Christine, our maternity unit is very small.  We have about 50 to 60 births
per month (about 70% Caesarean).

In recovery, the mothers are cared for by theatre staff  who are not happy
to have baby there as well.  Mothers stay in recovery for about 30 to 60
minutes and if their observations are fine they come to their postpartum
rooms where observations are continued for at least another 2 hours.

Baby comes to the nursery in an incubator accompanied by the midwife,
paediatrician and the baby's father.  By the time baby has been weighed,
measured, eyedrops instilled etc etc, the mother is usually back in
postpartum and baby is taken to her in a crib.  Baby stays with her for
quite a while (one to three hours?)  The person checking on the mother also
keeps an eye on the baby.  Once the spinal anaesthesia wears off, and pain
medication is given, most women are ready to let us take the baby to be
bathed.

If there is a problem with the baby, obviously baby will stay in the
incubator for further assessment or treatment.  Just last week we had a baby
whose SATs would not come up even with oxygen - he was extremely tense and
extended.
Surprisingly the paediatrician said he could go out for a quick feed.
Within seconds of being placed shin-to-skin he relaxed and latched and
suckled well.  I checked his SATs at the bedside and they were perfect.  I
am hoping that seeing these results will encourage more staff members to
support skin-to-skin care for all babies.

I am new in the unit - their first lactation post.  Taking babies to
mothers without dressing them first is something that I just do!  We have no
formal protocol - hopefully that will come.  We don't really have couplet
care, but do have a rooming-in policy.  The "nursery nurse" is supposed to
see to the feeding.  She is usually an assistant nurse with very little
training.

Some other hospitals do have babies in recovery with mom and others yet
again do not get mother and baby together for many, many hours.  One
hospital even has babies skin-to-skin immediately after birth in the
operating room.  I can't see how that would work in our facility, but you
never know!

"Baby-friendly "is not looked upon favourably in my hospital, but with
little steps I hope to gently guide them in that direction without them
knowing it.

Regards
Jean
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