Is there a Dr present at c-sections just for baby where you work.

[crysobrn]

We are a smaller hospital. Approx 400 deliveries a year. We have always had a doctor present at c-section deliveries along with a nurse. Recently there has been a push by the family practice docs to NOT attend c-sections with us, citing that we do not have a baby doc with us for vag deliveries, it's cutting into office hours, and that other hospitals do not have docs present just for baby, etc.

Just curious what they do at your hospital (please tell me how big your facility is, how many nurses are present etc...). We do not have a NICU and our RT's are not nrp so we cannot call them in an emergency situation. We doubt that anesthesia will be able to help us since they are in charge of mom and worry that no one will break scrub to assist. Also if anyone knows of any standards of care regarding this it would be helpful. Thanks in advance.

[SmilingBluEyes]

OHHHH danger, danger Will Robinson.

If I am reading right, you have problems here.

What exactly is meant by no doctor for a c/s???

And no NRP-trained person dedicated soley to baby attendance at every birth, c/s or lady partsl? Am I reading right?

We are a smallish community hospital where I am, doing about 800 del/year. Each time a c/s is done, we have as follows:

The OB/GYN on call to do the "cut" and an assist who can be:

The family practice doc to whom the patient is assigned

A RN first assist or PA used to assist or

another OB/GYN doc to assist

Also we have a scrub tech

Of course, MDA for anesthesia

And an RN who circulates

And another RN dedicated to the baby who is NRP trained. ( we dont' use cardiopulm personnel in our births, except to collect cord gases or help set up oxyhoods etc).

This is for every c/s, every time. For lady partsl deliveries, we have two RNs at every one. One for circulating for mom, other dedicated to baby. This is for every single birth, no exceptions.

IF there is a problem w/the baby anticipated, we also will have ped come in for the delivery to "take over" as need be....

as well.

Does this help you at all?

[Nicky30, BSN, RN]

Ok your post scared me a bit too.

We are a small country hosptial dealing on 350 births a year. For a section - planned or otherwise we have the surgeon (usually obstetrician), another doc to assist (baby doc), anaesthetist, midwife, anaesthetic nurse, srcub nurse and scout nurse.

Just less one doc is scary. Only a month ago we had one go wrong and baby had to be flown to level 2 NICU. Hate to think what could have happened if doc hadn't been there. Or another one a month or so before that where mom had excessive bleeding (another pair of hands was needed immediately - thank heavens they were there).

For a normal lady partsl delivery one midwife (sometimes 2), hopefully one doc although they don't always make it (they never made it to the deliveries of both of my children).

Nicky.

[canoehead, BSN, RN]

In a small hospital I worked at the PCP was the assistant to the OB/GYN, and also was great as a contact for the family.

[imenid37]

Our babies have a ped dr. and and RN to care for them at birth for c/s. Fp will not come to c/s anymore, so Ped comes as a consultant if it is an FP baby, then Fp is called and assumes care then.

[BeccaznRN, RN]

Ditto for us - OB MD, MD assist (can be family practice MD, RNFA, or another OB), MDA, scrub tech, circulating RN, and a RN and RT from our NICU to tend to baby. If baby is under 34 weeks gestation, a neonatologist comes as well. We are a community facility with approx. 3000 births/year. and level III NICU. We also have two RNs present for each lady partsl delivery - one for mom and one for baby.

I think the OP is talking about family practice MD not wanting to come to tend to baby during C/S births. From the OP, it sounds like a very unsafe proposition to not have anyone present at a C/S birth that is NRP certified to tend to baby exclusively. AWHONN might be a good place to start for standards of practice regarding this issue. Might want to also check out the policies/procedures manual at your hospital.

[crissrn27, RN]

Is a NRP certified nurse available solely for the baby at the c-sec? Not the circulator, but a NICU, or nursery nurse?

[LDRNMOMMY, BSN, RN]

Where I used to work a NICU team consisting of a NNP, NICU RN, and RCP attended every single c-section. Occasionally the neonatolgist would make an appearance but it wasn't typical.

A NICU team would attend lady partsl deliveries per policy or RN/MD request. Typically only 1 RN at delivery and one surgical tech. Yeah, not really missing that aspect of the job.

[DutchgirlRN, ASN, RN]

We always have a pediatrician present during a c-section.

[crysobrn]

Oh sorry... Yes we have an OB that cuts, then an assist (unless a code red situation emerges and one does not make it, but that's another story), then we have the OR crew which for us is a circulator, scrub tech and the crna or mda... But our OB and OR are completely seperate... so WE as in the OB nurse attends now with a PEDS doc (or family practice) for every c/s done... scheduled or emergency... The peds actually don't mind coming but the family practice docs are trying to say that as long as the ONE nurse is present then they don't have to...

I hope that clarifies... We haven't been able to find awohnn or acog standards specifically for c-sections and a doc designated for the baby. We have a hard time believing that our OB's will break scrub to help us resuc a baby if needed...

[DutchgirlRN, ASN, RN]

I understood perfectly that there is an OB present to do the section. I think the problem is in the title and the person answering not bothering to read the post just reacting to the title.

[NRSKarenRN, BSN, RN]

Title editted: added "Dr just for baby"