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Special Delivery: AAMC Leads With New Family-Centered C-Sections

Aug 18, 2015 10:31AM ● By Cate Reynolds
Kristen DeBoy Caminiti has a photo she loves. Actually it’s more than that. “It’s my favorite picture, ever,” she insists.

In the photo, taken by her husband, Matt Caminiti, Kristen cradles her son just seconds after his birth. She has her cheek against his, their eyes are closed and Kristen looks wrapped in grace.

It’s a beautiful photo. Yet for many mothers it might not seem that unusual. That’s because when a healthy baby is delivered vaginally, he or she is usually put right on the mother’s chest. Early skin-to-skin contact is good for both mom and baby, and, as an added benefit, it makes for a great picture.

But for generations now, immediate skin-to-skin contact hasn’t been an option for women giving birth by cesarean section. In a traditional C-section, after the baby arrives, he or she is briefly held up for mom to see, and then whisked off by the neonatal team while the obstetrician finishes surgery. It can take close to half an hour before mother and child are reunited.

Kristen and Matt know the routine well. Their first two boys arrived this way. While they still remember the births fondly, Kristen says she never got the birth experience she’d dreamed about.

Then, a couple of weeks into her third pregnancy, a friend posted a video that caught Kristen’s attention. It was about family-centered cesarean techniques catching on in Britain. The techniques were relatively easy, and the goals simple—including letting mom see the birth and getting the baby onto mom’s chest as soon as possible. After viewing the video,Kristen was elated. “I thought, ‘Wow, this is cool.’ I decided I’d do everything I could to make it happen for me.”

AAMC Adapts

AAMC is committed to patient- and family-centered care. So when Kristen asked her OB-GYN, Marcus Penn, MD, whether he’d be open to a family-centered cesarean, the answer was yes. While the techniques had never been tried before at the hospital, that didn’t bother Dr. Penn.

“I knew it would be different than the norm, but I didn’t think it would be that hard to do,” says Dr. Penn. “So I met with the hospital’s clinical team, and we started setting it up.”

Kristen was an ideal test case. Since she was having a scheduled cesarean, there was plenty of time to plan. Also, she’d done her research. If all went well, Kristen had this wish list:

  • She wanted her head lifted and the drape lowered so she could see the birth.
  • She wanted the baby placed immediately on her chest.
  • She hoped her husband might be able to cut the umbilical cord.

That was it. Of course, this list meant changes to cesarean routines that hospitals and doctors have honed to perfection over the decades.

Because it would be a first for all involved, the Caminitis and hospital staff crafted a written birth plan together. “It was super-positive,” Kristen says. “Everybody was on board.”

Still, there were concerns. Anesthesiologist John McAllister, M.D., says he fully supported the effort but wanted to be sure caregivers could still do their jobs and that the mother was aware plans might have to change. “Our primary goal is always patient safety,” he says.

“A significant amount of planning went into this,” says Henry Sobel, M.D., chair of Women’s and Children’s Services at AAMC. “It truly was a team effort that involved every care provider.”


Success Story

On Oct. 1, 2014, Kristen’s son Connor was born. The birth went exactly as planned.

“When Dr. Penn pulled Connor’s head out, it was so amazing,” Kristen remembers. “He had dark hair!” After delivery, the baby was passed straight to Kristen. Matt was at her side. “It was magical,” she says. And Connor stayed there, on Kristen’s chest, for the rest of surgery. “It was so great to be able to share the experience of meeting our baby together rather than me going with the baby to a separate room,” says Matt.

Betsey Snow, R.N., the senior director of Women and Children’s Services for AAMC, says the birth represents the first big change to cesarean procedures in years. The last big change, she says, “was in the ´80s, when dads were finally allowed in the operating room.”

Besides the advantages of early skin-to-skin contact, Betsey says a family-centered C-section may be particularly helpful to women who’d hoped for a vaginal delivery but couldn’t have one. “A lot of women feel like they failed because they couldn’t have a vaginal delivery,” says Betsey. “This is a way to give them another option.”

Of course, AAMC still recommends vaginal deliveries when possible. And in emergency situations, these techniques might not be appropriate. But Betsey believes family-centered C-sections may one day be the norm.

This community health story is provided by Anne Arundel Medical Center.