Why is skin-to-skin contact at Caesarean births not always routine practice?

It is often difficult for women to experience immediate skin-to-skin contact with their baby after caesarean birth for of a variety of reasons

1.   Issue - Sometimes women have not clearly expressed their desire to the key personnel e.g., their midwife, anaesthetist, paediatrician and obstetrician therefore, as is routine, baby is first taken to the resuscitation cot for cord clamping and assessment by the paediatrician or midwife before spending time with the Mother.

Solution: Advise midwife and medical staff of your desire immediate skin-to-skin contact providing baby is well.

2.   Issue - Theatre gowns don't lend themselves for easy access the mothers bare chest.The gowns usually have the opening at the back therefore fabric has to be bunched up under mothers chin making visibility and handling complicated.

Solution: Negotiate with your anaesthetist and midwife prior to epidural or spinal to reverse the gown to have the opening at the front ready for baby’s placement on chest. A warm bunny rug can be placed over baby's back if the theatre is cold.

3.  Issue - Habit or policy, some facilities are in the habit of taking baby first to cot and swaddling tightly before handing to mother with only face visible.

Solution: – Discuss your desire to have immediate skin-to-skin contact, emphasising the research demonstrating the benefits to mother and baby for and bonding and in establishing lactation. 

4. Issue – Baby is having breathing difficulties and needs medical attention.

    Solution: Once baby’s condition has stabilised request skin to skin contact whilst still in theatre if possible.