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Corbaz F, Boussac E, Lepigeon K, Gomes Dias D, Marcadent S, Desseauve D, Horsch A. 'connEcted caesarean section': creating a virtual link between MOthers and their infanTs to ImprOve maternal childbirth experieNce - study protocol for a PILOT trial (e-motion-pilot). BMJ Open 2023; 13:e065830. [PMID: 37286319 DOI: 10.1136/bmjopen-2022-065830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/09/2023] Open
Abstract
INTRODUCTION One-third of mothers rate their childbirth as traumatic. The prevalence of childbirth-related post-traumatic stress disorder (CB-PTSD) is 4.7%. Skin-to-skin contact is a protective factor against CB-PTSD. However, during a caesarean section (CS), skin-to-skin contact is not always feasible and mothers and infants are often separated. In those cases, there is no validated and available solution to substitute this unique protective factor. Based on the results of studies using virtual reality and head-mounted displays (HMDs) and studies on childbirth experience, we hypothesise that enabling the mother to have a visual and auditory contact with her baby could improve her childbirth experience while she and her baby are separated. To facilitate this connection, we will use a two-dimensional 360° camera filming the baby linked securely to an HMD that the mother can wear during the end of the surgery. METHODS AND ANALYSIS This study protocol describes a monocentric open-label controlled pilot trial with minimal risk testing the effects of a visual and auditory contact via an HMD worn by the mother airing a live video of her newborn compared with treatment-as-usual in 70 women after CS. The first 35 consecutive participants will be the control group and will receive the standard care. The next 35 consecutive participants will have the intervention. The primary outcome will be differences in maternal childbirth experience (Childbirth Experience Questionnaire 2) at 1-week postpartum between the intervention and control groups. Secondary outcomes will be CB-PTSD symptoms, birth satisfaction, mother-infant bonding, perceived pain and stress during childbirth, maternal anxiety and depression symptoms, anaesthesiological data and acceptability of the procedure. ETHICS AND DISSEMINATION Ethics approval was granted by the Human Research Ethics Committee of the Canton de Vaud (study number 2022-00215). Dissemination of results will occur via national and international conferences, peer-reviewed journals, public conferences and social media. TRIAL REGISTRATION NUMBER NCT05319665.
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Affiliation(s)
- Fiona Corbaz
- Woman-Mother-Child, Lausanne University Hospital, Lausanne, Switzerland
| | - Emilie Boussac
- Anesthesiology, Lausanne University Hospital, Lausanne, Switzerland
| | - Karine Lepigeon
- Woman-Mother-Child, Lausanne University Hospital, Lausanne, Switzerland
| | - Diana Gomes Dias
- Woman-Mother-Child, Lausanne University Hospital, Lausanne, Switzerland
| | | | - David Desseauve
- Woman-Mother-Child, Lausanne University Hospital, Lausanne, Switzerland
| | - Antje Horsch
- Woman-Mother-Child, Lausanne University Hospital, Lausanne, Switzerland
- Institute of Higher Education and Research in Healthcare, University of Lausanne, Lausanne, Switzerland
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Li L, Ji F, Wang Y, Wang L, Yu L, Wu X, Lyu T, Dou Y, Cao Y, Hu XJ. The clinical experience of early skin-to-skin contact combined with non-nutritive comfort sucking in mothers of preterm infants: a qualitative study. BMC Pregnancy Childbirth 2023; 23:281. [PMID: 37095429 PMCID: PMC10123578 DOI: 10.1186/s12884-023-05581-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Accepted: 04/07/2023] [Indexed: 04/26/2023] Open
Abstract
BACKGROUND In most areas of China, mothers typically do not participate in early care of preterm infants in NICU. This study aims to examine the early experience of mothers of preterm infants participating in skin-to-skin contact combined with non-nutritive comfort sucking in China. METHODS This qualitative research study used one-on-one, face-to-face, semi-structured in-depth interviews. Eighteen mothers who participated in early skin-to-skin contact combined with non-nutritive comfort sucking were interviewed in the NICU of a tertiary children's hospital in Shanghai between July and December 2020. Their experiences were analyzed using the inductive topic analysis method. RESULTS Five themes about skin-to-skin contact combined with non-nutritive comfort sucking were identified, including alleviation of maternal anxiety and fear during mother infant separation, reshaping the maternal role, promotion of active breast pumping, enhances the mother's willingness to actively breast feed and building the maternal confidence in baby care. CONCLUSION Skin-to-skin contact combined with non-nutritive comfort sucking in the NICU can not only enhance the identity and responsibility of the mother's role, but also provide non-nutritive sucking experience for promoting the establishment of oral feeding in preterm infants.
