Pediatricians attendance for scheduled c-section

  1. At my hospital the policy states that a physician needs to attend those scheduled/low risk/repeat c/sections in case the infant needs resusitiated. All of the staff are certified in NRP. Some of the drs are trying to change the policy and have dug up studies stating that infants born via a repeat c/section with an uncomplicated pregnancy are no more likely to run into trouble than with a vag delivery (where the pediatrician is not present).
    Was wondering what other hospitals do? Personally I do not think they need to attend but to be forwarned and be available stat if needed. We are a community hospital that "births" about 650 babies a year and have a level 2 nursery.
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  2. 17 Comments

  3. by   fergus51
    Our hospital also requires peds at all scheduled c-sections.
  4. by   wsiab
    We use NICU transport nurses.
  5. by   layna
    We are a community hospital that delivers about 400 babies per year. All our nurses have NRP. No doctor attends the baby unless we know ahead of time that there is a major problem. If we feel that there is a potential for problems, we call the baby's doc and have him/her on standby and call if needed.
  6. by   shay
    We have peds attend ours too. Do about 1200 deliveries a year.
  7. by   rdhdnrs
    Both places I work, one community hospital, one teaching facility, have peds at all sections.
  8. by   Sable's mom
    I work in a small rural hospital that does 450 births per year. We don't even have a pediatrician on staff - all our babies are cared for by family practice docs.
    Our obstetrician has a family doc as an assistant at all sections and he/she is expected to break scrub and assist w/ neonate if needed, but since all our nurses are NRP certified, it's usually not an issue.
  9. by   Hardknox
    All our nurses have NRP certification. We have a neonatologist on staff 24 hours. if there is a known problem with the sceduled c/sec he is there. No one attends the reg. scheduled c/sec but he carries a beeper and comes with a Special Care Nursery RN if a problem arises.,STAT. We have 4000 births a year. (I keep forgetting I just resigned...shows how hard it is to leave....)
  10. by   Angel Baby
    The standard of care is that you have adequately trained staff who can resuscitate appropriately. So, the real question is whether you have enough experienced nursery nurses to handle a full code of a neonate (and an OB who is NRP certified and knowledgeable to lead until a pediatrician or neonatologist can step in).

    Being NRP certified isn't enough--it's a matter of ongoing competency--but if you have the support immediately available to initiate the resuscitation and have pedi's who are available to come if there are problems then you should be covered.
  11. by   bbnurse
    Of the places I have worked, it was required that a physician, whether a family practice, OB, or Pedi, attend all C-S to "receive" the baby. All OR and Nsy staff also had to have NRP to assist this "receiver". One was a small hospital with about 30/month, one a large hospital with 4000/yr, and a midsize with about 1100/yr. deliveries. One place tried a few without a pedi when it was a planned C-S but had too many near misses d/t failure to recognize potential problems so that practice was stopped.
  12. by   prmenrs
    I have attended quite a few "routine", "low risk", repeat, scheduled c-sections that didn't work out that way for the baby. We have an RN, an RCP, and a fellow, 3rd year resident or occassionally an NNP and a resident (minimum 3 people) @ all deliveries that are NOT NSVD.

    Don't forget that when the baby doesn't go through the vagina, it's harder for them to get rid of all the fluid in their lungs. Also the L&D RN who's not scrubbed has a lot to handle, and she cannot observe the baby as well as may need to be done.

    I think a pediatrician and a NRP trained RN are the LEAST amount of personnel I'd want there. An RCP is very handy, too.
  13. by   Jolie
    I don't mean to sound stupid, but what is an RCP?
  14. by   prmenrs
    RCP=Respiratory Care Practitioner. aka, Respiratory Thearapist.

    By the way, we have a home birthing-type place 2 floors above us; the nurse-midwives deliver babies up there. We got called "stat" for a baby up there today.

    I know it's a normal process and all, but, boy--when things do go wrong, it's real scary!!
    Last edit by prmenrs on Apr 27, '02

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