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Hospital Tries 'Gentle C-Section' To Improve Bonding, Breastfeeding

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Ohio State University Wexner Medical Center
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Experts say early bonding with baby improves breastfeeding among other benefits.

A mother's first instinct is to cradle her newborn after it's delivered. But for many moms, cesarean section delivery impedes those first bonding moments that studies report are critical to a baby's wellbeing. So some Central Ohio hospitals are taking a new more "gentle" approach to the C-section.

When Amber Wallis delivered her first child, in 2010, the baby boy was five weeks early and needed special medical care. Wallis had to have a cesarean section.

"It was a very rushed and scary kind of process...Never had it crossed my mind that I might have to have a C-section," Wallis said. 

Wallis had planned to have skin-to-skin contact with her baby in those first moments after delivery, but she didn't see or hold him for four hours. Fast forward six years, Wallis reports a much different cesarean delivery of her third child, a full-term girl.

"I had her on my chest while they were closing me up. So that was fantastic," she said. 

Wallis took part in a new initiative at the Ohio State University Wexner Medical Center. It takes some components from so-called "gentle C-section," which aims to make the major surgery more closely resemble a natural birth experience. In the "gentle C-section," baby is placed on mom's chest right after delivery and breastfeeding is encouraged. Some hospitals have begun to use clear drapes so the mother can see the moment her child is delivered.

"Just because we've always done a cesarean section a certain way doesn't mean that's the way we need to continue," said Ruth Labardee, R.N. 

Labardee helps oversee Ohio State's nursing evidence-based practice and standards. She spearheaded the "gentle C-section" initiative which began last month.

"Mothers who deliver by cesarean often times feel a little deflated if they were anticipating a vaginal birth," she said. "So by having some strategies within the operating room to make it seem a little more natural-like is very appreciated by the family."

Small changes are made to make skin-to-skin contact and breastfeeding in the O.R. possible. For instance, heart monitor patches are placed more laterally on mom's chest and her dominant arm is free of IVs.

"You just see this overwhelming relaxation come across them, and it's like they have tuned everything else out," Labardee said. 

But the new approach has larger implications than just a better birthing experience. For some time, doctors have known skin-to-skin contact with mom in those first moments after birth lowers baby's stress hormone levels, helps regulate body temperature and improves breastfeeding rates.

Labardee said C-section babies should have the same opportunity.

"This is very important from a global health perspective because we are not where we need to be as a country meeting the Healthy People 2020 goals," she noted. 

Ohio State's Dr. Heather Frey is an assistant professor of maternal fetal medicine. She's a proponent of skin-to-skin contact and breastfeeding and, under the right circumstances, even in the operating room.

"In theory, it's a wonderful idea," Frey said. "But there's a lot of obstacles, and it has to be the right situation."

Dr. Frey cautions patient safety must trump patient experience. 

"If the mom is doing skin-to-skin during the C-section and she has increased bleeding or something else happens that needs to be addressed very quickly, that someone also is aware that baby's there and baby needs to be taken care of and maybe brought somewhere else to be in a safe situation," Frey said. 

These are some of the circumstances Ohio State wants to iron out before it fully adopts the initiative as policy. Right now, only full-term moms who have a planned C-section and intend to breastfeed are offered skin-to-skin during the procedure.

For mom Amber Wallis, the opportunity made her third cesarean experience a "more peaceful" one with less anxiety. With this baby, Wallis said she has been able to breastfeed, which she attributes to early skin-to-skin contact.

"To have her right there in my arms and know that even though they're still doing what they need to do to me, she is here, she is safe. Nothing else mattered," Wallis said.