Investigation of the Effects of Early Skin-to-Skin Contact on Mother and Baby in Cesarean Births

Summary

The rate of cesarean birth continues to increase in the world and in our country. As with all surgeries, the risks of cesarean birth include the possibility of bleeding and infection, prolonged recovery time after birth, delays in initiating breastfeeding and skin-to-skin contact (SSC), and increased likelihood of complications in future pregnancies.

While many hospitals apply SSC after normal births, it is known that the number of hospitals that apply SSC in the operating room after cesarean birth is very few. Factors that prevent the initiation of SSC after cesarean birth include the effect of the current operating room culture, the physiological evaluation process of the baby after birth, the presence of procedures such as measuring body weight, aspiration, and Apgar score evaluation.

Since the mother and baby are separated after cesarean birth, the mother's initiation of breastfeeding in the first hour of life may be delayed, and the duration of exclusive breastfeeding may be shortened. The 90-minute uninterrupted skin-to-skin contact during which the baby is dried and placed directly on the mother's bare chest after birth maximizes the chance that babies are physically ready to breastfeed.

Although there are studies showing the benefits of SSC application in the operating room such as breastfeeding rates, maintaining the body temperature of the newborn, reducing maternal stress levels, and increasing oxytocin levels, a limited number of studies have been reached in the literature using SSC application guidelines developed to ensure the sustainability of SSC application in the operating room, post-op care unit, and obstetrics clinic. The first contribution of this planned study to the literature will be to standardize SSC application with SSC checklists prepared for use in the cesarean operation room, post-op care unit, and obstetrics ward based on SSC application guidelines. As a second contribution, considering the conditions of the health institution where the study will be conducted, the effects of starting SSC as early as possible and applying it in the cesarean operation room, post-op care unit, and obstetrics ward on the stress level of newborns, sucking success, and pain and salivary cortisol (stress) levels of mothers will be evaluated.

Conditions

• Skin-to-skin Contact

Interventions

OTHER

SSC Group 1 (Operation room)

Salivary cortisol sampling from mothers, pain assessment (VAS), and measurement of physiological findings will be done at the following 3 measurement times. (1)Before transfer to the operating room (OR) (2)1 hour (h) after admission to the post-op room (PR) (3)at least 1 h after admission to the maternity ward (MW) The stress levels of the newborns will be assessed using the "Neonatal Stress Scale" at the following 4 measurement times, the heart rate and O2 saturation will be measured and recorded. 1. At least 5 min after the initiation of SSC in the OR 2. During the Hep-B vaccination in the PR 3. At least 30 min after SSC after admission to the MW 4. At least 24 h after birth in the MW, at least 30 min after SSC. The success of the newborn sucking will be assessed using the LATCH at the following 3 measurement times. (1) At least 5 min after the initiation of SSC in the OR (2)At least 1 h after admission to the MW, during SSC (3)At least 24 h after birth in the MW during SSC.

OTHER

SSC Group 2 (Post-operation room)

SC sampling from mothers, pain assessment (VAS), and measurement of physiological findings will be done at the following 3 measurement times. (1)Before transfer to the OR (2)1 hour (h) after admission to the PR (3)At least 1 h after admission to the MW. The stress levels of newborns will be assessed using the "Neonatal Stress Scale" at the following 4 measurement times, and heart rate and oxygen saturation will be measured and recorded. (1)At least 5 min after birth under radiant heater in the baby care room (BCR) (2)At least 10 min after being taken to the BCR during Hep-B vaccination under radiant heater (3)At least 5 min after being admitted to the maternity ward after SSC (4)5 min after being held in the mother's arms Newborn sucking success will be assessed using LATCH at the following 3 measurement times. (1)At least 5 min after starting SSC in the post-op care unit (2)During SSC after being admitted to the MW (3)At least 24 h after being held in the mother's arms in the MW.

Sponsors & Collaborators

• Kutahya Health Sciences University

  lead OTHER

Study Design

Allocation

RANDOMIZED

Purpose

HEALTH_SERVICES_RESEARCH

Masking

DOUBLE

Model

PARALLEL

Eligibility

Min Age

18 Years

Max Age

45 Years

Sex

FEMALE

Healthy Volunteers

Yes

Timeline & Regulatory

Start

2025-03-19

Primary Completion

2026-01-31

Completion

2026-01-31

Countries

• Turkey (Türkiye)