Advocacy, Birth Challenges, Research

Who owns the baby after cesarean?

If I were to ask you who is allowed to make decisions for a baby, the obvious answer would be the mother and/or father. But a strange thing happens during childbirth, especially cesarean, where the immediate needs to assess the safety of the newborn and the mother result in a system where decisions are made by the midwife and/or physician.

In some cases, this seems reasonable and beneficial. If a baby is born with a serious problem it is unreasonable to get parental permission for each step of a resuscitation protocol. It is assumed that by admitting yourself to the hospital, you agree to the treatments the hospital staff deem necessary during an emergency. But even with that assumption good practice dictates that parents at a minimum remain informed and at best continue as part of the decision making team.

All of this makes this paper about the dynamics of handling the baby in the operating theater interesting and challenging.1This paper examines the way that women during cesarean do not even “own” their bodies, creating a strange power dynamic where women are limited in the decisions they are given authority to make about their own body and about their baby.

One of the issues we commonly complain about cesarean deliveries is the inevitable separation of the mother and baby. Many hospitals have implemented protocols to help promote immediate mother/baby bonding. But the reality is that many cesareans are done for reasons that make things like skin-to-skin contact unsafe. Cesareans are still performed in operating theaters that were not designed to accommodate the work necessary to promote immediate bonding. Hospital policies prioritize infant assessment. Though not wrong, this prioritization can result in the baby remaining on the other side of the room with a surrogate caregiver if staff do not actively pursue ways to conduct assessments with the mother.

Enjoy the paper.

Stevens J, Schmied V, Burns E, Dahlen HG. Who owns the baby? A video ethnography of skin-to-skin contact after a caesarean section. W. March 2018. doi:10.1016/j.wombi.2018.02.005
Jennifer (Author)