I am writing a new policy for our unit regarding "Attendance of Neonatologist at Elective C Section ", IF any one can help me in making this policy or want to share your current hospital/unit policy regarding this issue, I will be greatful.

Currently our practice is that we are attending all elective C Sections and the evidence is that a neonatologist need not to be present at the elective c section but can be approachable on contact.

Thanks

Hi!

In the hospital I used to work, there were about 5-8 elective C-sections every weekday. (the obs department had a separate maternity ward for elective C-sections only).

No ped/neo-dr was attending unless there were special circumstances. For the vast majority of of C-sections an attending neoantologist was not indicated, as judged by the midwife&obstetrician responsible for the C-section.

I have not looked into the literature on this topic, but the strategy in our hospital worked just fine.

In our hospital i attend all c sections. It's because of 2 reasons.1.Many of the cases are referred here with some perinatal problems.2.100 % of rpt sections want puerperal sterilisations to be done on the table.

We have to take the decision whether to allow PS or not.

Do you face the second situation often?

At our ward residents routinely attend cs unless difficulties are expected. Our NICU is right next to the delivery room, so in case there is trouble, the attending neonatologist will be available within seconds.

In our hospital, the residents attend all C/S, but recently we started discussion with the perinatology team to renew our protocol regarding this issue,but not yet established. The main points we stressed on are :

1.The midwifes or the nurse supposed to take of the baby should be qualified to resuscitate the baby in case heneeds, at least Positive Pressure Ventitation (for this purpose we organized many NRP sessions in order to graduate qualified staff in this domain.NRP (neonatal resuscitation Program) is vey well program published by AHA and AAP,and ther is ongoing international workshops.)

2.The C/S should be clearly classified as elective,low risk by the attending obstetrician.

3.a skilled personnel(pediatrician 0r neonatologist should always available in the hospital just in case