During nine long months of pregnancy, Evelise Greene dreamed of the moment she could hold her baby girl, Claire, in her arms.
That moment came sooner than she expected, thanks to a special drape created for cesarean sections.
Just minutes after the surgeon pulled Claire from the womb, she handed the wiggling, wide-eyed infant through a small doorway in the surgical drape. A nurse took the baby and set her on mom’s chest. Claire nestled in, just above the heartbeat that had thrummed through her ears every second in the womb.
Evelise held Claire gently as her husband, Michael, embraced them both.
“Welcome to the world,” Evelise murmured to her daughter. “We love you so much. You are so beautiful.”
Mothers who have babies by C-section often must wait longer for that golden, bonding moment.
The Spectrum Health Family Birthplace at Butterworth Hospital is the first hospital in Michigan, and one of only a handful nationwide, to use the Clever Medical drape to bring Mom and baby together post-C-section.
Annie Evans, BSN, RNC-OB, clinical services program manager of women’s health at Spectrum Health, said the drape holds the solution she sought as she researched ways to improve the experience for moms who had C-sections.
The drape, designed by three labor and delivery nurses in Richmond, Virginia, makes it possible for the doctor to pass the baby to the mother, directly after birth. It gives moms and babies the opportunity for immediate skin-to-skin contact while maintaining the sterile field around the incision.
Skin-to-skin contact is more than a feel-good moment―it holds significant medical benefits for newborns and their mothers, Evans said. When a newborn snuggles against Mom’s chest, oxytocin surges through mother and child. The so-called bonding hormone triggers feelings of elation, which intensify the emotional connection.
She already feels more serene because of the beginning of her outside life.
Babies’ heartbeats remain calmer. Their temperature regulates better. Research shows they are less likely to have problems with low blood sugar or to need warming lights.
About a half-hour after birth, the baby often starts moving toward the breast for the first feeding.
“We used to, as a medical profession, interrupt that process,” Evans said. “We would take the baby away to be monitored, to make sure he’s breathing, to clean him off. It was all well-intentioned. But we found we were interrupting a process that was supposed to be happening.”
As evidence has emerged on the value of skin-to-skin contact, the medical field has embraced the bonding moment, making it routine for most childbirths―but only those that involve vaginal delivery.
“We want to move that into the C-section world,” Evans said.
Now, the baby often is brought to the warmer and then quickly delivered to Mom. The new drape, with the hole that allows a pass-through, makes the connection even more immediate, Evans said.
Evelise Greene welcomed that development with open arms.
From Brazil to Grand Rapids
Evelise, born and raised in Brazil, met her husband while waiting in an ATM line one day with her mother, Emilia. A conversation led to texts and then dates and, eventually, a wedding in 2012.
Michael, a native of Grand Rapids, Michigan, ran a consulting business in Brazil. The couple lives in Sao Paolo. But in December, the Greenes relocated to Grand Rapids for the duration of the pregnancy.
“Because of the Zika virus,” Evelise said. “I was too afraid of being bit (by a mosquito).”
New reports emerged every day about the number of babies born in Brazil with microcephaly, a birth defect that causes small heads and severe brain damage. Doctors blame the rise in cases on the mosquito-borne Zika virus, which can be passed from a pregnant woman to her unborn child.
Evelise, a physical therapist who previously worked with premature babies, wanted to put distance between herself and Zika.
In Grand Rapids, she saw obstetrician Robyn Hubbard, MD, for prenatal care.
Evelise’s doctor in Brazil had told her she might need a C-section because of her petite frame. As her due date neared, Claire remained in the breech position―head-up instead of head-down―so Evelise scheduled a C-section.
She knew that meant she likely wouldn’t get to hold Claire right after birth.
In a typical C-section, the baby goes to a warmer after birth while the doctor finishes surgery. A nurse dries and assesses the baby, takes measurements and vital signs.
“Dad is standing there typically. And mom is just lying there, looking over her left shoulder as all this happens,” Evans said.
But shortly before delivery day, Dr. Hubbard told Evelise the new drape was available and asked if she wanted to use it―assuming all went smoothly with the C-section.
Evelise responded with an enthusiastic, “Yes.”
A baby-sized doorway
Like other drapes for C-sections, the new drape covers the mother’s belly and forms a curtain-like barrier between Mom’s face and the surgical site.
But in the curtain is a doorway, covered with flaps on both sides.
After a baby is born, a nurse or doctor opens a flap that faces the belly. The other flap pulls down toward Mom’s face, creating a sterile landing pad.
That reveals an 8-by-8-inch hole, just big enough for a baby.
When Claire was born, Dr. Hubbard handed her through that square opening. A nurse, wearing sterile surgical gloves, carefully took Claire and set her on Evelise’s chest. They closed both flaps.
As Evelise bonded with Claire, Dr. Hubbard finished the surgery.
“It keeps that area sterile,” said Kim Jarrelle, one of the nurses who invented the drape. “And mom doesn’t have to see them sewing her up.”
A mother’s tearful sobs inspired the creation of the drape, Jarrelle said. A Richmond midwife brought in a patient one day who had planned on a home birth but needed a C-section.
“She lay on the table and cried and cried,” Jarrelle said. “I thought, ‘How could we create a better experience for this mom? How could we make this an intimate, loving experience for moms and babies in an operating room?’
“Mom should always be the first to hold her baby, and a C-section should not be an exception,” she said.
Asked if the baby could be handed over the top of the drape, rather than through an opening, Jarrelle said it would be too risky.
“You worry about the sterile field,” she said. “And it would be more dangerous. Babies are wet and slippery.”
‘Still a learning curve’
Jarrelle worked with nurses Debbie Burbic and Jess Niccoli to create prototypes and test them. They put the new product on the market in June 2015.
Evans, who has worked in labor and delivery since 2007, had been searching for a way to improve C-section deliveries. She learned about the Clever Medical drape at a conference and was excited to bring it to Spectrum Health.
Using the drape requires planning and coordination from staff, Dr. Hubbard said.
“It’s still a learning curve, because we are still trying to work through the awkwardness of who does what and how do we do it,” she said, after she delivered baby Claire and finished Evelise’s surgery.
But she was open to working with it. Seventeen years ago, she gave birth to twins. They went to the nursery while she went to the recovery room. An hour passed before she could hold them.
“I love the idea that we are finally letting moms in C-sections do skin-to-skin,” Dr. Hubbard said. “We’ve come a long way.”
A serene beginning
In the operating room, Evelise and Michael cooed in English and Portuguese as they cuddled their daughter, a brown-haired, blue-eyed little girl. A nurse took Claire to the warmer for assessments and measurements―she weighed a healthy 7-pounds, 1-ounce―and then placed her back in Evelise’s arms.
“I thought it was awesome. I couldn’t ask for more,” Evelise said two days later.
She sat in her hospital bed, cradling Claire, who wore a pink flowered headband. Claire stretched, opened her eyes and looked around.
“She already feels more serene because of the beginning of her outside life,” Evelise said.
As a physical therapist, she knows well the value of skin-to-skin contact with newborns. When she thought that moment would be delayed by a C-section, she was disappointed, but understanding. A safe and healthy childbirth mattered most.
But she was thrilled she did get to hold her baby moments after birth.
“It was a great surprise,” she said. “It was a blessing I didn’t expect.”