1. Skin-to-Skin in the OR Concerning Vitals Temp < 36.3 Temp > 37.5
The Mizzou Standard of Care
Call 4th Floor to
alert them of impending
delivery
Inform mother that
infant will be
resuscitated by
NICU and will
go to NICU
Decision to do
Cesarean Section NO
YES
Mother/Baby
candidate for
S2S?
Baby is born &
goes to warmer in
resuscitation room
Keep mother up to date
on baby’s progress – begin
pumping and hand expressing
in recovery room NO
Baby to NICU or
NOU
Newborn team resuscitates
& evaluates baby (obtains weight) NO NO
Send colostrum to NICU for oral care
Inform mother of
baby’s status and where
the baby is going
Baby Stable?
YES
Record in chart:
Hand expression taught
Time that pumping/hand
expression performed
Newborn team calls
transition nurse (TN)
to resuscitation room (if not
there already)
Call for baby
update
from NOU
Encourage mother
to do S2S immediately
upon being reunited
with her infant
Infant Stabilized?
TN takes newborn into OR
& places infant skin to skin
YES
Baby to NICU
or NOU
Infant returned to mother
in PACU NO
TN continually assesses:
Breathing
Color
Tone
Cry
Stability of infant on chest
Bulb suction and stimulates as needed
In order to keep warm, baby must be
skin-to-skin with either mother
or support person, wearing a hat &
both covered with warm blanket NO
At 30 minutes, TN
performs Vitals
(Temp, Pulse, Resp)
YES
Stable?
Stable?
YES
At 1 hour of life:
1 - administer eye ointment
And vitamin K injection
2 – Perform second set of vitals
When surgery completed, roll baby with mother
TN will support infant (each time baby removed from
S2S, infant cools and is stressed)
Infant to PACU in mother’s arms
Teach mother:
Feeding cues
Importance of S2S
Biologic Hold
Hand expression
Assist baby in latch
Concerning Vitals
Temp < 36.3
Temp > 37.5
HR < 100
HR > 170
Resp < 35
Resp > 65
Once mother/infant stable and PACU nurse
comfortable,
call up report to NOU and record information:
Record that infant went S2S
Record infant vitals
Record newborn weight
Record administration of eye ointment and Vitamin K
Infant transferred to 4th floor in mother’s arms
Newborn bath and assessment occur in mother’s room