Skin-to-skin for all births, cesareans included!


“This feels so good – is it even legal?” I routinely embarrass my adult children by talking about the life-changingly blissful experience of having them placed on my naked chest at the moment of birth.

After the intensely hard work of each labor, a warm, wet, wiggly, complete human being came out of my body (wow!) and nestled under my chin. Somebody put a blanket over us, and my body helped my babies thermoregulate to a perfect 98.6.

The midwives did the newborn exam without taking my babies from my arms – it was a gift that I will never forget. Together, the babies and I figured out breastfeeding, just like puppies and kittens and orangutans do.

Then they peed on me and pooped on me, and I still loved them. That’s a life-changing experience right there.   I was, in fact, thrilled to see that their little bodies worked so well.

Now, decades later, scientists at the World Health Organization and UNICEF are recommending “SSC” (immediate skin-to-skin contact) following all vaginal births, and as soon as the mother is alert and responsive following cesareans.

There are some small measures recommended to ensure that this ancient mammalian behavior is safe: making sure the baby’s nostrils aren’t buried in the mom’s flesh (duh), and keeping a watchful eye to make sure the baby’s getting off to a good start. Other than that, there’s no potential “downside,” and SSC facilitates bonding, breastfeeding, and mother-infant communication. It may lower mothers’ perception of pain, and mitigate their “depressive symtomatology,” especially post-cesarean. Clearly, it makes both mothers and babies happy.

It’s gratifying (even though it seems like such a no-brainer) to see some hospitals implementing routine SSC for vaginal births. I watched one nurse’s face the first time she witnessed SSC when it was a brand-new policy where she worked – there were tears of rapture in her eyes.

But what about cesareans? It’s trickier to implement SSC in the operating room, mostly because the staff needs to be trained to support it, and an extra nurse might be required. This blog is based on an excellent 2014 survey article in Maternal and Child Nutrition, which also includes a set of “How-To’s” for medical staff. There are also wonderful videos about the importance and the logistics of supporting SSC here.

Cesarean birth is considered essential in a maximum of 10-15% of births (according to the WHO). But the cesarean rate in the US is currently around 32% (compared to less than 5% in 1965). That means that there are a whole lot of medically unnecessary surgical births.

Advocating for post-cesarean SSC is not an endorsement of high cesarean rates. But it is a humane and medically sound recommendation, so that all babies (medical conditions permitting) might have the opportunity for this primal moment, and all mothers might have the opportunity to embarrass their children as I do.


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