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Hospital won't/can't help with skin to skin or bf attempt during stitching phase of C-Section.

(39 Posts)
onehitwonder Mon 01-Jun-09 12:21:24

Hi

I am booked for an elective section (due to issues post natural birth last time) next monday. I have just had my final appointment with the consultant and a midwife to discuss the procedure.
I raised the possibility of skin to skin or attempting to feed whilst I was being stitched (if I felt ok and not too shaky etc). The consultant said 'good idea - don't know why more people don't try it' but then I saw a midwife, who when I raised it with her said 'we have never acheived skin to skin or feeding in theatre' in fact 'no one has ever even asked about it'. She pretty much dismissed it out of hand, saying that they were looking into how other hospitals did support and acheive it, but that due to how the sterile area was arranged there, access to the chest was difficult etc etc.
She did say that they would help with skin to skin and feeding in recovery.

This has thrown me a bit. With my DD, I didn't manage to have much skin to skin or to feed her at all during the 'golden hour' post delivery as I was having a PPH and being stiched for about 45 minutes. My DD then didn't latch for 36 hours and so I had colostrum hand expressed by a midwife in tiny amounts for DD. I also had some issues bonding with DD and I don't know if earlier skin to skin & feeding would have helped this.

This is why I was so keen to try for skin to skin and feeding in theatre if possible.

I do understand that priority is the babies and my safety and with all the issues around infection etc that any 'compromise' to the sterility of the area being stiched would be a problem.

Her only suggestion was to talk to the surgeon when I see him on the morning of the op, but if the midwives have no experience of this and seem unwilling to try, even if he or she says go for it I am really not confident of getting support from them.

I just feel like I hit a complete brick wall. Do I just accept this? I was really hoping to at least have skin to skin. Apparently baby will be with the midwife/paediatrican for tests - cleaned up, dressed and then given to dad to hold whilst I am being stiched. I really wanted to be close to the baby as soon as possible sad.

Any advice on how to proceed here?

charleymouse Mon 01-Jun-09 12:33:23

I think as your consultant was supportive that is a good sign. If it is really not possible what about babies dad having some skin to skin until you are in recovery and wrap babe in a blanket that smells of you.
Have a look here under CS birth plans.
www.caesarean.org.uk/

If it is important to you try to do it, this was just one MWs opinion.
Good luck

elvislives Mon 01-Jun-09 12:46:46

I was offered skin to skin while being stitched after cs but hadn't thought about it in advance and didn't feel confident to try (cannula in hand, tilted on an angle and having already been sick )

It must be possible because they then put in my notes that they'd offered and I'd refused.

MrsHappy Mon 01-Jun-09 12:47:31

There will be one midwife in theatre, but there will also be a lot of doctors. If you ask the consultant to speak to the team who will be in there with you in advance, to say you have a strong wish to try skin to skin when being stitched and to discuss how that might be achieved, that might just do the trick.

I found with my CS that the screen was too high up my body and I couldn't hold DD, but I am sure they could have arranged it a few inches lower, so that might be something to raise.

They do not need to clean and dress the baby before handing it over. I am not sure whether they really need to take the baby away for tests (or if they could do the apgars as you/your DH hold the baby and only take it away if it isn't breathing well) but this is something I would ask about.
Also, here is an article about "natural caesarean" which shows what can be done. Perhaps you could show a copy to your medical team?

If you are too shaky or it doesn't work out that you get your immediate contact, please don't worry. My DD did not latch for about 12 hours after the surgery, but did latch by herself that night. My top tip is once you get on the ward to keep the baby in your top next to your breasts. It helped us no end.

FabulousBakerGirl Mon 01-Jun-09 12:49:07

Please forgive me if I am being thick but to me

baby born
checked all okay
you checked all okay
your partner in the theatre, if no staff available, help you to hold the baby and the midwife puts the baby to the breast.

How hard can it be?

I had an emergency section, wasn't able to feed for 3 hours but I was able to hold the baby while the messed up sewed me up.

And when I say hold, the laid him across my neck and nearly choked me.

elvislives Mon 01-Jun-09 12:49:24

I thought afterwards it's because while BF I find the left breast easier position-wise, and I was tilted towards the left with the cannula in my left hand. I'd have had to put her on my right, which feels awkward to start with.

OonaghBhuna Mon 01-Jun-09 12:49:30

i had skin to skin whilst being stitched, it was lovely. I waited to feed though until in recovery room.

They do need to check the baby but I was given DD2 to hold asap for the skin to skin. When I had the emergency section I wasnt allowed to hold DD1 at all until in the recovery room.

