In many cultures, newborns are placed naked on their mother’s chest immediately after birth which is viewed by many as necessary for baby’s survival.  In most community hospitals, mothers and babies are seperated quickly after cesarean delivery and not reunited until hours later.  In collaboration with our Post Anesthesia Recovery Team, our obstetrical nurses have created a seamless process to keep mother and baby together throughout the challenging post operative period.

Proposed change:

In an effort to provide immediate skin to skin contact and allow for early breastfeeding for mothers and their healthy infants after operative deliveries, the roles and responsibilities of the labor and delivery nurses were changed.  These changes enable the nurse to be off of the labor and delivery floor and provide one on one care for the newborn and mother as a unit both intra and post operatively.

Implementation, outcomes and evaluation:

A multidisciplinary team was formed that consisted of labor and delivery nurses, post anesthesia recovery team members, lactation consultants, and the director of Women’s Services.  This team was formed to change the policies and procedures to allow infants to remain with their mothers after a cesarean delivery and the immediate post partum surgical recovery period. A process was developed to assist with implementation of the new procedures and to educate and direct nursing teams involved with c-sections.  Evidence based best practice was used to guide staff education. The education incorporated the importance of skin to skin contact between mother/ baby and early breastfeeding after an operative delivery.  Evaluation revealed that keeping mother and baby together after cesarean delivery increased patient satisfaction, enhanced quality of care, allowed skin to skin contact, promoted early breastfeeding, and supported thermal regulation of the newborn.

Implications for nursing practice:

Implementing “Babies, Bonding & Breastfeeding in the PACU” has enhanced overall postpartum operative care, fostered teamwork between nursing units, and supports AWHONN’s commitment to positive perinatal outcomes.

Keywords:

Babies, Bonding, Breastfeeding, PACU