What's your protocol immeadiately after birth?

Specialties Ob/Gyn

Published

Hi there,

I was watching an interesting show last night on Discovery Channel about women's issues/birthing in various countries. They taped the labor and delivery of women in a number of different countries, Ireland, UK, Africa, Russia, Middle East, India, etc.

I thought it was interesting to observe what I guess are the "cultural" differences in how the women and newborns were treated by the nursing staff and in post labor care. ie. in Russia the doctors and nurses are more like "coaches" and the spouse is rarely ever in the delivery room. In Africa it was just one nurse with the patient, no family etc. and the nurse was a little tough on the woman, "no crying, no playing around" etc. In Ireland the mother gets a quick glance and they take the child to be cleaned up and then the baby is presented to the mother again to be held.

Also, because it was Mother's Day weekend there was a whole weekend of "Maternity Ward" and I got to see how it works here in America. ( I don't have any children of my own yet.)

I guess I was wondering what do you do with the newborn immediately after the birth? Do you give the mother and father a quick glance and then get it cleaned up and swaddled and then present it to the mother? In Russia they immediately took the child after birth and even before cutting the cord, put it to the mothers breast and the staff called it the "American Method". But judging by the episodes of "Maternity Ward" it seems that in America the staff takes the child and assess, cleans up, etc. and then gives to the parents.

I was just wondering what it's like where you work if in the US there are regional differences or personal preferences of the staff.

Also, I couldn't help but feel how lucky women in America are with all of our "birthing centers" "Private Labor rooms" etc. Seeing the hospitals, etc. in other countries we truly are lucky to have the resources and technology that many other countries do not.

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It depends on the facility, the doctor, the nurse, the family and the baby. I always asked what their preference was before the birth. If the babe is healthy and mom wants it right away, we stick baby on her chest on top of a towel and dry him/her off right there. Other moms want the baby cleaned up first.

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here the baby is placed on mom chest ASAP, often before cutting the cord, weighing, and so on. The baby is allowed to show interst in nursing before being given the breast.. ie we watch for rooting.

of couse this is assuming mom and baby are doing fine.

Dads are expected to coach.

I also watched the discovery show .. neat wasn't it ... I really felt for the indian man running about fighting red tape when all he wanted was to be allowed to help his wife... the dolphins were a bit "out there" though .. lol

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Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

where i work if the baby is healthy, he/she goes immediately on mom's chest for bonding .meds/bath are on hold til bonding and breastfeeding (if chosen) are initiated. Only time we "whisk a baby away" is if the baby is sick and needs immediate medical attention and /or special care.

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Originally posted by SmilingBluEyes

where i work if the baby is healthy, he/she goes immediately on mom's chest for bonding .meds/bath are on hold til bonding and breastfeeding (if chosen) are initiated. Only time we "whisk a baby away" is if the baby is sick and needs immediate medical attention and /or special care.

wish we always did that here! do they need any L&D nurses there?:)

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Specializes in Obstetrics, M/S, Psych.

Our birthing center sounds much like SBE's. We may take the baby to the stabilet for a bit of stimulation or blowby if needed, but then right back to mom. Weights and meds are definitely not priorities over bonding and breastfeeding. Even meconium babies spend the minimal amount of time with peds needed to assess then...back to mom. Those first few minutes are so important for bonding. It is a shame to take that time away from mother and baby for those things that can easily wait.

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Specializes in ER,Neurology, Endocrinology, Pulmonology.

I missed the show unfortunately, I would have liked to see it.

I'm actually from Russia and they never used to do anything like what goes on in the US. I don't absolutely agree with it, but in some cases it's great to have interventions.

I still have to say that medical care is much better here in US than there. While the russian people are more lenient towards herbal remedies, breastfeeding, natural birth, late immunizations, etc., the rates of infant mortality are great.

My sister and I both delivered at 36 weeks. My son was healthy (born here), her son ended up in a neonatal institute ( in moscow) with brain hemorrage and hemolitic desease for 2 months.

Medical ethics over there are also hard to compare. They will perform an abortion just about at any atage. probably close to 7 months.

sorry to get off topic. but yes, over there they do not do anything special to the babies. Unfortunately, in the past 10 years breast feeding rates went from 100% to 30 %, at least in my home city.

We also have birthing hospitals ( which makes total sense to me), instead of having a unit in the general hospital. I'm not really germophobic, but the thought of delivering my baby in the same building where SARS patients are coming to is not very exciting.

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Hi everyone, thanks for your responses,

Ana, your observations of the scenario in Russia are quite interesting. The young woman and husband from Russia did indeed decide on an abortion when she found out she was pregnant, because they could not afford a child. She had the abortion but found out a few weeks after that it did not work, she was still pregnant and then they decided that they would keep the child.

She had her choice of Maternity Hospitals named #1, #2, #3, #4 or #5 to go to for the birth.

The one thing that I could not keep from noticing in each of the countries was the environment of the hospitals. Cold tiled walls and floors, rickety old metal beds that are probably from the 1930's, no private rooms, and very meager medical technology ie. outdated sonogram machines and computers.

The poor woman from Africa who went through the whole delivery process with no one else except for one nurse/doctor (not sure which it was) was wheeled into the hallway and left there for a while after the birth.

Really made me feel grateful to be in the US.

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Originally posted by mark_LD_RN

wish we always did that here! do they need any L&D nurses there?:)

does sound great doesn't it?

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Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

Mark, knowing how I feel about ya and your skills, I would welcome you here anytime.

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Depending on how the infant is doing we will place the baby on mom's chest even before the cord is cut. When I am the nursery nurse doing babies for the night I will observe the baby on mom initally (as long as there is no mec fluid) If I notice anything wrong with baby or think it needs some fluid I will take the baby to the stabilette. We have a NICU team that comes to any delivery that we anticipate a problem (mec fluid, fetal distress, vacuum assists, prolonged rupture, premature....) If they are there the infant will immediately go to the sabilette. Once we decide they are O.k. we will give the infant to mom to see for a little before finishing everything else.

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In the unit in which I worked as soon as baby comes, she is put up on moms chest before the cord is cut. Dad or the coach can cut the cord, the nurse dries baby off while on moms chest. If baby is not well it is immediately taken to the warmer and given oxygen, etc. If baby is well it stays with mom for a few minutes then we take the baby to the warmer to get dried off and put in clean blankets. As long as all is well, we give the baby back to mom and breast feeding is initiated. Mom and baby stay in the DR for about an hour after birth and then mom goes to her room and baby to the nursery. Bath, meds and everything else is done there.

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