Bonding and Maternal Care

Amira's Birth Skin to Skin

By: Kate Kolb

At 8:22 am on December 19th, the operating room was filled with the sound of a tiny cry. The first breath of life outside the womb was heard amidst the quiet beeping and hum of the room’s equipment, and murmurs of the nurses and doctor’s conversation.

For Daniel and Kelli Bowler, this was baby number six, and I had been invited to the OR that morning to witness the welcoming of this new little life. Kelli, a nurse herself and a busy mom to her other five girls, was having another C-section to bring sweet Amira into the world. She had invited me to attend the birth of their final addition to witness the special bonding practice that Centra offers C-section moms. A process called skin-to-skin bonding time is offered to moms of regular vaginal deliveries, but in many hospitals around the world, it’s not an option for mothers who must have surgical deliveries.  

As I stood in the middle of the OR that morning and watched the anticipation build in Daniel and Kelli, I was transported back to 12 years prior and the birth of my first child. I was a naïve 25-year-old, not sure about this thing called motherhood. I’d experienced the crushing blow of a miscarriage just prior to the pregnancy with my son and I was still fragile and scared from that loss and overwhelmed at the thought of being responsible for a new little life. I had always been fiercely independent and had plans for everything. But, plans for my “perfect” birth experience were thrown out the window when my son was solidly frank breech in position and couldn’t be turned before delivery. Add to it a diagnosis of PUPPP syndrome in my last trimester, and it was time to get baby boy out.

I read up on the clinical portion of what a C-section was, but no one prepared me for what would happen emotionally or directly after surgery. I had seen image after image of mom and baby in a sweet embrace after a “normal” delivery but had no idea what to expect after my baby took his first breath outside the womb.

At the time, I had what most would consider a very successful, textbook delivery. No complications with the surgery itself or post-delivery bleeding. Don’t get me wrong. Having your abs separated and incisions on interior and exterior places of your organs is no picnic. But, my delivery went perfectly from a medical standpoint. However, I didn’t get to actually hold my baby for several hours. We got the classic “hold-the-baby-by-mom’s-head” picture in the OR, but then he got wheeled out to the nursery for his checks and bath, and I was closed up on the operating table and sent to recovery which was the same triage room I was in prior to delivery. I couldn’t move to the mother-baby room until I could wiggle my toes and move my legs with purpose.

I remember thinking it was so surreal to know that this little life that was inside me was now thriving outside of me, but that I hadn’t been able to wrap my arms around him yet. As the staff wheeled my bed down the hallway after over an hour in recovery, they took me by the nursery window where a sweet nurse held my baby up through the glass as I tried to memorize every detail of his brand-new face. Due to a very full mother-baby unit that day, it took even longer to get me settled into a room than we expected, and it was still another 20-30 minutes before I finally got to hold my firstborn.

Let me add here that the staff was extremely wonderful to me during my stay and that none of the timing of the events was anyone’s fault at all. It was just the status quo at the time for c-section patients or c-section surgeries. This was before Centra’s Baby Friendly designation, and moms who required surgical deliveries didn’t have another option at the time. But, while my vaginal birth delivery counterparts were enjoying immediate snuggles and skin-to-skin bonding time, I didn’t even get to hold my child for several hours.

Fast forward 12 years and the OR was a much different atmosphere. There was still the quiet hum of machinery and low whispers of mom and dad anticipating their first hello. There were nurses and the doctor taking inventory of operating instruments and running over the timing of the procedure. The warmer and scale were set and ready to go for the first physical of the baby’s life.

But, in this moment, as I stood with my camera capturing moments of the wait for Amira’s first breath, I was struck by how different Kelli’s experience was than mine. She was still prepped in the same fashion and securely in place on the operating table, she was still in sterile clothing and closely monitored for her anesthesia, and she was still attended to by the OR staff to make sure her health levels and comfort were taken care of during surgery. However, when little Amira made her appearance that morning, she was held by Kelli’s head for kisses, passed to Daniel for snuggles, and then handed back to the nurse so she could assist Kelli in holding Amira skin-to-skin.

Tears were freely flowing at this point, as Kelli got to hold her sweet baby on her chest while the doctor finished her surgery and closed her back up. Watching Amira immediately calm as she laid on Kelli’s chest was just beautiful. Mother and daughter in a bonding moment that had been absent for years earlier in the operating room.

“While Baby Friendly began as the implementation of evidence-based practice, it has grown into so much more,” explained Jackie Weaver, Mother-Baby Unit Manager. “I didn’t realize the impact of non-separation for mom and baby until I had the opportunity to hear the post-operative stories of patients like Kelli. To see the evidence in action of decreased anxiety, improved transition for mom and baby, and fewer interventions being used was impactful. However, hearing from moms about how they felt included, heard, and supported made all the difference. It is powerful to see the impact on both physical and mental health when a mom is simply empowered to have her baby with her.”




All these words were things that I would describe as true of Kelli in that moment with her daughter. It was a beautiful thing to witness as the mom who didn’t have that in any of her three c-section experiences.

“It’s just so calming,” Kelli described, “It took away that feeling of being disconnected, and replaced it with the chance to have a really important bonding moment right away. It’s just really special.”

Stacey Tribbett, another Birth Center Unit Manager praised the benefits of this process when I spoke with her after attending the delivery that morning. “We are proud to continue to offer skin-to-skin bonding after all deliveries in our Birth Center. This process began with our Baby Friendly designation in 2015 and has continued successfully. Skin-to-skin has so many positive benefits for mom and baby and we make every effort to create a memorable birth experience. During situations where skin-to-skin may not be possible because of certain medical circumstances, we still make every effort to initiate bonding between parent and child. Our focus continues to be patient satisfaction and safe outcomes.”

It was such a gift and a full-circle moment for me to be in the OR that December morning. The memories of the rush of emotions of welcoming each of my own miracles and the absolute joy of watching this amazing couple as they completed their family was overwhelming in the best of ways.

Welcome to the world, sweet Amira. Your future is as bright as your beautiful beginning.

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