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Affiliation(s)
- Liling Li
- Children's Hospital of Fudan University, the National Children's Medical Center, 399 Wan Yuan Road, Shanghai, 201102, People's Republic of China
| | - Futing Ji
- Children's Hospital of Fudan University, the National Children's Medical Center, 399 Wan Yuan Road, Shanghai, 201102, People's Republic of China
| | - Yuejue Wang
- Children's Hospital of Fudan University, the National Children's Medical Center, 399 Wan Yuan Road, Shanghai, 201102, People's Republic of China
| | - Li Wang
- Children's Hospital of Fudan University, the National Children's Medical Center, 399 Wan Yuan Road, Shanghai, 201102, People's Republic of China
| | - Ling Yu
- Children's Hospital of Fudan University, the National Children's Medical Center, 399 Wan Yuan Road, Shanghai, 201102, People's Republic of China
| | - Xi Wu
- Children's Hospital of Fudan University, the National Children's Medical Center, 399 Wan Yuan Road, Shanghai, 201102, People's Republic of China
| | - Tianchan Lyu
- Children's Hospital of Fudan University, the National Children's Medical Center, 399 Wan Yuan Road, Shanghai, 201102, People's Republic of China
| | - Yalan Dou
- Children's Hospital of Fudan University, the National Children's Medical Center, 399 Wan Yuan Road, Shanghai, 201102, People's Republic of China
| | - Yun Cao
- Children's Hospital of Fudan University, the National Children's Medical Center, 399 Wan Yuan Road, Shanghai, 201102, People's Republic of China
| | - Xiao-Jing Hu
- Children's Hospital of Fudan University, the National Children's Medical Center, 399 Wan Yuan Road, Shanghai, 201102, People's Republic of China.
- Research Unit of Early Intervention of Genetically Related Childhood Cardiovascular Diseases(2018RU002), Chinese Academy of Medical Sciences , Beijing, China.
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Mena-Tudela D, Soriano-Vidal FJ, Vila-Candel R, Quesada JA, Martínez-Porcar C, Martin-Moreno JM. Is Early Initiation of Maternal Lactation a Significant Determinant for Continuing Exclusive Breastfeeding up to 6 Months? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3184. [PMID: 36833878 PMCID: PMC9966801 DOI: 10.3390/ijerph20043184] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/17/2022] [Revised: 02/09/2023] [Accepted: 02/10/2023] [Indexed: 06/01/2023]
Abstract
BACKGROUND The World Health Organization (WHO) recommends early initiation of breastfeeding (EIBF) within the first hour after birth. However, certain perinatal factors, namely caesarean section, may prevent this goal from being achieved. The aim of our study was to examine the relationship between EIBF (maternal lactation in the first hours and degree of latching before hospital discharge) and the maintenance of exclusive breastfeeding (MBF) up to the recommended 6 months of age (as advocated by the WHO). METHODS This observational, retrospective cohort study included a random sample of all births between 2018 and 2019, characterising the moment of breastfeeding initiation after birth and the infant's level of breast latch (measured by LATCH assessment tool) prior to hospital discharge. Data were collected from electronic medical records and from follow-up health checks of infants up to 6 months postpartum. RESULTS We included 342 women and their newborns. EIBF occurred most often after vaginal (p < 0.001) and spontaneous births with spontaneous amniorrhexis (p = 0.002). LATCH score <9 points was associated with a 1.4-fold relative risk of abandoning MBF (95%CI: 1.2-1.7) compared with a score of 9-10 points. CONCLUSIONS Although we were unable to find a significant association between EIBF in the first 2 h after birth and MBF at 6 months postpartum, low LATCH scores prior to discharge were associated with low MBF, indicating the importance of reinforcing the education and preparation efforts of mothers in the first days after delivery, prior to the establishment of an infant feeding routine upon returning home.
