Doulas in the Operating Room: An Innovative Approach to Supporting Skin-to-Skin Care During Cesarean Birth

Area of Science:

• Maternal-Newborn Health
• Quality Improvement in Healthcare
• Perinatal Support

Background:

• Skin-to-skin care (SSC) is recommended post-birth but often delayed after cesarean births.
• Barriers exist to timely SSC initiation following cesarean delivery.
• Innovative strategies are needed to overcome these barriers.

Purpose of the Study:

• To implement and evaluate the use of volunteer doulas to support immediate skin-to-skin care (SSC) after cesarean births.
• To assess the impact of doula support on SSC initiation rates and timing.
• To evaluate client and nurse satisfaction with doula-assisted SSC.

Main Methods:

• Trained volunteer doulas provided support during scheduled cesarean births in operating and recovery rooms.
• Data collected included SSC rates, timing, and client/nurse satisfaction surveys.
• A 12-week quality improvement project was conducted at an academic health center.

Main Results:

• All 58 medically stable mother-newborn dyads initiated SSC in the operating room.
• 48 clients reported doulas were an important part of their birth experience.
• 20 nurses reported high satisfaction with doula preparedness and support.

Conclusions:

• Volunteer doulas can be effectively trained to support SSC initiation after cesarean birth.
• Doulas are perceived as valuable members of the maternity care team by clients and nurses.
• This model demonstrates a successful approach to improving early SSC after cesarean delivery.