I dont really understand the MWs problem with at least skin to skin.

onehitwonder Mon 01-Jun-09 13:48:54

Thanks for your words of encouragement.
I just phoned the maternity unit to try and speak to my consultant and got through to what I think was the same midwife.
I said I felt like I had been made to feel a bit mad for even asking for this and had been told that 'no one has ever asked before'. To which she replied 'oh no you aren't the first, I had to talk a lady through it this morning hmm' which is what makes me think it was the same midwife.
However she seems now to be very supportive of skin to skin - that of course it can be attempted in theatre, she has helped with this lots of times, just talk to the midwife I am allocated to on the morning of surgery. Good news of course, but a bit of a U-turn. I thought I was going mad and had imaginged half the conversation this morning, but DH who was with me confirms that she was definately saying skin to skin not possible in theatre.

It all really inspires confidence hmm. This is the same maternity unit that sent me up to the ward mid induction (as it was after visiting hours, so DH had to go home and they then left me to go through the whole first stage of labour on a 4 bed ward, with no support because they didn't believe I was in labour - despite a show and my waters breaking all within about 2 hours.

I thought I would be a bit more confident and informed this time, but apparently a different type of delivery means they can still tell me whatever and I just have to go with it. sad

Just had a smivel on DH.

forevermore Mon 01-Jun-09 13:58:27

Forgive my ignorance but what is the golden hour and does a baby actually feed straight away or just suckle? I have placenta previa so could have an c-section too. I didn't feed my first very easily and think it may be due to lack of skin to skin.

FabulousBakerGirl Mon 01-Jun-09 14:38:59

My baby was over 3 hours old before he was put to the breast.

crumpet Mon 01-Jun-09 15:12:48

Hello, in case it helps, I did not have skin to skin in theatre, but for both my cs's I was back in the recovery room after about 1/2 hour, and fed both mine then.

onehitwonder Mon 01-Jun-09 15:15:43

As I understand it the 'golden hour' is the super alert period that a lot of babies have immediately post delivery. As babies are alert I think is it therefore a good time to try for a first feed. Certainly with my DD, she was alert during this period (we have the pics to prove it smile, but unfortunately I wasn't encouraged to try and feed and was a bit out of it myself due to pain, stitching, and the gas and air I was sucking on to try and forget the stitching. By the time we got to the ward, she was very sleepy and we didn't manage to get a successful latch for 36 hours.

MrsMattie Mon 01-Jun-09 15:16:05

I didn't breastfeed until we were in recovery, but I had skin to skin while being stitched up. They assisted me in pulling my gown down so that my chest and tops of my breasts were exposed and put my DD straight on to my chest for a cuddle as soon as she was born. Then took her for a quick check (always keeping her in my eyeline - doctor even shouted at a HCA who stood in front of me so I couldn't see her for a split second!), then she came straight back to me wrapped loosely in a towel and was put on to my chest. As soon as we were in recovery I had my top off and her lying naked on me. the midwves were really encouraging.

Insist on at least the skin to skin. There's no reason why not, unless you have a complicated delivery.

onehitwonder Mon 01-Jun-09 15:18:31

Oops forgot to say that I am not sure if they feed or suckle - I am guessing different for different babies, but hopefully someone who knows a bit more than me can clear that one up.

ihatemyjob Mon 01-Jun-09 15:21:08

I fed whilst being stitched up. I did not ask anyone I just did it.

I had skin to skin straight away both times with c-sections. Well the babies may have had some sort of partial clothing wrapped around them. The first I did not try to feed in the theatre as he was my first and I had no idea what to do. With my second I was desperate to start straight away as my first had not latched on properly and took nearly 2 weeks to get the hang of feeding (not helped by being bottle fed cos of my gestational diabetes). So I just thought I would try. He got it straight away and I think I suprised the anesthestist who had never seen anyone do this. (though he was a night mare on the breast I didn't use and caused me pain through wrong positioning or god knows what for 6 weeks!)

onehitwonder Mon 01-Jun-09 15:46:05

Great that you managed to do that Ihatemyjob. Did you manage to hold the baby yourself, or did your birth partner do that?

The midwife/s seem very keen to stress that there are so many issues with feeding whilst being stitched:

The table is too small - narrower than an examining table,so no room to get the baby in a good position.

Risk of compromising the sterile area. She seemed keen to stress that the 'hole' that the baby was coming out of would be huge - about the size of the hole in a toilet seat so not much room between that and my chest. Which seems odd as I have read on some threads of people having the curtain lowered so they could see baby delivered and not to worry about seeing the incision as bump is in the way?

