupture. It is actually a good thing I was being monitored by an MD because the baby’s heartrate was deaccelerating and she needed to come out ASAP!

  13. It is good to see an article sharing how to make a c-section birth as bonded as possible. We has a planned home birth and I had no complications over the course of my pregnancy. However, after 42 hours of active labor at home we transferred to the hospita with our midwives. I tried for 6 more hours there to birth her naturally but remained at 6/7 cent just as I did at home. She was 42 weeks and 3 days and was delivered via c-section. Because of meconium aspiration she was taken to the NICU however, due to a hospital mistake she was kept for one week instead of three days. We fought with them because she was being treated unnecessarily.
    I was not able to hold her till 12 hours after her birth. I regained feeling during my surgery and was screaming in pain, had to be out under and I also received a blood transfusion. However, 12 hours was the soonest they said I could walk and at 12 hours I got out of bed (very carefully, slowly, painfully lol) and walked to the nicu to feed my baby. I did this for a week everytime she was hungry and she has been EBF since birth. Fortunately my partner was present and able to accompany her to the nicu and stay with her while I could not.
    I know that we did everything possible to have our baby drug free, naturally, at home.

  14. I had two c-sections. With my first due to hospital regulations, after they closed me up I was able to hold him long enough to get wheeled out to my family to see, but then he was taken and I was in the recovery room alone for a couple hours. After that, I was able to have him in my room and nurse him. He had a lot of trouble latching on, and I had a very difficult time nursing for the first month. I even supplemented with formula. With my second, they had changed their regulations, and as soon as they closed me up, they gave him to me and took us to the recovery room together where I was able to nurse him immediately. He latched on with absolutely no problem! He was a champ at nursing. I didn’t get skin to skin immediately with either of them, but I truly believe that my second did so much better with nursing because I was able to nurse him very soon after having him and wasn’t separated from him like with my first. Whenever I have my next one, I am definitely going to stand strong for skin to skin!

  15. Stephanie – Good for you! It sounds like your experiences have helped you define what’s important for you and your relationship to your baby. Plus you’ll be paving the way for other mothers in the future!

  16. I am soooo happy i found this! My frist baby i was induced and did pretty good until it came time to push. My epidural had warn off(accept for my legs were numb)and i had this god awful pain in my back where the epidural had been placed. On top of that when i was ready to push my dr figured out my son was face up not face down. So she was able to turn him face down. 1 push after that his heart rate dropped and i was being preped for a c-section. They ended up giving me a spinal since i could feel everything in my body accept my legs to numb me for the c-section. Before i knew it my sweet baby boy was here i barely got to see him over the cloth and then he was rushed to be weighed,cleaned,ect. i saw him 1 more time as my husband was walking out of the room with him. He was born at 7:52pm and i never got to see him again until 3am the next morning. They said they couldnt get his blood sugar to stablize :-( by the time i got to see and hold him again he had sugar water out of a bottle and formula(even though i said over and over i wanted to breastfeed!!). My son had liked how easy it was to suck from a bottle and didnt want to work for breast milk. i was quite upset but i obviously am not going to let my baby starve! I had no idea that you could get skin to skin after a c-section. i had always known they wisk your baby away and you get them when THEY say you can have your baby. I am due in 6weeks and i am determined to have skin to skin as well as try 1,000% to breast this new baby.(if this one wont breast feed at least then i can say i gave it my all) Thanks so much again for the hope!

    jess

    1. In the event that something is wrong with the new baby’s blood sugar, ask them to syringe feed him if need be. I had gestational diabetes and when my first was born, his blood sugar was also very low. The nurses told us it would really be best to get some formula in him to get it back up and asked if I planned to breastfeed. When I said I was, they said they would use a syringe instead of a bottle to make it “more difficult” for him to get it so he wouldn’t like the ease of a bottle so much. We had no problems with latching afterward.

  17. I had my 1st elective c-section 6 years ago when my son was discovered at 36 weeks to be a footling breech, he was delivered at 39 +1 weeks which is the practice here in the UK. I did not have any problems with the section but yours sounded horrific, it truly does not bear thinking about what you must have endured. I was planning on a VBAC this time and my midwives and consultant were pushing for that in the early stages, until I saw a registrar at 20 weeks who put the fear of God into me. I won’t go into what she said but it sent me into a high level of anxiety which I haven’t been able to recover from, unfortunately what she said unknowingly stepped all over past trauma events and regular counselling therapy hasn’t alleviated it. So for my mental health I’m now having another elective c-section next week at 39 + 5 weeks, or as she’s partially engaged an emergency c-section if I go into labour this coming week. I had been thinking of asking to have skin to skin and being able to breast feed ASAP for some weeks now as I felt last time as a first time Mum I didn’t have the opportunity until sometime after my son was born. I’m glad to have found this article as it validates what I had already decided, and it is the only thing in my birth plan which has been added by me.

  18. Wish I had known this was an option when having my son. He was an emergency c-section. Thankfully they did not give him a bottle so I was able to breastfeed him, but we did have problems for about a month (inverted nipples). We co-slept for a long time and he still needs skin-to-skin as a toddler.

  19. Wow, I enjoyed reading this, you had some great perspective to consider! I have been a Labor and Delivery nurse for 27 years, and I have had 4 C-Sections, so I realy do see both sides of the issue. Recently we began having moms ask for skin-to-skin in the operating room (We already do it immediately upon arrival to the recovery room if mom is stable) but our director asked us to stop because we didn’t have a “policy in place.” Just wanted you to know I shared this on our departments private Facebook page (staff only) Hopefully we can get some momentum to get policies in place to allow skin to skin in the OR :)

    1. I also am an L & D RN. I agree this idea needs to be visited and evaluated, but I take issue with some of your wording. In the title, you use the words “demand” and “rights”, and answered others with “demand what you want”. I can tell you right now that the most ineffective way to get what you want in a hospital with strict rules and guidelines in place to protect themselves and patients is by showing up demanding things be done your way. Even in your article, you said you had to shop around for a hospital that would accommodate your desires, with “conversations, discussions, and tears”.
      This worked for you. Where did the “demand your rights” part come from? According to your article, you didn’t demand anything. Women need to call around to find a hospital that will accommodate them, long before their delivery date, not the day of surgery, just like you said you did. If enough women start asking, hospitals will take notice. And if hospitals A and B start losing patients to hospital C because they accommodate their patients wishes, it won’t be too long before they realize they need to change.

      1. Thanks for your perspective. I do understand what you are saying and it is something to consider. Unfortunately, market demand did not create change in our community. Dr. Hartung was one of the only doctors to do vaginal breech deliveries and VBAC and the hospital he worked at imposed more restrictions (see below). People come from miles around to have him attend their births.

        https://www.facebook.com/permalink.php?story_fbid=613646871984625&id=140458025970181

  20. i was given skin to skin after my c-section. i was shown baby as removed,
    baby was then given a quick ‘all bits intact check, at which point the pead specialist was ‘released’ as not required.
    and then my LO (little One) was handed to me for skin to skin
    (the hospital had checked who was the back up – if i wanted it – just in case).

    baby was then removed after a bit for proper weighing in etc, and given straight back to me for a bit moe cuddling.
    then baby and daddy were taken out to delivery suite, as they finished me off and took me back to the room.
    i arrived to baby being cuddled, and a recovery nurse supported bf’ing for first hr aftewards. though she was there for us both.

    couldnt of been more imporessed with Swindon NHS Great Western.
    Even OH was impressed.

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