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Affiliation(s)
- Desirée Mena-Tudela
- Department of Nursing, Universitat Jaume I, 12071 Castellón de la Plana, Spain
| | - Francisco Javier Soriano-Vidal
- Department of Nursing, Universitat de València, 46007 Valencia, Spain
- Department of Obstetrics and Gynaecology, Xàtiva-Oninyent Health Department, 46800 Xàtiva, Spain
| | - Rafael Vila-Candel
- Department of Nursing, Universitat de València, 46007 Valencia, Spain
- Department of Obstetrics and Gynaecology, Hospital Universitario de la Ribera, 46600 Alzira, Spain
| | - José Antonio Quesada
- Department of Clinical Medicine, Universidad Miguel Hernández, 03202 Elche, Spain
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), 03550 Alicante, Spain
| | - Cristina Martínez-Porcar
- Department of Obstetrics and Gynaecology, Hospital Universitario de la Ribera, 46600 Alzira, Spain
| | - Jose M. Martin-Moreno
- Department of Preventive Medicine and Public Health, Universitat de València, 46010 Valencia, Spain
- Biomedical Research Institute INCLIVA, Clinic University Hospital, 46010 Valencia, Spain
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Bäcke P, Thies-Lagergren L, Blomqvist YT. Neonatal resuscitation after birth: Swedish midwives' experiences of and perceptions about separation of mothers and their newborn babies. Eur J Midwifery 2023; 7:10. [PMID: 37213413 PMCID: PMC10193297 DOI: 10.18332/ejm/162319] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 03/13/2023] [Accepted: 04/03/2023] [Indexed: 05/23/2023] Open
Abstract
INTRODUCTION This study aimed to investigate midwives' experiences of and perceptions about mother-baby separation during resuscitation of the baby following birth. METHODS A qualitative study was conducted using an author-designed questionnaire. Fifty-four midwives from two Swedish birth units with different working methods regarding neonatal resuscitation - at the mother's bedside in the birth room or in a designated resuscitation room outside the birth room - completed the questionnaire. Data were analyzed using qualitative content analysis. RESULTS Most midwives had experience of removing a newborn baby in need of critical care from the birth room, thus separating the mother and baby. The midwives identified the difficulties and challenges involved in carrying out emergency care in the birth room after birth and had divergent opinions about what they considered possible in these birth situations. They agreed on the benefits, for both mother and baby, in performing emergency care in the birth room and avoiding a separation altogether, if possible. CONCLUSIONS There are good opportunities to reduce separation of mother and baby after birth; training, knowledge, education and the right environmental conditions are important factors in successfully implementing new ways of working. It is possible to work towards reducing separation and this work should continue and strive to eliminate separation as far as possible.
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Affiliation(s)
- Pyrola Bäcke
- Neonatal Intensive Care Unit, University Hospital, Uppsala, Sweden
- Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden
| | - Li Thies-Lagergren
- Midwifery Research – Reproductive, Perinatal and Sexual Health, Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden
| | - Ylva Thernström Blomqvist
- Neonatal Intensive Care Unit, University Hospital, Uppsala, Sweden
- Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden
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Sheedy GM, Stulz VM, Stevens J. Exploring outcomes for women and neonates having skin-to-skin contact during caesarean birth: A quasi-experimental design and qualitative study. Women Birth 2022; 35:e530-e538. [DOI: 10.1016/j.wombi.2022.01.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 01/19/2022] [Accepted: 01/20/2022] [Indexed: 11/30/2022]
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Kirca N, Adibelli D. Effects of mother-infant skin-to-skin contact on postpartum depression: A systematic review. Perspect Psychiatr Care 2021; 57:2014-2023. [PMID: 33476428 DOI: 10.1111/ppc.12727] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Revised: 12/16/2020] [Accepted: 12/28/2020] [Indexed: 01/01/2023] Open
Abstract
PURPOSE The aim of this systematic review was to evaluate the effects of the skin-to-skin contact (SSC) method on postpartum depression. DESIGN AND METHODS A systematic review of the literature was performed. FINDINGS This review was completed with three studies meeting the research criteria. Two studies were randomized controlled studies and one study had a quasi-experimental design. PRACTICE IMPLICATIONS SSC is such a low-cost intervention that it would be accessible, simple, and feasible for most mothers in the first postpartum weeks. By reducing mothers' depressive symptoms and physiological stress, SSC facilitates mothers' wellbeing and ultimately affects infants' development by enhancing the mother/infant relationship.
