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Mother-led Skin to Skin: The First Minutes

Open Letter to Dr. Nils Bergman                                                                                     By Mary Esther Malloy

Your research has shown the world

a baby belongs on its mother,                                                                                                                     skin to skin.

You argue:

a baby on its mother,                                                                                                                                      it is where we lay the foundation for healthy people and healthy societies.

You say:

Skin to skin must start at birth,                                                                                                                     Skin to skin must be continuous.

Kangaroo Mother Care is not yet the bedrock of maternity care you’d have it be, but the world is listening. We are reconsidering one of the 20th Century’s grand experiments: the practice of separating mothers and babies at birth.

Now, when it is possible, a baby is delivered to its mother’s chest.

Immediate skin to skin.

But, what if we were to trust birth and women even further? What if, instead of delivering a baby immediately to her mother’s chest at the moment of birth, what if the midwife or doctor simply guides the baby down where she is born? …what if everyone pauses… and leaves the mother to initiate the skin to skin, on her time frame?

What might this look like?

Well…it has its own pace.

When a baby is guided down at birth, below or before her mother, the mother now has a moment to catch her breath.4-niamh pause 2 cropped

Then, slowly (or not so slowly), she turns her attention from the work of birth to her child before her.

She sees and studies her baby. She absorbs her child’s presence.

An extraordinary moment.

She reaches out to touch, soothe and welcome her child, as she is ready.

The baby, meanwhile, is transitioning to extra-uterine life, resting on pads below 1-Mary Esther seeing her daughteror before her mother.  With gravity’s aid, the baby is receiving an efficient transfusion of blood from cord and placenta. The cord blood supplies a secondary source of oxygen at this delicate time of transition, as well as an abundance of pluripotent stem cells for her immature organs and iron-rich red blood cells that will support years of cognitive and motor development to come.

Slowly and safely, the baby arrives, her mother’s hands on her small body, welcoming her with every fiber of her being. And, finally, when this newly-minted mother is ready, she gathers her baby in.

Mother-led skin to skin.3-Niamh just born cord pic

As a participant investigator (this is how I met my third child), I assure you that being able to see my daughter as she lay before me, to study and touch and welcome her in those first moments after her birth, made a deep impression. No FMRI scnanner caught what was lighting up in my brain, but I am certain it was a neurologically on moment, distinct from what 6-niamh embrace 2 croppedI experienced with my first babies (who were delivered immediately to my chest). I met my daughter face to face. I saw ALL of her in the very moments of her arrival. The visual was profoundly in play. It was my daughter and me. No one told me what to do. My midwife simply stood by, quietly assessing my daughter’s and my well-being. When I was ready, I picked up my girl. I will never forget the particular ecstasy of those exquisitely unhurried moments.

Dr. Bergman, you remind us that humans of one species or another have walked this planet for over two million years. Modernity is so recent that our DNA still anticipates being born to hunter gatherers. Very likely, these hunter gatherer foremothers birthed upright and birthed their babies down. Maybe they too paused, their babies below.

Perhaps, like skin to skin, this too is in our most ancient wiring.

We’ve learned so much from baby-led breastfeeding. Why not mother-led skin to skin?

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