Abstract
Problem
Women having an elective caesarean birth are often separated from their babies at
birth with newborns transferred to a postnatal ward with the significant other.
Background
Two midwives were employed in 2019 to provide skin-to-skin contact for women who planned
for elective caesarean births in a public hospital in metropolitan New South Wales
with 4000 births per year and a 39% CB rate (57.8% of these births being elective).
Aim
To compare the outcomes for women and their newborns on the effects of skin-to-skin
contact at elective caesarean births within the first five minutes of birth to those
who did not have skin-to-skin contact and to explore the lived experiences of women
having skin-to-skin contact during their elective caesarean births.
Methods
A quasi-experimental design study with a qualitative component of in-depth interviews.
Quantitative analyses included independent t-tests, chi square and logistic regression.
Thematic analysis was used for the qualitative data.
Findings
In the quantitative results, there was a reduction in the time to the first feed (t(100)
= −11.32, p < 0.001) (M = 38.9, SE = 20.7) (M = 124.9, SE = 50.1) and the first breastfeed (t(100) = −5.2, p < 0.001) (M = 53.2, SE = 82.5)
(M = 277, SE = 295.8) with increased breastfeeding on discharge for women that had
skin-to-skin contact at caesarean birth in comparison to those who did not receive
skin-to-skin contact χ2(1) = 10.22, p < 0.05. In the qualitative results, women who
had skin-to-skin contact during their caesarean birth had a positive experience with
improved bonding and reported less anxiety and depression than their previous caesarean
birth.
Conclusion
This study provides evidence of the benefits of skin-to-skin contact during a caesarean
birth.
Abbreviations:
SSC (skin-to-skin contact), CB (caesarean birth), BF (breastfeed), NICU (neonatal intensive care), BGL (blood glucose level), AF (artificial (breast milk substitute/formula) feed), NH (neonatal hypoglycaemia)Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Women and BirthAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Skin-to-skin contact after elective caesarean section: investigating the effect on breastfeeding rates.Br. J. Midwifery. 2016; 24: 18-25
- Immediate or early skin‐to‐skin contact after a Cesarean section: a review of the literature.Matern. Child Nutr. 2014; 10: 456-473
- Australia’s health 2018.Australia’s Health Series Canberra. 2018: 221
- Implementation Guidance: Protecting, Promoting and Supporting Breastfeeding in Facilities Providing Maternity and Newborn Services: The Revised Baby Friendly Hospital Initiative.2018
- An implementation algorithm to improve skin‐to‐skin practice in the first hour after birth.Matern. Child Nutr. 2018; 14e12571
- Impact of continuous Kangaroo Mother Care initiated immediately after birth (iKMC) on survival of newborns with birth weight between 1.0 to < 1.8 kg: study protocol for a randomized controlled trial.Trials. 2020; 21: 280https://doi.org/10.1186/s13063-020-4101-1
- Immediate “kangaroo mother care” and survival of newborns with low birth weight.N. Engl. J. Med. 2021; 384: 2028-2038
- Skin-to-skin: a modern approach to caesarean delivery.J. Obstet. Anaesth. Crit. Care. 2017; 7: 13
- Skin-to-skin contact following caesarean section: a narrative review.Br. J. Midwifery. 2020; 28: 754-760
- Newborn behaviour to locate the breast when skin‐to‐skin: a possible method for enabling early self‐regulation.Acta Paediatr. 2011; 100: 79-85
UNICEF. 2021. Retrieved on 27th August 2021 from: https://www.unicef.org.uk/babyfriendly/baby-friendly-resources/implementing-standards-resources/skin-to-skin-contact/.
- The influence of mother-newborn skin-to-skin contact on bonding and touch.South Afr. J. Occup. Ther. 2019; 49: 11-17
- Immediate, uninterrupted skin-to-skin contact and breastfeeding after birth: a cross-sectional electronic survey.Midwifery. 2019; 79102535
- Pronurturance plus at birth: a risk reduction strategy for preventing postpartum haemorrhage.Women Birth. 2016; 29: 279-284
- Implementing skin‐to‐skin contact in the operating room following cesarean birth.Worldviews Evid. Nurs. 2014; 11: 414
- A juxtaposition of birth and surgery: providing skin-to-skin contact in the operating theatre and recovery.Midwifery. 2016; 37: 41-48
- Midwives׳ experiences with mother–newborn skin-to-skin contact after a caesarean section: ‘fighting an uphill battle’.Midwifery. 2015; 31: 215-220
- Epigenetic matters: the link between early nutrition, microbiome, and long-term health development.Front. Pediatr. 2017; 5: 178
- Skin-to-skin contact in cesarean birth and duration of breastfeeding: a cohort study.Sci. World. 2017; 2017 (1940756-5)
- Delivery mode is associated with maternal mental health following childbirth.Arch. Womens Ment. Health. 2019; 22: 817-824
- Understanding the relationship between cesarean birth and stress, anxiety, and depression after childbirth: a nationwide cohort study.Birth. 2017; 44: 369-376
- Intraoperative mother and baby skin-to-skin contact during cesarean birth: systematic review.MCN Am. J. Matern. Child Nurs. 2020; 45: 296-305
- Sudden unexpected postnatal collapse during early breastfeeding and skin-to-skin care.J. Pediatr. 2020; 220: 269https://doi.org/10.1016/j.jpeds.2020.01.003
- Making the first days of life safer: preventing sudden unexpected postnatal collapse while promoting breastfeeding.J. Hum. Lact. 2015; 31: 47-52
- Continuous pulse oximetry during skin-to-skin care: an Australian initiative to prevent sudden unexpected postnatal collapse.Acta Paediatr. 2021; 110: 1166-1170
- Research Methods and Statistics in Psychology.2nd edn. SAGE Publications Ltd, 2014
- Focus group data saturation: a new approach to data analysis.Qual. Rep. 2016; 21: 2124-2130
- In-depth Interviewing: Principles, Techniques, Analysis.Pearson Education, Australia2008
- Interventions for women who have a caesarean birth to increase uptake and duration of breastfeeding: a systematic review.Matern. Child Nutr. 2017; 13e12390https://doi.org/10.1111/mcn.12390
- ‘Thematic analysis’.Encyclopedia of Critical Psychology. Springer, New York2014: 1947-1952
- An interprofessional quality improvement project to implement maternal/newborn skin‐to‐skin contact during delivery.J. Obstet. Gynecol. Neonat. Nurs. 2014; 43 (caesarean): 488-496
- Effects of skin-to-skin contact during cesareans: a quasiexperimental feasibility/pilot study.Breastfeed. Med. 2019; 14 (Mary Ann Liebert, Inc.)https://doi.org/10.1089/bfm.2019.0202
- Skin-to-skin contact and what women want in the first hours after a caesarean section.Midwifery. 2019; 74 (Epub 2019 Mar 27. PMID: 30954633): 140-146https://doi.org/10.1016/j.midw.2019.03.020
- Mother’s experiences and perceptions of a continuous caring model with fathers after caesarean section: a qualitative study.Womens Health Open J. 2015; 1: 63-71
- Systematic review confirmed the benefits of early skin-to-skin contact but highlighted lack of studies on very and extremely preterm infants.Acta Paediatr. 2021; 110: 2310-2315
Article info
Publication history
Published online: January 26, 2022
Accepted:
January 20,
2022
Received in revised form:
January 19,
2022
Received:
July 16,
2021
Identification
Copyright
© 2022 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.