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Affiliation(s)
- Nurcan Kirca
- Department of Obstetrics and Gynecological Nursing, Faculty of Nursing, Akdeniz University, Antalya, Turkey
| | - Derya Adibelli
- Department of Public Health Nursing, Faculty of Health Sciences Kumluca, Akdeniz University, Antalya, Turkey
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Machold CA, O'Rinn SE, McKellin WH, Ballantyne G, Barrett JFR. Women's experiences of skin-to-skin cesarean birth compared to standard cesarean birth: a qualitative study. CMAJ Open 2021; 9:E834-E840. [PMID: 34465580 PMCID: PMC8428890 DOI: 10.9778/cmajo.20200079] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Skin-to-skin contact between mother and infant immediately after birth is recommended regardless of delivery method; however, it is less common after cesarean delivery. We aimed to describe and compare women's experiences of cesarean birth with and without skin-to-skin contact at an urban tertiary care hospital. METHODS In this hermeneutic phenomenologic study, we used semistructured telephone interviews from 2015 to 2018 to interview a convenience sample of women who delivered at term by scheduled skin-to-skin cesarean birth at an urban tertiary care hospital in Toronto, Ontario. Women were invited to participate if they had had a previous planned or unplanned cesarean birth and a scheduled skin-to-skin cesarean birth between 2013 and 2017. Participants were excluded if they had antenatally diagnosed conditions, they delivered before 37 weeks, they had general anesthesia, their condition was unstable at the time of surgery, a skin-to-skin cesarean birth was not possible or they declined skin-to-skin cesarean birth. Interviews were recorded, transcribed and analyzed by means of thematic analysis. RESULTS Ten women were interviewed 1-19 months postpartum. Four central themes emerged: support for skin-to-skin cesarean birth (women feeling supported by their families and health care providers); control (participants experiencing greater control during their skin-to-skin cesarean birth); connection with the infant, which enabled women to be active participants in their delivery, enhanced bonding and intimacy, facilitated breastfeeding and bolstered confidence during early parenthood; and logistic considerations, with participants recognizing that skin-to-skin cesarean birth required additional resources. INTERPRETATION These findings refine what is known about skin-to-skin cesarean birth and provide a critical perspective, that of mothers. They support the transformation of traditional operating room dynamics to a more patient-centred environment.
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Affiliation(s)
- Clea A Machold
- Collingwood General and Marine Hospital (Machold), Collingwood, Ont.; Sunnybrook Research Institute (O'Rinn) and Aubrey & Marla Dan Centre for Women & Babies (O'Rinn), Sunnybrook Health Sciences Centre, Toronto, Ont.; Department of Anthropology (McKellin), University of British Columbia, Vancouver, BC; Birthing Unit (Ballantyne), Aubrey & Marla Dan Centre for Women & Babies, Sunnybrook Health Sciences Centre, Toronto, Ont.; Department of Obstetrics and Gynecology (Barrett), McMaster University, Hamilton, Ont.
