By Christine Tumpson / Photographs by Michael Fornataro
Pittsburgh’s exploding younger population means an increased demand in women’s and infants’ services, and also is an opportunity to incorporate ground-breaking science to take that level of care to new heights.
From 2013-2014, births at Allegheny Health Network’s West Penn Hospital alone increased 15 percent, and with numbers rising every month, hospital officials expect that more than 4,000 newborns will see their first light of day there this year. The job of taking care of all of those tiny souls, and their families, means a new obstetrics unit, with 33 postpartum beds, a family waiting room, and an emphasis on bonding in ways that is changing lives.
Sandy Stanley, RN, is one of the new “stork nurses,” eager to bring the power of skin-to-skin research to every family. The “stork nurse” helps to enhance the peaceful interaction between mom and baby. On staff for 15 years at the hospital, Stanley lights up when describing her mission. “Kangaroo care, where the infant is swaddled while nestled on top of the mother, brings about physiological changes,” she explains. Stanley takes little 20-hour-old Linden, sliding her under mother Becky Bruce’s soft T-shirt, with the baby’s little head peeking out from the neckline. Immediately, the baby’s skin tone changes from a purple cast to a healthy shade of red. Becky’s skin tone changes, too, as she softly coos to Linden, stroking her head, “Shhhh, little darling, shhhh. So sweet.” Immediately, the infant starts pushing herself up onto her mother’s chest. “See,” Stanley explains, “She’s already trying to get to her mother’s breast to nurse. So smart she is. And with this type of skin-to-skin, she has access and warmth, too.” The goal of skin-to-skin is to promote easy, more immediate breast-feeding and more intimate mother-baby bonding.
The concept of skin-to-skin began in the late ‘70s as a way to keep premature babies warm without incubators. Used primarily in third-world countries, the practice is being seen as life changing for everyone. Typical Cesarean-section births mean the infant is taken away for testing. But now, the priority is on keeping everyone together — touching and bonding, allowing nature to provide its connective cement through the release of oxytocin, the “feel-good” chemical. The effects are felt profoundly on the baby and the mother. As baby takes warmth and nutrition from mother, the mom’s body responds with increased lactation and relaxation. Family-focused practices are in place at West Penn, and the other Allegheny Health Network Labor and Delivery Units at Forbes, Jefferson, and Saint Vincent hospitals.
For the Bruce family, father Daniel says the delivery was magical. “My birthday is 5-10, and she was born at 5:10 p.m. on 5-10. The nurse was with us the entire time, keeping everything calm and quiet. It was so peaceful that we thought maybe we were the only ones in the unit. But then, we found out it was a busy night! For us, it was a 10 out of 10 experience. Or maybe we should say a 5-10,” he jokes. “Let’s just say it was an immensely different birth than with our first daughter.”
As if on cue, little Opal dances into the room, a pretty three-year-old wearing a pink tutu and holding an identically dressed Minnie Mouse doll. In moments, the entire family is on the bed, exemplifying the importance of the family room. Stanley smiles, “I swear I didn’t stage this, but this is really what we’re talking about. Everyone together, bonding, and feeling good to be connected, to be one family, together.”
The staff at West Penn takes the concept of skin-to-skin seriously, beginning in the operating room. The power is in its simplicity and the science of the neurotransmitters in the sensation of touch. This patient testimonial touches the heart as well:
“This is my third child, second who’s been delivered at West Penn,” says Stephanie Livshin. “The one thing that was different with this baby was the stork nurse was in the OR with us. She asked if I wanted skin-to-skin with the baby. I thought she was nuts. Didn’t think she realized my arms were restrained. Long story short, she brought my beautiful baby girl up to me and held her against my chest while the docs finished the procedure. This didn’t happen with my first two, and honestly, I didn’t care. My kids were healthy and that’s all I cared about. But when she offered and actually stood there hunched over me, holding that baby by my face for at least 20 minutes, it was amazing. She would adjust the baby who would cry when pulled away from me. Later, the RN explained it was a newer initiative with all moms, but specifically with Cesarean-section moms. I appreciated this opportunity and her willingness to do this. Like I said, I didn’t know what I was missing, but it was truly the most memorable part of my experience with Allegheny Health Network.”
Jenn Marafka, RN, is also a stork nurse at West Penn Hospital. Today, she is on the run between the operating room, where she is needed to assist with a Cesarean-section birth, to a postpartum room, where a family is waiting to be discharged. “I feel like this is what I’m meant to be doing — that my place is here with these families, helping them to bond, and to feel safe and cared for,” she says. The idea of not leaving them alone is tantamount; the fact that the facilities are fresh and new helps make the families feel special. “Because they are,” she enthuses. Only then does it become apparent that Marafka herself is pregnant — her baby due in August. “This means a lot to me because I will be there myself soon.”
There is a trending thought in modern psychology that many problems arise from the fear of abandonment and rejection. What if by making these small changes, by keeping infants skin-to-skin with the mothers, and the families together as one unit after birth, those issues would be lessened? That fathers could feel important during the birthing process, and little siblings could bounce on the beds in the hospital rooms. It might make a huge difference in the world we now know. And that’s what Allegheny Health Network is expecting, one birth at a time. That’s how to bring a new life into the world.
> Allegheny Health Network, ahn.org.
The Physician’s Perspective:
“All that we do in Women’s and Infants’ Care at West Penn Hospital, and throughout the Allegheny Health Network, promotes family-centered care and mother-baby bonding,” says Mark Caine, MD, FACOG, Medical Director, Labor and Delivery, West Penn Hospital. “Our new parents overwhelmingly tell us this makes for a positive birth experience. But also, family-centered care is evidence-based practice, proven by research to enhance the health and well-being of both mother and baby. For all kinds of infants — those born by Cesarean-section or natural childbirth, those who are healthy or those who need extra care in our Level III Neonatal Intensive Care Unit — we emphasize initiating skin-to-skin contact, so called ‘Kangaroo Care,’ as early and as often as possible. Research shows that babies who experience skin-to-skin contact have more stable heartbeats and regular breathing, longer periods of sleep, more rapid weight gain, decreased crying, longer periods of alertness, and more successful breastfeeding. Parents experience greater closeness to their babies and greater confidence in their ability to care for their babies. Our new postpartum unit at West Penn is specifically designed to encourage mother-baby and family-baby bonding. It has been a wonderful innovation for us at West Penn to be able to extend the benefits of skin-to-skin contact to women undergoing Cesarean-section, and we are proud to be among the national leaders in this new modality of giving birth.”