“I got to touch him once and they took him right away from me,” Northern Light Eastern Maine Medical Center labor and delivery nurse Jennifer Wickett says, remembering the birth of her first child 19 years ago.
Wickett desired non-medicated births, but her three children ended up being born via cesarean sections for various reasons. Wickett’s personal birth experiences coincided with her early professional life, working at a hospital in Massachusetts as a labor and delivery nurse.
At the time, she explains, the process was this: the baby was born, taken to the warmer, vitals and weight were recorded. The baby was wrapped in a blanket and held next to mom’s face for five to ten minutes and then taken to the newborn nursery.
“I hated that for my patients and I hated that for me,” Wickett says.
So Wickett singularly started changing that culture of mother baby separation.
Now, at Northern Light Eastern Maine Medical Center, Wickett attends about 95 percent of the c-sections, and she says she was able to “take control.”
“[Initially] I wasn’t tucking baby in skin-to-skin, but I was putting baby on top of mom with the support person helping hold the baby,” Wickett explains.
She deemed it the Wickett hold: baby placed chest down on mom with knees tucked under the left breast and baby’s head on the right breast.
Attending a Kangaroo Mother Care Conference in Cleveland galvanized her efforts: the evidence clearly supported skin-to-skin contact immediately after birth and beyond. Fellow nurses, anesthesiologists and other team members were resistant, but Wickett and a few other fellow nurses who created the Kangaroo Care Committee kept at it, always leading with kindness and communication. Rather than approaching the process with an “I have to do this” agenda, Wickett involves and acknowledges all of the participants in the room.
For instance, to the mother, she asks permission while also explaining the importance of skin-to-skin contact.
“They’re in hook line and sinker when I explain that their body regulates their baby’s temperature,” Wickett explains. “They don’t want to give that baby up; they are not letting that baby go.”
To the anesthesiologist, she facilitates open communication. Wickett lets them know that she assumes responsibility for the baby. “Are you good?” she often checks in with the anesthesiologist, while minding their space to work safely and efficiently.
Wickett makes certain to involve the partner in their baby’s care, asking them to keep a watchful eye over mom and baby.
Just about half of the babies she sees begin breastfeeding in the OR, she reports. From the OR, babies are kept on their mothers’ chests as they’re transferred to the recovery room, continuing the opportunity to breastfeed. All in all, Wickett says that babies born by c-section at her hospital spend more time skin-to-skin than those who are born vaginally.
After a vaginal birth, eager nurses often disturb skin-to-skin contact to complete their screenings and documentation. Excited partners wanting to hold their baby tend to do the same.
In the OR though, Wickett says there are at least 30 minutes without these disruptions. Once mother and baby are transferred to the PACU, mothers report decreased pain when skin-to-skin is practiced.
What’s more, Wickett reports hearing often “This baby is such a good breastfeeder!” because the babies have an opportunity to initiate breastfeeding within the first two hours of life.
The World Health Organization (WHO) recommends that immediate, continuous, uninterrupted skin-to-skin contact should be the standard of care for all mothers and all babies (from 1000 grams with experienced staff if assistance is needed), after all modes of birth. The recent Skin-to-skin contact after birth: Developing a research and practice guideline synthesizes the evidence. [Read more here.]
Wickett and seven other colleagues had the opportunity to complete the Lactation Counselor Training Course (LCTC) last year.
While she says she would have loved to have been able to take the course in-person, Wickett still found the material and resources “fabulous.”
For the past four years, there’s been a vacancy in the perinatal coordinator position at her hospital, so Wickett hopes that her new credentials will allow her to fill the need. In the meantime, Northern Light Eastern Maine Medical Center offers outpatient lactation visits. The center’s breastfeeding support groups halted during the height of COVID and have yet to resume; Wickett reports that they are trying to bring those back virtually.
Additionally, Maine residents have access to the CradleME Program which
offers home-based services to anyone pregnant up to one year postpartum.
In partnership with the Mothers’ Milk Bank Northeast , Northern Light Eastern Maine Medical Center became the first milk depot in the Bangor area.
You can read more Our Milky Way coverage on skin-to-skin after cesarean birth in Skin-to-skin in the operating room after cesarean birth , The Association Between Common Labor Drugs and Suckling When Skin-to-Skin During the First Hour After Birth , and Skin to skin in the OR.
Also check out Skin to Skin in the First Hour After Birth; Practical Advice for Staff after Vaginal and Cesarean Birth Skin to Skin.
Find some beautiful KMC imagery here.