Hello all of you L&D nurse's out there!  I am looking for some input. 

I have worked in L&D for 12 years now in a for-profit hospital that does approx 2600 deliveries a year.  With our vaginal deliveries with healthy babies we transition them together in the same room to help promote bonding and to initiate breast feeding as sson as possible.  However, with our cesarean sections, the babies are delivered, held up above the sterile drape so that the parents may see the baby and then taken over to a warmer where they are assessed, weighed, and measured.  As long as the baby is healthy, the baby is wrapped in blankets and capped, then brought back over to the parents to see for a few more minutes before the baby is then taken to the nursery with the father of the baby (or support person) if they wish to stay with the baby.  The mother's surgery is then completed and she is taken back to her private  L&D room for her recovery period.  During this time the baby remains in the nursery and only one family member may stay in room with the mother along with the primary L&D (PACU) nurse.  The recovery period is a minimum of 1 hour, if all remains stable and the baby is doing well, the baby may be brought back to the room.  Usually by the time the baby has gotten back with the mother, the baby is anywhere between 1.5-2 hours old.  We all know how important the initial bonding time between a baby and it's mother is and getting breast feeding going.  So, with all that being said.  Our unit is thinking about how we can keep the mother/baby couplet together even in the event of a C/S as long as both are healthy.  Our standard is to have 1:1 nursing care ratio during the recovery time of the mother.  So an addition nurse would be needed to help care/transition the baby.  Are there any units out there doing this?  If so, how are you doing it?  Obviously, working in a "for-profit" hospital, we have to be aware of cost.  I have ideas on how it could work for the scheduled C/Ss, but how do you do it for the non-scheduled ones?

Hi Teri,

   I work at Kaiser Permanente in Honolulu.  After the c/s birth, the baby goes directly to the warmer and is assessed.  Within 5 minutes, a healthy baby is wrapped up and given to Dad to take to Mom.  Her arms are released and she is able to touch and kiss her baby.  They usually have about 15 minutes together and then Dad and baby go to the recovery room with the nursery nurse and await Mom.  When Mom arrives in recovery we assess her and as long as she and baby are OK they go skin to skin and hopefully breastfeed.

   I have been doing a research paper on skin to skin in the OR immediately after a healthy baby comes out.  Fascinating stuff!  Mom's electrodes are initially placed on her side and back by anesthesia so they are not in the way.  The wet baby goes directly to mom's chest and is dried and assessed there.  Covered with warm blankets she can even breastfeed in OR.  I found a great video on YouTube...12 minutes. by reelflowtv  "The natural caesarean: a woman centered technique".  Hospital staff and parents are interviewed about the technique and it shows the baby's birth and skin to skin.

Caroleyan, Thank you so much for your input and YouTube video suggustion.  I viewed and found it very informative and aspiring.  I will be forwarding this information along to our director to review.