| | - Susan E O'Rinn
- Collingwood General and Marine Hospital (Machold), Collingwood, Ont.; Sunnybrook Research Institute (O'Rinn) and Aubrey & Marla Dan Centre for Women & Babies (O'Rinn), Sunnybrook Health Sciences Centre, Toronto, Ont.; Department of Anthropology (McKellin), University of British Columbia, Vancouver, BC; Birthing Unit (Ballantyne), Aubrey & Marla Dan Centre for Women & Babies, Sunnybrook Health Sciences Centre, Toronto, Ont.; Department of Obstetrics and Gynecology (Barrett), McMaster University, Hamilton, Ont
| | - William H McKellin
- Collingwood General and Marine Hospital (Machold), Collingwood, Ont.; Sunnybrook Research Institute (O'Rinn) and Aubrey & Marla Dan Centre for Women & Babies (O'Rinn), Sunnybrook Health Sciences Centre, Toronto, Ont.; Department of Anthropology (McKellin), University of British Columbia, Vancouver, BC; Birthing Unit (Ballantyne), Aubrey & Marla Dan Centre for Women & Babies, Sunnybrook Health Sciences Centre, Toronto, Ont.; Department of Obstetrics and Gynecology (Barrett), McMaster University, Hamilton, Ont
| | - Gillian Ballantyne
- Collingwood General and Marine Hospital (Machold), Collingwood, Ont.; Sunnybrook Research Institute (O'Rinn) and Aubrey & Marla Dan Centre for Women & Babies (O'Rinn), Sunnybrook Health Sciences Centre, Toronto, Ont.; Department of Anthropology (McKellin), University of British Columbia, Vancouver, BC; Birthing Unit (Ballantyne), Aubrey & Marla Dan Centre for Women & Babies, Sunnybrook Health Sciences Centre, Toronto, Ont.; Department of Obstetrics and Gynecology (Barrett), McMaster University, Hamilton, Ont
| | - Jon F R Barrett
- Collingwood General and Marine Hospital (Machold), Collingwood, Ont.; Sunnybrook Research Institute (O'Rinn) and Aubrey & Marla Dan Centre for Women & Babies (O'Rinn), Sunnybrook Health Sciences Centre, Toronto, Ont.; Department of Anthropology (McKellin), University of British Columbia, Vancouver, BC; Birthing Unit (Ballantyne), Aubrey & Marla Dan Centre for Women & Babies, Sunnybrook Health Sciences Centre, Toronto, Ont.; Department of Obstetrics and Gynecology (Barrett), McMaster University, Hamilton, Ont
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Deys L, Wilson PV, Meedya DS. What are women's experiences of immediate skin-to-skin contact at caesarean section birth? An integrative literature review. Midwifery 2021; 101:103063. [PMID: 34157585 DOI: 10.1016/j.midw.2021.103063] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 06/02/2021] [Indexed: 12/12/2022]
Abstract
BACKGROUND Skin-to-skin is a well-established practice at vaginal births promoting the health of women and babies. Facilitation of skin-to-skin at caesarean section birth is growing despite environmental and historical challenges. This is led by the expectancy of women and of health professionals increasingly understanding its importance. OBJECTIVE To synthesise original research that explores the experience of women having immediate and uninterrupted skin-to-skin contact at caesarean section when woman and baby are well. DESIGN Integrative literature review. DATA SOURCES The databases of SCOPUS, PubMed, CINAHL plus, Wiley Online, Cochrane Library, Web of Science and MIDIRS were used to identify studies from 2010-2020. Hand searching of library journals, reference and citation lists were also used. METHODS The framework of Whittemore and Knafl (2005) was used to guide the literature search, thematic analysis, and synthesis of original research. Initial screening against inclusion criteria was utilised for English-published papers of full-term, well, woman and baby dyads who experienced skin-to-skin at caesarean section birth. Papers were not limited by methodology. The validated Mixed Methods Appraisal Tool (MMAT) was used for critical quality appraisal (Bartlett et al., 2018). FINDINGS In total, 750 results were returned in the initial search and a final 13 papers were included in this review including quantitative (6), qualitative (5) and mixed method (2) designs. Immediate and uninterrupted skin-to-skin at caesarean section birth, when mother and baby are well, is safe, appropriate and desired by women, improving birth experience and satisfaction. Three main themes were identified with sub-themes - Positive birth experience (satisfaction; breastfeeding goals); Sense of control (empowered; birth, not a procedure); Natural (wanting to hold their baby; becoming a mother). CONCLUSIONS The findings of this review show that skin-to-skin improves the experience for women, and particularly empowers women having a caesarean section giving them a sense of a more natural birth. Women see skin-to-skin as an opportunity to maintain control and not be separated from their baby. Many studies have focused on the benefits of skin-to-skin but less so on the wants and choices of women. Women want to see, hold and feed their babies but are unable to achieve this of their own volition during a surgical birth. Understanding how women value this close physical contact can seek to inform further research on the impact of separation. This can inform policy and practice development in maternity care services to ensure best outcomes for both women and infants. IMPLICATIONS FOR PRACTICE The practice of skin-to-skin and keeping mother and baby together is valued by women and justified by research as best-practice for health and well-being. The findings of this paper highlight the importance of maternity settings facilitating both skin-to-skin and non-separation for all women and their newborns, even more so at caesarean section births.
