Immediate skin-to-skin, not possible, if elcs, say MW at Kings Hospital today.

[Oblomov]

Went to Kings today. Saw MW aswell. Mentioned birth plan, when to start talking about it. Because never had one with ds (elcs aswell).
She said we could start one asap. Great. Told her my main wish was skin-to-skin asap, after birth. I wanted ds2 to be placed on my chest as soon as he came out.
She said this was very difficult. Because as ds will be pulled out, Mr Marsh needs to remain sterile, because he will then proceed to sew me up. She says this means him literally throwing baby over the screen divide, to the MW. She says she finds this very un-nerving becasue she literally has to catch the baby. Then she says, becasue my sheets will be up to my chest there is very little room for skin-to-skin anyway.

She says they prefer to whisk baby away, wrap them, and then return them so that the first skin-to-skin is with dh. A few minutes after being born.
After 20 minutes or so, once I am in recovery, I can then have skin-to-skin.

This is ttoally not what I had imagined. This is not the skin-to-skin, immediate placing baby on mum, that I had thought was the norm.

What to do you think to her comments/suggestions ?

That's what happened to me with my planned section with DD3. I asked the (lovely, wonderful, senior obstetrician) if I could have immediate skin to skin when she was born but he said it's not possible. As he would be sterile and need to stay sterile to sew me up, he couldn't pass the baby over to the non-sterile area, which is minute.

Also what with ECG leads on my chest, BP cuff on my arm, oxygen mask on and limited movement of my arms and no room on my chest he said it wouldn't really be safe to put the baby on my chest. The spinal also means you have virtually no feeling from the boobs down and only one arm in use which you can hardly move, so too much room for a rolling/dropping baby-type incident!

Also as section babies don't always breathe as well at delivery they do like to whisk them away to stimulate them and give them a whiff of oxygen.

As mine went, despite the delayed skin-to-skin I wanted it was lovely - they showed her to me immediately, sorted her out, gave her to DH who placed her next to my cheek so I could kiss and smell her, then in recovery she came straight in with me for skin to skin and breastfed. And there she stayed for hours! It wasn't exactly as I'd hoped for but I could understand their reasons and they were very accommodating as much as they could be and it was still a wonderful experience (I had had a crash section with general anaesthetic for DD2 so wanted a very different experience for DD3)

Hope it goes well for you

I think she's been very honest with you - 20 minutes doesn't sound too long to me to wait?

I'm not sure about the skin to skin after elcs, but I did hold my ds after mine, even though the mw took him first to check his lungs and tag him, but I was able to hold him despite as sidge said bp cuff, and spinal block (no oxygen mask for me). I even held him as I was wheeled to recovery, the sides were up on the trolley though so if he'd slipped I wouldn't have dropped him! Wait and see what you're capable of.

Hi Oblomov

No direct experience of this myself but this is in the current NHS guidance:
Your healthcare team should encourage you
to have skin-to-skin contact with your baby
as soon as possible. This tends to improve
how women feel about their baby, their
mothering skills and their chances of
successfully breastfeeding. It also tends
to reduce the amount a baby cries.

www.nice.org.uk/Guidance/CG13/PublicInfo/pdf/English

This is certainly consistent with what I was told in my NCT class.

Thank you for your comments. Esp Sidge, very interesting.
The Lovely PInkyMinky, from my AN thread, pointed in the direction of a great Victorian Squalor thread VS which I think I have read before. I am sure I remember reading about how VS asked for her arm to remain free.

But as Sidge says, I was so numb last time. will having an arm help, really help me keep ds on my chest.

And yes, as petitfilou says, I suppose 20 minutes, assuming that is how long it takes to get to recovery, is not a long time. But if this is a 2nd elcs, won't it take longer to sew ?

Plus, I am thinking of asking to nbe sterilised at the same time. So I could be there for some time.

In which case, if I don't get skin-to-skin immediately, I may not get to be with ds for ages.

And that defeats the whole objective of immediate skin-to-skin, surely ?

Try having a read here on the caesarian birth plan section.

www.caesarean.org.uk/

I had decided if DH was not going to be in theatre with me I would ask for there to be no screen. He is squeamish so had to have it as he was there.

We both wish we had seen more now as DT2 was born in his amniotic sac. The surgeon referred to him as being shrink wrapped as he came out so gently in his bag of fluid, supposedly it is meant to be good luck.

As it was an emergency section at 31 weeks though I had not even got to discussing my birth plan/ideas and had planned a visit round theatre for the following week.

I was going to have a nice calm empowering elective but fate took that out of my hands.

Hi Oblomov

This is very interesting - I have had 2 CSs, 1(em) at St Thomas's and the second (el) at King's. I'll be having no 3 at Kings in Dec as well.

In 1st one, the chap doing the CS (his first, bless him) handed the baby to the MW, and dh cut the cord and brought her over to me. The MW said I could have skin to skin but I was shaking too much and thought i'd drop her! Dh held her next to me whilst I was stitched up and I held her in recovery about 1/2 hour after she was born.

