Effects of Skin-to-Skin Care During Cesareans: A Quasiexperimental Feasibility/Pilot Study

Breastfeed Med. 2019 Dec;14(10):731-743. doi: 10.1089/bfm.2019.0202. Epub 2019 Nov 18.

Abstract

Introduction: Our aim was to describe feasibility and outcomes of skin-to-skin care (SSC) that began during cesarean surgery and continued, uninterrupted, for about 5 hours. We described maternal/newborn measures of physiologic stability and stress; maternal measures of comfort; maternal satisfaction with surgery and SSC; and exclusive breast milk feeding at discharge. Materials and Methods: We used a quasiexperimental, time-interrupted design and randomly assigned women to receive SSC that began during surgery (Group 1, intervention; n = 20) or after surgery, before transfer to recovery (Group 2, standard care; n = 20). We analyzed differences across time and for five observations: before transfer to the operating room (OR); in the OR, about 20 minutes after birth; in the recovery room, about 1 hour after admission; in the New Family Center (NFC), about 1 hour after admission; and in the NFC, about 2 hours after admission. Results: Group 1 began SSC an average of 0.89 minutes after birth and continued an average of 300 minutes and Group 2 began an average of 46 minutes after birth and continued an average of 126 minutes. Women who began SSC during surgery were more satisfied with the experience (p = 0.015) and had lower levels of salivary cortisol across time (p = 0.003). We found no negative effects on maternal or newborn measures of physiologic stability and no difference in exclusive breast milk feeding rates at discharge. Conclusion: Immediate and uninterrupted SSC during medically uncomplicated cesarean surgery is a feasible, low-cost intervention that can safely begin during surgery and continue, uninterrupted, for extended durations.

Keywords: cesarean birth; maternal satisfaction with cesarean; newborn thermoregulation; skin-to-skin care; skin-to-skin contact.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adaptation, Physiological*
  • Adult
  • Breast Feeding* / psychology
  • Breast Feeding* / statistics & numerical data
  • Cesarean Section / methods*
  • Feasibility Studies
  • Female
  • Humans
  • Hydrocortisone / analysis
  • Infant Behavior*
  • Infant, Newborn
  • Kangaroo-Mother Care Method / methods*
  • Maternal Behavior / physiology*
  • Mother-Child Relations / psychology
  • Pilot Projects
  • Postoperative Period
  • Pregnancy
  • Time Factors

Substances

  • Hydrocortisone