Implementing an Enhanced Birth Experience for Family‐Centered Cesarean Birth

Abstract

<h2>Poster Presentation</h2><h3>Purpose for the Program</h3> To create a more family‐centered birth experience for the woman undergoing a cesarean birth. <h3>Proposed Change</h3> Based on evidence, our perinatal clinical practice committee chose to implement specific changes to create an enhanced birth experience called Family‐Centered C‐Section. We realized that about one third of our patients did not get to experience a home‐like birthing environment or have immediate skin‐to‐skin contact with their newborns. Our interventions included dim operating room (OR) lighting, patient‐selected music, minimal to no family separation (i.e., support person remains at the patient's side through the entire perioperative period), skin‐to‐skin contact, and initiating breastfeeding in the OR. <h3>Implementation, Outcomes, and Evaluation</h3> A multidisciplinary team approach was taken: labor and delivery (L&D) nurses, anesthesiologists, obstetricians, pediatric hospitalists, nursery nurses, neonatal nurse practitioners, OR technicians and nurses, and maintenance personnel all had input into the innovative practice. Logistical issues were considered and resolved. Equipment was moved around the room in different positions, electrical work was done to dim the overhead fluorescent lights, and speakers were purchased with dock and auxiliary jacks for phones to play music. Education for the nurses and physicians followed regarding the new process. Like any change, we encountered staff who were excited and staff who did not allow for some of the interventions to take place. Further education and role‐modeling helped with staff that were reluctant. Patients have expressed satisfaction in the new process, especially if they had previous cesarean births without the interventions. Families are amazed that their newborns are able to breastfeed while the mother is still on the operating table. <h3>Implications for Nursing Practice</h3> Shared governance is an important aspect for implementing changes in the unit. The process reflected the desire of the practice council members. All of the interventions were evidence based. For example, music and minimal separation of the support person allows for decreased anxiety and heart rate. Our previous staffing guidelines in which a nurse was responsible for the newborn allowed us to easily transition to keeping the newborn with the mother for the entire procedure (skin‐to‐skin contact and providing breastfeeding support). Another nursing implication is that our patients are educated in the office, visit our hospital website, and participate in prenatal classes about our Family‐Centered C‐Sections, so the expectation has been set in the community. Nurses and physicians who do not follow the interventions often are questioned or reminded by patients, families, and other staff members.