Friday, March 10, 2017

Skin-to-Skin Contact After Cesarean

Image by Nicole Monet Photography. Isn't this beautiful?
Here is yet another research study showing the benefits of skin-to-skin contact for babies and mothers, even during a cesarean. 

The study showed significantly lower rates of babies needing to be transferred to the NICU (Neonatal Intensive Care Unit) for observation when they had skin-to-skin contact with their mothers during a cesarean.

Other research shows that Skin-to-Skin Contact (SSC) improves breastfeeding rates. Although it noted that research quality needs improvement, the Cochrane Registry states:
Evidence supports the use of SSC to promote breastfeeding.
Skin-to-Skin Contact also has benefits beyond breastfeeding and fewer NICU transfers. An Australian study found that SSC and early breastfeeding decreased the rates of mothers experiencing post-partum hemorrhages. A study in Texas found that women who had SSC after cesareans reported less post-surgical pain. And a study from India found lower rates of infant hypothermia (low body temperature) after SSC.

Many hospitals around the country are now implementing skin-to-skin contact immediately after birth, and more and more are not differentiating between cesarean and vaginal births. Of course, SSC is not always possible under certain medical situations and there remain barriers to implementation, but most of the time it is indeed possible and many nurses, midwives, and doctors are leading the way in implementing these new policies.

Wouldn't it be nice to see ALL hospitals offering skin-to-skin contact immediately after birth, no matter the mode of birth? The World Health Organization  recommends SSC after a vaginal birth and "as soon as the mother is alert and responsive" after a cesarean. This is a big and important recommendation, and radical stuff for some hospitals. 

As long as medical circumstances allow and safety precautions are followed, Skin-to-Skin Contact should become standard of care everywhere, regardless of mode of birth. 


Reference

Nurs Womens Health. 2017 Feb - Mar;21(1):28-33. doi: 10.1016/j.nwh.2016.12.008. Influence of Immediate Skin-to-Skin Contact During Cesarean Surgery on Rate of Transfer of Newborns to NICU for Observation. Schneider LW, Crenshaw JT, Gilder RE. PMID: 28187837
We conducted an evidence-based practice project to determine if skin-to-skin contact immediately after cesarean birth influenced the rate of transfer of newborns to the NICU for observation. We analyzed data for 5 years (2011 through 2015) and compared the rates for the period before implementation of skin-to-skin contact with rates for the period after. The proportion of newborns transferred to the NICU for observation was significantly different and lower after implementing skin-to-skin contact immediately after cesarean birth (Pearson's χ2 = 32.004, df = 1, p < .001). These results add to the growing body of literature supporting immediate, uninterrupted skin-to-skin contact for all mother-newborn pairs, regardless of birth mode.