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Affiliation(s)
- Linda Deys
- School of Nursing, University of Wollongong, Northfields Avenue, Wollongong, NSW 2500 Australia; Clinical Midwife Consultant/IBCLC/RN, Illawarra Shoalhaven Local Health District, Australia; Maternal & Women's Health, Locked Bag 8808, South Coast Mail Centre, NSW 2521, Australia.
| | - Professor Valerie Wilson
- University of Wollongong School of Nursing and Illawarra Shoalhaven Local Health District, Australia.
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Abdulghani N, Cooklin A, Edvardsson K, Amir LH. Mothers' perceptions and experiences of skin-to-skin contact after vaginal birth in Saudi Arabia: A cross-sectional study. Women Birth 2021; 35:e60-e67. [PMID: 33608236 DOI: 10.1016/j.wombi.2021.02.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Revised: 11/22/2020] [Accepted: 02/01/2021] [Indexed: 12/12/2022]
Abstract
PROBLEM The World Health Organization recommends immediate skin-to-skin contact after birth, however, worldwide, separation of mothers and infant is common. BACKGROUND In Saudi Arabia, there is a lack of research exploring mothers' experiences of skin-to-skin contact after birth. AIM To estimate the rate of skin-to-skin contact and describe mothers' perceptions and experiences of immediate skin-to-skin contact after vaginal birth in two largest hospitals in Jeddah, Saudi Arabia. METHODS A cross-sectional study conducted in 2017. A total of 254 mothers completed the survey on the postnatal ward (92 % response rate). The survey consisted of 36 closed and open-ended items. Data were described using summary statistics and free text comments were analysed using content analysis. RESULTS The rate of direct skin-to-skin contact was 15%. A further 54% of mothers had the baby placed on their chest/abdomen but with a sheet/gown between them. Mothers reported favourable perceptions towards skin-to-skin contact and reported the practice as acceptable (67%). Most mothers did not express concerns about feeling exposed (85%) or that skin-to-skin contact was inconsistent with norms of modesty or culture (87%). The free text comments indicated that most mothers felt positive about their experience of skin-to-skin contact, while some mothers felt overwhelmed and unprepared. DISCUSSION AND CONCLUSIONS Skin-to-skin contact was not routinely implemented after birth and the rate was low. Mothers held positive perceptions and wanted to practice skin-to-skin contact. Policy makers and clinicians should acknowledge mothers' needs and feelings by facilitating skin-to-skin contact to achieve optimal outcomes for mothers and infants.
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Affiliation(s)
- Nawal Abdulghani
- Faculty of Nursing, Umm Al-Qura University, Makkah, Saudi Arabia; Judith Lumley Centre, School of Nursing and Midwifery, La Trobe University, Melbourne, Victoria, Australia.
| | - Amanda Cooklin
- Judith Lumley Centre, School of Nursing and Midwifery, La Trobe University, Melbourne, Victoria, Australia
| | - Kristina Edvardsson
- Judith Lumley Centre, School of Nursing and Midwifery, La Trobe University, Melbourne, Victoria, Australia
| | - Lisa H Amir
- Judith Lumley Centre, School of Nursing and Midwifery, La Trobe University, Melbourne, Victoria, Australia
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Frederick A, Fry T, Clowtis L. Intraoperative Mother and Baby Skin-to-Skin Contact during Cesarean Birth: Systematic Review. MCN Am J Matern Child Nurs 2020; 45:296-305. [PMID: 33095544 DOI: 10.1097/nmc.0000000000000646] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE Experts recommend immediate skin-to-skin (SSC) contact for all alert and stable mothers and newborns after birth. Clinicians are working to incorporate immediate (intraoperative) SSC during cesarean birth. The purpose of this systematic review is to describe the state of the science of intraoperative SSC for mother and baby and increase clinician's awareness of its potential benefits and risks. STUDY DESIGN AND METHODS A systematic approach was followed throughout the review process. CINAHL, PubMed, and Embase databases were searched using strategies constructed by an academic health sciences librarian. Articles included in the review focused on SSC initiated during cesarean birth. RESULTS Thirteen studies were selected for the mixed-method systematic review. Six prospective studies, four retrospective chart reviews, and three qualitative studies met the inclusion criteria. Maternal stress levels were reduced, whereas comfort, oxytocin, and antioxidant levels increased with intraoperative SSC. Physiologic measures of successful newborn transition showed little difference between newborns held in intraoperative SSC and those who were not. Synthesis of qualitative experiences revealed mothers' intense desire to hold and know their baby immediately after birth. CLINICAL IMPLICATIONS Intraoperative SSC is a safe, beneficial, and highly desirable practice for mothers and newborns experiencing cesarean birth. Although barriers exist to its implementation, nurses can facilitate and support this practice. Evidence-based, family-centered intraoperative SSC should be offered to all stable mothers and babies according to recommendations and in a manner that promotes safe outcomes, including following current nurse staffing guidelines.