With DD2, she was transverse lie and it took a while (and a lot of tugging, forceps etc) to get her out. The OB passed her to a MW who then brought her to DH, showed her to me and then took both of them out! I had a couple of complications afterwards which meant I was in theatre for over an hour. I then had skin to skin in recovery.

I can't actually see why the MW could not put her on your chest if there is space. Presumably Mr Marsh will pass him to someone and they could put him on your chest? He can remain sterile and you can have skin to skin (if room with monitors, cuffs etc)? I am going to ask that, this time, my DH and baby stay with me til I am out of theatre and no one washes the baby. Last time, DD2 was cleaned up despite my instructions to DH (not as forceful as I would have liked!) and no one told DH why it was taking so long for me to come back. He thought something awful had happened and no one came to find out when he asked.

Incidentally, I am under Mr Marsh as well, but haven't met him yet. He was away at my last appointment and I saw Ms Jain, but have an appt to see him in Sept. I understand he's very good though. Will he be doing your CS or will it be an underling?

I had skin to skin with DD2 pretty much all day, she fed well and carried on feeding til 13m. The CS was very positive. The PN ward, OTOH, was less than great but that's Kings for you.

Good luck. When areyou due?

Incidentally, there's never been actual throwing in either of mine. Obs wrenches baby out (my screen was dropped in the elective for this) and then the baby was passed to MW on a green towel and taken to the resuscitaire at the back. Having gone through all that, I'd have been less than impressed by a throw and a drop!

I had an emergency c-sec with dd and she was whisked off to the side to be checked as she had IUGR but pretty quickly (certainly whilst being stiched up) the midwive took dd off dh and plonked her on my chest (she was wrapped up and I guess I was too so not skin to skin as such). There was certainly room (although she was small ) and didn't seem to get in the way of the business. That said it was pretty scarey trying to balance a teeny baby on your chest whilst not being able to feel most of your body but then I was pretty spaced out.

I've had 2 sections and both times the first skin to skin contact was in the recovery room (about 20 mins after birth as you say). I can't quite imagine how we would have managed in in theatre to be honest, what with all the wires and monitors and stuff. However, DD was handed to me about 2 mins after birth once they had checked her and breathing started etc and we cuddled and stared into each others eyes while I was sown up. It was lovely. Both times, once in the recovery room they immediately helped me to hold DDs skin to skin and start breast feeding, and I found it all a wonderful experience. I'm not sure what to advise, just saying that if skin to skin is slightly delayed hopefully you will none the less have a wonderful experience as I did.

Thank you for more replies.
Yes very interesting. I had always imagined that baby would be pulled out , and immediately placed on my chest, before being whisked away for checks, to be wrapped etc. Maybe I have that all wrong. Maybe that is unrealistic. I am not sure. THAT is the question I REALLY want answered. Are my perceived ideas realistic/possible ?

Both Wheely and Nelly, describe baby being whisked off. Interesting.

Chutney, I am a daibetic on a pump and was happy with my cs at Kings for ds. I was actually under Mr Marsh then, but forgot that. I did have a number of meetings with him. It was not him who performed my cs. My dh said OB was chinese. He did a fab job.

I 'see' Mr Marsh every 2 weeks, when I go to diabetic clinic. Although I have not spoken to him yet re this pregnancy. I think I will get to see him in about a months time.

I am not due till mid nov, but they will prob plan cs for 38 wks, so end Oct. Plus, with ds he came early, so I am thinking anytime from mid oct onwards.

I like Mr Marsh. He is 'old school'. Proper. Well spoken. Highly highly regarded, not just in the UK, but Worldwide. Fact.

Given the fact, that Mr Marsh is so well known, I am a bit surprised that he does not 'recommend' immediate skin-to-skin. Maybe I need to find out more on why this is, what his and Kings policy is.

Anyway Chutney, wishing you all the best, let me know how you are getting on.

Oblomov - in my case, dd was potentially not very well hence whisking her off (thankfully she was fine) but the doctor who performed the c-sec was adamant she stayed with me and she was placed on my chest within about 5 mins of coming out which isn't bad considering before the c-sec I had been warned she might need immediate transfer to another hospital as the SCBU was busy !

What I'm trying to say is that, I can't see why you couldn't have the baby on your chest straight away even if it isn't quite skin to skin because of sheets etc - providing there is no extra risk and the baby doesn't need immediate help.(I don't think you say why you are having a c-sec)

It may even be that this is just the midwife saying its not possible. Before my c-sec I was induced for a few days and when they finally broke my waters and put me on syntocin I had a succession of midwives (shift changes etc) and some insisted I couldn't even leave the bed to go to the loo and others had me bouncing on a ball and asking me why I had a bed pan as I could walk to the toilet .....

Yes Wheely, you are so right. As we all know, it depends on who you talk to.
I will start a birth plan. I only want a very few minor things. I will note it down. I will gently enquire more details from all the MW's that I see from now on. And I will check with Mr Marsh himself when I get my appt with him.