Skin to skin after delivery

[Kldrn9963, MSN]

What practice does your hospital follow for skin to skin after delivery? Do you continuously monitor the baby on a pulse ox? How often do you get vital signs in the baby? How long to you keep them skin to skin? Does a staff member stay in the room at all times with the mom and baby? Have you had any difficulty with your process? Any feedback would be greatly appreciated.

[klone, MSN, RN]

Yes, we practice this with every baby as part of having Baby Friendly designation (unless there is a medical need for baby to be at the warmer). We keep the infant skin to skin for at least an hour or after the first feed. No, we don't do continuous pulse ox monitoring. We do q 15 minute vitals. No, it doesn't require a nurse to be in the room constantly, although that first hour there are so many tasks involved with recovering both mom and baby that usually there is a nurse in there pretty consistently.

[LibraSunCNM, BSN, MSN, CNM]

What klone said---goes for both the freestanding birth center and the large academic medical center where I work.

[babeinboots, MSN, NP, CNM]

Everything Klone said except I’ve worked at facilities where the vitals are every 30 minutes after the initial set of vitals that has to be taken within 15 minutes of life.

[AZBlueBell]

On 7/20/2019 at 1:33 PM, klone said:

Yes, we practice this with every baby as part of having Baby Friendly designation (unless there is a medical need for baby to be at the warmer). We keep the infant skin to skin for at least an hour or after the first feed. No, we don't do continuous pulse ox monitoring. We do q 15 minute vitals. No, it doesn't require a nurse to be in the room constantly, although that first hour there are so many tasks involved with recovering both mom and baby that usually there is a nurse in there pretty consistently.

Pretty much the same for our facility as well, except we do q30min vitals on baby. No specific timeline for baby staying skin to skin. We encourage at least until the first feed or first hour, but we’ve had moms that keep baby with them until the last possible second. “Hey, we need to transfer you to postpartum and need to get baby weights and measurements first”. Our facility sees a lot of natural mamas and so constant skin to skin is very common for us.

[klone, MSN, RN]

Most of our moms are not natural, but the nurses are still really good about encouraging skin to skin and early breastfeeding. Our IOL rate is about 50% and our epidural rate is >75%.

[AlleeBooRN]

We do 30 min vitals x4, then 1 hour, then qshift. We do 60 minutes of sts

[gamecaco4, BSN]

In a normal, low risk delivery with a stable mom and baby, we do STS for at least the 1st hour before taking baby to the warmer for measurements, vit k, and physical. Vitals are q30min x4 with the first being wishing 15 mins of birth.

[LaborRN]

Quote

What practice does your hospital follow for skin to skin after delivery? Do you continuously monitor the baby on a pulse ox? How often do you get vital signs in the baby? How long to you keep them skin to skin? Does a staff member stay in the room at all times with the mom and baby? Have you had any difficulty with your process? Any feedback would be greatly appreciated

The hospital I came from had a goal of getting the baby skin to skin within 7 minutes of delivery for a c/s and immediatley for vag. We didnt use a pulse ox for monitoring. If the baby was looking blue or like it was having a hard time transitioning then we would take it over to the warmer and would have to write a note saying why we did so. We would get vital signs as soon as possible after delivery and then every 30 minutes until the first 2 hours of life. We would keep them skin to skin for a minimum of 1 hour. If we took them off sooner we would need to document why skin to skin was interrupted. Staff would not stay in the room at all times with mom and baby as long as the patient is alert and doing well. But would mention to visitors/family to keep a close eye and keep them in the loop if you as the nurse need to leave the room. It can be challenging when it is busy to follow these practices to a tee because you are tempted to want to get your assessment done but have to wait until the 1 hour mark since skin to skin time is supposed to be "uninterrupted" .

[YYZ0821, RN]

On 7/20/2019 at 3:33 PM, klone said:

Yes, we practice this with every baby as part of having Baby Friendly designation (unless there is a medical need for baby to be at the warmer). We keep the infant skin to skin for at least an hour or after the first feed. No, we don't do continuous pulse ox monitoring. We do q 15 minute vitals. No, it doesn't require a nurse to be in the room constantly, although that first hour there are so many tasks involved with recovering both mom and baby that usually there is a nurse in there pretty consistently.

What they said! Only difference is that our baby VS are q30min x2 then q1h until they go to their postpartum room.