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Affiliation(s)
- Anitra Frederick
- Dr. Anitra Frederick is a Clinical Assistant Professor, The University of Texas Health Science Center (UTHealth), Houston, TX. Dr. Frederick can be reached via email at Dr. Tena Fry is APRN for Women's and Newborn Services, The Children's Hospital of Oklahoma City, OK. Dr. Licia Clowtis is Postdoctoral Fellow, Case Western Reserve University, Francis Bolton College of Nursing, Cleveland, OH
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Kahalon R, Preis H, Benyamini Y. Who benefits most from skin-to-skin mother-infant contact after birth? Survey findings on skin-to-skin and birth satisfaction by mode of birth. Midwifery 2020; 92:102862. [PMID: 33126046 DOI: 10.1016/j.midw.2020.102862] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Revised: 08/16/2020] [Accepted: 10/13/2020] [Indexed: 12/17/2022]
Abstract
OBJECTIVE Previous research has shown that skin-to-skin contact in the delivery room is associated with an increase satisfaction with childbirth. The purpose of the present study was to examine whether this association differs as a function of mode of birth, such that the positive effect of skin-to-skin contact would be especially pronounced for women who had operative births. DESIGN Survey design using self-administered questionnaires during pregnancy (Time 1) and at two months postpartum (Time 2). SETTING At Time 1, women were recruited at community and hospital medical centres in two large metropolitan areas in the centre of Israel and through home midwives and internet forums. At Time 2, women completed a second questionnaire in which they reported whether they had skin-to-skin contact with their infant immediately after birth and their birth satisfaction. PARTICIPANTS Pregnant women, gestation week ≥24, with singleton pregnancy, who took part in both T1 and T2 (N = 1371, 75% of the 1833 women recruited at T1). MEASUREMENTS Analysis of covariance (ANCOVA) was used to examine whether the association between skin-to-skin contact after birth and birth satisfaction two months post-partum, differs as a function of mode of birth. Maternal or infant complications during birth, parity, and whether the pregnancy was planned, served as covariates. Birth satisfaction was measured using the Childbirth Satisfaction Scale. All measures were self-reported. FINDINGS The frequency of skin-to-skin was high (83%) for women who had vaginal birth, but lower for women who had an instrumental birth (66%) or a caesarean section (31%). At two months postpartum, women who had operative births reported less satisfaction with their birth than women who gave birth via vaginal birth. A significant interaction between skin-to-skin and mode of birth showed that although skin-to-skin was associated with higher birth satisfaction among women across all three modes of birth, i.e., vaginal (Cohen's d = .41), instrumental (Cohen's d = .64) and caesarean (Cohen's d = .87), the effect for the difference in birth satisfaction between women with and without skin-to-skin was especially large for operative births, particularly for caesarean sections. KEY CONCLUSIONS Operative birth is related to lower satisfaction with childbirth and lower rates of skin-to-skin contact immediately after birth. Yet, the association between skin-to-skin and birth satisfaction is especially strong for women who had operative births and specifically a caesarean section, suggesting that the possible contribution of skin-to-skin to birth satisfaction should be emphasised particularly after operative births. IMPLICATIONS FOR PRACTICE It is recommended that maternity care providers, managers, policy makers and medical teams facilitate skin-to-skin contact between the woman and her infant immediately, or as soon as possible, after childbirth, in both operative and non-operative births.
