Minutes after taking her first breath outside the womb, Kathryn "Katie" Marie Wilusz cuddled on her mom's bare chest, gazing in the direction of her voice. Dad sat close by, dressed in scrubs, as she wrapped a tiny hand around his index finger.
The new parents, Lauren and Joe Wilusz, sang happy birthday in celebration of their daughter's arrival.
As the family bonded at one end of the operating bed, a doctor, nurse and medical technician at Anne Arundel Medical Center in Annapolis, Md., worked to close the incision that was cut to deliver Katie by cesarean section.
The medical center has joined hospitals around the country trying to improve the birth experience for mothers who undergo planned C-sections. The surgical procedure in which doctors open a woman's abdominal wall and uterus to deliver the baby can be cold and impersonal for mothers who say they miss out on early bonding.
During a typical C-section, the baby is whisked away to get cleaned up, measured and weighed. Dad can follow and hold the baby, but mom often must settle for a quick glimpse and kiss. Another 30 minutes or more may pass before she gets to snuggle with the newborn. Often it is not until she is transferred to the recovery room.
Under the new family-centered approach gaining traction at hospitals, mother and baby are joined as soon as possible, as long as there are no health risks. Greater Baltimore Medical Center is also moving to provide the service to patients.
"It is a measure of more humanity into something that is usually so technical," said Dr. Victor A. Khouzami, chairman of obstetrics and director of the Towson hospital's Women's Health Service Line.
Efforts at making C-sections more "natural" or "personalized" have gained widespread acceptance in recent years as hospitals work to make the entire delivery process one that embraces the whole family. Hospital rooms now have beds so fathers can stay the night, for instance, and nurses place babies in the room with the mother rather than in a nursery.
Studies have found that immediate skin-on-skin contact with mom is good for bonding, which has spurred a movement to ensure that moms see their babies right away.
At 11:15 a.m., an obstetrician lifted Katie from the womb and confirmed she was a girl. The baby sputtered a cry as the surgical team immediately laid her on her mother's chest, clamped her umbilical cord and wiped the protective coating that covered her body.
Katie had been delivered by C-section because she was in the breech position, which left her legs splayed straight in the air. Her parents, both 33, grinned at that and looked in awe at the surprise wisps of strawberry blonde hair. Their first child Tommy, who is 2, was born with dark strands. They kissed Katie's head and whispered how precious she looked.
"It's OK, Daddy's right here," Joe Wilusz cooed whenever she cried.
The delivery of the Wilusz family baby was the fifth at Anne Arundel Medical Center using the family-centered approach. Lauren had read an article about the idea and wanted to try it. She delivered her first baby vaginally and was unsure how a C-section would go.
"The C-section caught us by total surprise, and I thought this sounded like a good way to do it," she said.
In Maryland, Sinai Hospital, the University of Maryland Medical Center, Johns Hopkins Hospital, the University of Maryland Shore Regional Health and University of Maryland Upper Chesapeake Health are among the other hospitals that offer the family-centered method. The options vary and can include being able to watch the birth through a clear curtain.
"It's a big push now," said Linda Szymanski, medical director of labor and delivery at Johns Hopkins Hospital.
Part of the transition to the new method involves convincing the delivery team — nurses, doctors, anesthesiologists, medical technicians — of the benefits. Some are resistant to changing practices that have been in place for years because of concerns about maintaining a sterile environment.
"Doctors are getting more comfortable that this isn't something strange or a negative or weird, but a slight alteration in the surgical practice while still maintaining a safe environment," said Jeff Livingston, a Texas doctor who has employed the method for more than four years.
The American Congress of Obstetricians and Gynecologists has not taken a position on the practice. Spokeswoman Kate Connors explained that studies haven't been done on the practice but noted that the group doesn't believe it is dangerous.
Dr. Marcus Penn performed Anne Arundel Medical Center's first family-centered C-section in October after a patient requested it. After he did some research, the idea seemed reasonable, he said. "We have been regimented on doing something a certain way, and it takes a certain kind of mindset to try something different," Penn said.
Penn and other doctors said safety still comes first. They said they wouldn't put a distressed baby on a mother's chest, nor would they use the family-centered approach during emergency C-sections.
Medical staff took the Wiluszes' baby to a separate room after five minutes because she looked blue and seemed to have problems breathing. After rubbing her body to stimulate breathing and checking her vitals, staff took her back to mom.
Kristen DeBoy Caminiti, Penn's patient from October, has delivered all three of her boys by C-section. While she didn't feel as if she missed out on any part of the birth experience with her first two children, she liked to be able to immediately bond with her third child and her husband.
"I was in the room with all these nurses and doctors, and it felt like we were the only three in the room," said 33-year-old Caminiti said.
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