Providing immediate neonatal care and resuscitation at birth beside the mother: parents’ views, a qualitative study

Abstract

ObjectivesThe aims of this study were to assess parents’ views of immediate neonatal care and resuscitation at birth being provided beside the mother, and their experiences of a mobile trolley designed to facilitate this bedside care.DesignQualitative study with semistructured interviews. Results were analysed using thematic analysis.SettingLarge UK maternity hospital.ParticipantsMothers whose baby received initial neonatal care in the first few minutes of life at the bedside, and their birth partners, were eligible. 30 participants were interviewed (19 mothers, 10 partners and 1 grandmother). 5 babies required advanced neonatal resuscitation.Results5 themes were identified: (1) Reassurance, which included ‘Baby is OK’, ‘Having baby close’, ‘Confidence in care’, ‘Knowing what's going on’ and ‘Dad as informant’; (2) Involvement of the family, which included ‘Opportunity for contact’, ‘Family involvement’ and ‘Normality’; (3) Staff communication, which included ‘Communication’ and ‘Experience’; (4) Reservations, which included ‘Reservations about witnessing resuscitation’, ‘Negative emotions’ and ‘Worries about the impact on staff’ and (5) Experiences of the trolley, which included ‘Practical issues’ and ‘Comparisons with standard resuscitation equipment’.ConclusionsFamilies were positive about neonatal care being provided at the bedside, and felt it gave reassurance about their baby's health and care. They also reported feeling involved as a family. Some parents reported experiencing negative emotions as a result of witnessing resuscitation of their baby. Parents were positive about the trolley.

Neonatal transitional support with intact umbilical cord in assisted vaginal deliveries: A quality-improvement cohort study

“…A more pragmatic explanation; given the mothers' legs placed in stirrups for delivery; may be that the mobile trolley was a convenient station to place infant when sampling for cord blood gases. Although direct skin-to-skin contact between mother and baby was interrupted, the parents could still watch, touch and comfort their baby during transition, as valued positive in the study by Sawyer et al (38). An increased focus on incorporating Kangaroo Care (39) in these situations would probably have reduced separation.…”

“…Delayed cord clamping was attempted in all deliveries, while providing essential care. An assistant midwife obtained arterial and venous cord blood gases from a pulsating cord within the first [30][31][32][33][34][35][36][37][38][39][40] seconds. Apgar Scores were evaluated after 1, 5 and 10 minutes by the paediatric team.…”

Abstracts

“…Fathers' experiences of the newborn life support for their baby at delivery room The purpose of this study was to describe fathers' experiences of the newborn life support for their baby at delivery room. In earlier studies, parents have valued the opportunity to be present in immediate neonatal care and resuscitation at birth bedside the mother (Sawyer et al, 2015) and in resuscitation in a pediatric intensive care unit (Tinsley et al, 2008). However, parents have also felt fear at resuscitation (Tinsley et al, 2008).…”

Systematic review and network meta-analysis with individual participant data on Cord Management at Preterm Birth (iCOMP): study protocol

“…An alternate emerging strategy is to provide immediate neonatal care with the cord intact beside the woman using a mobile resuscitation trolley or on the mother's leg. (19)(20)(21)(22)(23)(24) Another potential mechanism of deferred clamping is allowing time for the infant to establish spontaneous breathing whilst still placentally supported. Immediate cord clamping before the infant has established breathing may be harmful since it can lead to large fluctuations in blood pressure, a period of hypoxia, and restricted cardiac function.…”