Preserving the Golden Hour With A Cesarean

When you find out you’re going to have a cesarean birth, it’s common to feel like you’ve lost something. The vision you had for your birth may have been vastly different. Perhaps you were planning an unmedicated birth with the bare minimum of interventions or maybe you were open to an epidural, but regardless of how labor went you probably imagined a vaginal birth. You might have envisioned your baby being placed on your chest immediately after birth and soaking in the golden hour together as undisturbed as possible. 

Take Time to Process This Change of Plans

Adjusting for this new plan of how your baby will come into the world can be understandably jarring and painful. It’s OK to acknowledge the grief you’re experiencing and allow yourself to mourn the loss of the birth you thought you were going to have. Be patient with yourself and understand it’s normal to be disappointed about this unexpected outcome.

Once you’ve given yourself adequate time to process this change of plans you can begin to make new ones. You may think that because you’re going to be giving birth in the operating room that your hope for an uninterrupted golden hour immediately postpartum has been dashed. But that doesn’t necessarily have to be the case. Although we can all agree that the operating room is not the same as a birthing center—or even a standard labor and delivery room—you can work with your care providers to preserve the golden hour as much as possible when planning a cesarean birth.

So.. What’s the Golden Hour Anyways?

If you’re unclear what the golden hour is, it’s the period immediately following birth where baby and parent bond. In ideal circumstances, your baby should be placed skin-to-skin on your chest and remain there undisturbed for the first one to two hours. Unfortunately, this rarely happens within American hospital unless you explicitly request uninterrupted skin-to-skin contact for at least the first hour.

While there are several reasons, why an undisturbed golden hour is so uncommon, it mostly has to do with the myriad procedures are performed in the first moments postpartum that interfere with this sacred time. This disruption of the golden hour isn’t limited to cesarean births, either—it’s common for care providers to take babies away from their birthing parents one or more times during the first hour of birth after giving birth in a standard labor and delivery room, let alone an operating room.

The Game Plan for a Cesarean

So what hope is there of preserving the golden hour after a cesarean? Although you may not be able to achieve 100% uninterrupted time for the first hour postpartum, there are requests you can make to ensure as much quality time with your baby as possible immediately after birth. Here are some things you can include in your birth plan to preserve the golden hour after a cesarean:

• Delayed cord clamping: how your care provider defines delayed cord clamping can be subjective so get clarity on this in advance to ensure it is truly delayed, meaning that all the blood has left the cord and it has become white, flat, and stopped pulsing
• Skin-to-skin contact: make sure the hospital gown and swaddle blankets are removed so the baby’s skin is making direct contact with your skin across your shoulders and chest. If the birthing parent can’t give skin-to-skin contact, their partner can instead
• Music: requesting relaxing music to be played sets a tone for the room and is a constant reminder to the care providers to keep cross-talk to a minimum and honor the baby-birthing parent dyad
• Hold off on the vitamin K shot: it can wait until you’re out of the OR (up until 6 hours postpartum)
• Lose the hat: to effectively bond with your baby you need to breathe in their scent—their head is the optimum body part for this. The staff will definitely want to ensure baby is warm in the cold operating room, so opt for warm blankets tented over you and baby instead of the hat so you can maintain warmth as well as scent

Maybe Most Importantly, Communicate these Plans

Make sure you discuss your preferences with your care provider before being rolled back into the operating room. Depending on where you’re giving birth, you may receive pushback from the staff if they’re unaccustomed to these standards of care. The good news is that science is on your side—data supports these practices even if the hospital’s policies and procedures haven’t caught up with the science yet. Remember that it’s your birth and that you are the consumer. You have rights and the freedom to consent to or refuse care. Education can help empower you to make the best decisions for you and your baby.

For ways to clearly state your wishes about newborn procedures and protect your birth room, click here to take our Newborn Procedures course.