PINEHURST – Cesarean sections (C-sections) have long had a stigma in the labor and delivery world due to the surgical aspect of delivery. But now, the procedure is getting a makeover.
At FirstHealth Moore Regional Hospital in Pinehurst, a dedicated “stork nurse” will now be assigned to ensure that families undergoing a C-section are given the same bonding experience as families experiencing a vaginal delivery. This includes having the baby placed “skin to skin” on the mother, and even initiating breastfeeding, while the mom is still being sewn up.
The changes support evidence that early bonding and skin-to-skin care promotes bonding and facilitates early breastfeeding. The newer procedure generally aims to place the baby with the mother within five minutes or so after birth, rather than waiting an hour or longer until the mother’s surgery and recovery is finished and she is moved out of the operating and recovery room. The newly created stork nurse team at Moore Regional piloted the program for several weeks before implementing it in November.
Moore Regional’s Women and Children’s leadership team initiated the idea of dedicating a nurse to attend operative and vaginal deliveries to increase the skin-to-skin and early breastfeeding experience and decrease separation time for mother and baby.
Jennifer Bowyer, R.N., and Kelli Baker, R.N., both nurses in the Women and Children’s department at Moore Regional, were enthusiastically receptive to taking on this project as their capstone project, which is required for the completion of their Bachelor of Science in Nursing degree.
“We knew that this program was something we were both very passionate about and were thrilled to be given the opportunity to take it on,” says Baker. “Our management team was more than happy to involve us in this new initiative and has given overwhelming support to us throughout this project.”
“We had great success during the pilot weeks, and all departments have worked collaboratively to make the vision a reality,” says Bowyer. “ The stork nurses have been able to place the infant skin to skin in the OR and transfer the infant, by way of the mother’s chest, to PACU and then to their post-partum room, all the while never interrupting the bonding process.”
About 30 percent of women require the surgical removal of babies through an incision in the lower abdomen when complications arise or labor does not progress, according to the latest U.S. Vital Statistics from 2015. Around 600 C-sections are performed at Moore Regional Hospital annually.
Although the changes at Moore Regional may seem minor, they made a big impact on Julia Amin of Aberdeen, who had her first child, a baby girl, via C-section at the hospital on Nov. 5.
“We have tried for four years to have a baby,” says Amin. “It has been a long journey for me and my husband. We started to give up and began to consider either fertility options or adoption, and then we finally found out we were pregnant.”
After an extremely tough labor and pushing for nearly 24 hours, Amin learned she would need a C-section.
“I was scared to death of a C-section,” she says, “but the entire experience ended up being wonderful.”
Members of Amin’s stork nurse team, who were introduced to her prior to labor, explained to her why they were there and how they would be assisting her throughout her time at Moore Regional.
“Everyone was so kind and nice,” says Amin. “The scared feeling went away. I knew our little girl and our nurse team were going to be there with us the whole time.”
With the help of her stork nurses, Amin was able to hold her baby right away and breastfeed immediately.
“It was so nice to have that bonding time with just the three of us as a family,” she says. “We have waited four years – and 9 months – to see and hold her. It was a wonderful feeling to hold her immediately after the C-section. I am so pleased with the care we received.”
These changes are not just for sentimental reasons. Research has shown improved outcomes when babies are immediately placed skin to skin on their mothers, a process known as kangaroo care. Benefits include more stable temperatures for the baby, a reduction of stress hormones and better initiation of breastfeeding.
“Being placed skin to skin with mother as soon as possible increases the ease of breastfeeding,” says Beth Hutchinson, MSN, R.N., administrative director of Women and Children’s Services at Moore Regional. “Since the infant is not separated and bathed, but instead left skin to skin with the mother, the bond is not broken and the baby is allowed to root around when ready to feed.”
With the research and positive outcomes from the pilot weeks, the FirstHealth medical staff is completely on board with the new program.
"Our hope is that, with this further development of the stork nurse program, we can provide around-the-clock nursing support to the entire family during the birth of their new child,” says Nicholas J. Lynn, M.D., medical director of the Clarke Neonatal Intensive Care Unit (NICU) at Moore Regional. “These staff members have volunteered for this task due to their interest in promoting the role of both parents in the immediate care of the newborn and minimizing outside interference.”
And the nurses are the critical part of this program, Dr. Lynn points out.
“These are highly experienced nurses and trained newborn caretakers who can assess and provide immediate intervention for a wide range of newborn issues if that assistance is necessary,” he says.
The stork nurse is a specially trained nurse who attends vaginal and surgical deliveries and is responsible for the care of the infant. These nurses ensure that the baby is skin to skin as soon as possible, initiate and assist the mother with breastfeeding, provide any care needed to the baby, and help to educate the mothers on baby care and feeding choices.
“Our Labor and Delivery nurses are well-trained and knowledgeable about the importance of skin to skin and can assist mothers if the stork is not available,” says Hutchinson.
The implementation of the stork nurse role will allow Moore Regional to offer a more family-centered approach to C-section deliveries.
“This program not only allows the newborn to remain with their mother, but also allows the patient and support person and baby to stay together as a family,” says Lee Lowery, M.D. “I think that the entire OR benefits from being able to witness the initial interaction of this new life with its mother.”
“The first few hours of life are so precious, and we want to promote and facilitate bonding between mom and baby,” says Jane Claire Dawkins, R.N., clinical director of the NICU. “This role has been our vision for quite some time, so we are excited to finally see it come to life. We feel strongly this will enhance the patient experience.”
To learn more about FirstHealth Women & Children's Services, click here.
Fifteen nurses comprise the stork nurse team at Moore Regional Hospital. Their background includes post-partum and neonatal intensive care, and their first priority is to attend C-sections in order to avoid separation of mother and baby. The stork nurses assume care for the baby in the OR, transport mother and baby to the PACU, and remain with the family for the PACU stay. Pictured from left are Beth Hutchinson, R.N., administrative director, Women and Children’s; Darla Wiegand, R.N.; Ellen Davis, R.N.; Michelle Leitheiser, R.N.; Jennifer Bowyer, R.N.; Kara Oldham, R.N.; Kelli Baker, R.N.; Jane Claire Dawkins, R.N., clinical director, Clarke NICU; April Feliciano, R.N.; Jennifer Starr, R.N.; and Tricia Lerma, R.N., clinical director, Women and Children’s.
The Amin family is pictured immediately after labor. “I am so pleased to have this hospital, and this level of care, right here in Moore County,” says Julia Amin.