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Affiliation(s)
- Rotem Kahalon
- Bob Shapell School of Social Work Tel Aviv University, Israel; The School of Psychological Sciences, Tel-Aviv University, Israel.
| | - Heidi Preis
- Bob Shapell School of Social Work Tel Aviv University, Israel; Department of Psychology, Stoney Brook University, U.S
| | - Yael Benyamini
- Bob Shapell School of Social Work Tel Aviv University, Israel
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Finlayson K, Crossland N, Bonet M, Downe S. What matters to women in the postnatal period: A meta-synthesis of qualitative studies. PLoS One 2020; 15:e0231415. [PMID: 32320424 PMCID: PMC7176084 DOI: 10.1371/journal.pone.0231415] [Citation(s) in RCA: 95] [Impact Index Per Article: 23.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Accepted: 03/23/2020] [Indexed: 12/17/2022] Open
Abstract
INTRODUCTION The postnatal period is an underserved aspect of maternity care. Guidelines for postnatal care are not usually informed by what matters to the women who use it. This qualitative systematic review was undertaken to identify what matters to women in the postnatal period, to inform the scope of a new World Health Organization (WHO) postnatal guideline. METHODS We searched MEDLINE, CINAHL, PsycINFO, POPLINE, Global Index Medicus, EMBASE, LILACS, AJOL, and reference lists of eligible studies published January 2000-July 2019, reporting qualitative data on women's beliefs, expectations, and values relating to the postnatal period. DATA COLLECTION AND ANALYSIS Author findings were extracted, coded and synthesised using techniques derived from thematic synthesis. Confidence in the quality, coherence, relevance and adequacy of data underpinning the resulting findings was assessed using GRADE-CERQual. RESULTS We included 36 studies from 15 countries, representing the views of more than 800 women. Confidence in most results was moderate to high. What mattered to women was a positive postnatal experience where they were able to adapt to their new self-identity and develop a sense of confidence and competence as a mother; adjust to changes in their intimate and family relationships, including their relationship to their baby; navigate ordinary physical and emotional challenges; and experience the dynamic achievement of personal growth as they adjust to the 'new normal' of motherhood and parenting in their own cultural context. CONCLUSION This review provides evidence that what matters to women in the postnatal period is achieving positive motherhood (including maternal self-esteem, competence, and autonomy), as well as fulfilling adaptation to changed intimate and family relationships, and (re)gaining health and wellbeing for both their baby, and themselves. Where this process is optimal, it also results in joy, self-confidence, and an enhanced capacity to thrive in the new integrated identity of 'woman and mother'.
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Affiliation(s)
- Kenneth Finlayson
- Research in Childbirth and Health (ReaCH) group, University of Central Lancashire, Preston, United Kingdom
| | - Nicola Crossland
- Faculty of Health and Wellbeing, University of Central Lancashire, Preston, United Kingdom
| | - Mercedes Bonet
- Department of Reproductive Health and Research, UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), World Health Organization, Geneva, Switzerland
| | - Soo Downe
- Research in Childbirth and Health (ReaCH) group, University of Central Lancashire, Preston, United Kingdom
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Abdulghani N, Edvardsson K, Amir LH. Health care providers’ perception of facilitators and barriers for the practice of skin-to-skin contact in Saudi Arabia: A qualitative study. Midwifery 2020; 81:102577. [DOI: 10.1016/j.midw.2019.102577] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Revised: 10/23/2019] [Accepted: 11/16/2019] [Indexed: 12/13/2022]
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Allen J, Parratt JA, Rolfe MI, Hastie CR, Saxton A, Fahy KM. Immediate, uninterrupted skin-to-skin contact and breastfeeding after birth: A cross-sectional electronic survey. Midwifery 2019; 79:102535. [DOI: 10.1016/j.midw.2019.102535] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Revised: 08/28/2019] [Accepted: 09/04/2019] [Indexed: 10/26/2022]
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Skin-to-skin contact during caesarean delivery: An intriguing interaction between the mother and her child. Eur J Anaesthesiol 2019; 36:973-976. [PMID: 31688300 DOI: 10.1097/eja.0000000000001107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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