I may well feel too sick or shaky - now I freely admit that this may well be the case and I may not want to try to feed in that case.

They didn't want the baby in the way in case of any complications whilst stiching me and medical team needed quick access to my chest - but don't see why that would be more of an issue for feeding than skin to skin?

So all in all doesn't sound like I will get any support in trying to feed unless DH manages to prevail, but it is hard to imagine going against these medical reasons they are giving me.

spicemonster Mon 01-Jun-09 16:00:15

I think I would have struggled to feed in all honesty - I was lying on my back and felt really sick. I did hold my DS on my chest though while I was being stitched and was in recovery in less than an hour and my MW put him straight to the breast the minute I was wheeled through. There's no reason why you can't do that at all I wouldn't have thought. And unless you're very, very small, there is plenty of room for you to hold a newborn and to be stitched at the same time!

CoteDAzur Mon 01-Jun-09 16:03:02

Just a quick note to say that if you don't get to breastfeed in theater, you can still bond and successfully BF later.

I had an elCS 10 days ago, following vaginal birth 4 years ago. I didn't have skin to skin nor breastfed until i was out of recovery bout 2 hours later, during which time baby was checked and put in incubator for observation.

We bonded quickly, and he quickly started to breastfeed like a champ. A very positive experience in all.

I wouldn't have been able to feed him in theater if I wanted to, by the way, as I had constant blood pressure monitor on one arm and IV canula & finger tip thingie on the other.

ihatemyjob Mon 01-Jun-09 16:05:48

That's really annoying as no-one said anything like that to me. I am quite large so they may have had a larger table? I felt shakey when the epidural was first put in but not after. I had enough room for the baby. I have a long body but then my baby was almost 10lbs.

I remember holding my first one ok too. The second one who I fed I held across my chest. I have large breasts which may or may not have made a difference. I don't think I have ever fed like that before or since; it was sort of horizontal across me. I think my arms ached quite a bit so I may have moved him. Its only been 2 years and my memories are already fading!

Also I may have just been lucky because he was an obsessive feeder the first few days. He was hours and hours on the breast or would scream the ward down. That may have been due to the diabetes.

ihatemyjob Mon 01-Jun-09 16:07:40

I fed with all of the things that cote d'azur had on too as I was being monitored.

expatinscotland Mon 01-Jun-09 16:08:13

I echo Cote's experiences.

I had an instrumental birth in November of last year and the baby had his cord wrapped round his neck, so he needed to go to the paeds after his birth and I needed stitched.

I also had to have some medication during labour after the epidural didn't bring down my BP enough, and it made me sick, so I couldn't really hold DS right away, then I briefly held him and had to give him to the midwife to put in a cot next to me as I was projectile vomitting.

But was okay to hold him after a few hours and all went well.

Lizzylou Mon 01-Jun-09 16:14:25

Similar to Cote and Expat here.

I have had two ventouse deliveries, albeit different experiences.

DS1 - I had had a spinal (thought I'd needed an em c/s, turned out ventouse would do job), he had cord round his neck and was floppy, he was whisked away and I don't think I had skin to skin with him for at least 1.5hrs. All was well, established breastfeeding that night with help from a lovely mw.

DS2 - Ventouse delivery, straight onto breast where he remained for 45mins.

Breastfeeding was fine with both boys and we bonded fine.

Meglet Mon 01-Jun-09 16:16:28

I had skin to skin after a planned cs. The consultant was all for it smile and I told the theatre staff I wanted it too. TBH I found it jolly tricky to hold dd as I was lying down and had tubes everywhere, but we managed 5 mins of skin to skin (pic on my profile, poor dd is a little bit squished) . I didn't dare try bf in theatre as it was way too tricky. I bf. In high dependency ward after about an hour and she took to it like a duck to water.

Hope you get it sorted, just pester them on the day.

Meglet Mon 01-Jun-09 16:20:39

Just to clarify mine.... Dp held dd while I did skin to skin. There was no way I could have held her all on my own. I used one arm to support her.

onehitwonder Mon 01-Jun-09 16:23:52

Thanks Cote and Expat for your positive experiences of feeding later smile.

I think what happened last time is colouring my views on this and of course this is a different baby who I am sure will react to things in different ways to my first.

Maybe the positive stories of hospitals which are a bit more progressive which I have read on here have also given me unrealistic expectations. It is just that I expect hospitals to be so pro-breastfeeding that I anticipated a very different reaction from the midwife - at least along the lines of 'we can try' rather than 'we have never acheived it'.

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