Immediate, uninterrupted skin-to-skin contact and breastfeeding after birth: A cross-sectional electronic survey

Objective: To determine the incidence of immediate, uninterrupted skin-to-skin contact and breastfeeding after birth; and which factors are associated with it. Design: Cross-sectional e-survey was developed and piloted prior to distribution. Sampling was purposive and included snowball sampling. Associations between maternity care practices and the primary outcome measure were examined using logistic regression. Setting: Australia. Participants: Women who birthed a term baby within the previous three years, in any Australian setting (hospital, birth centre or at home), were eligible to participate. Measurements and findings: 1200 postpartum women met the eligibility criteria and completed the e-survey. The primary outcome, 'pronurturance', included: (1) immediate mother/baby holding; (2) skin-to-skin contact; (3) uninterrupted holding for at least 60 min; 4) breastfeeding in the birth setting. Of 1200 participants, 22% (n = 258) experienced pronurturance. Pronurturance was less likely following caesarean section (adjusted Odds Ratio (aOR) 0.07, 95% Confidence Interval (CI) 0.03-0.17). Pronurturance was more likely with a known midwife during labour and birth (aOR 1.89, 95% CI 1.35-2.65). Contributing to the low rate of pronurturance were lack of antenatal skin-to-skin information; babies being wrapped; women wearing clothing; and non-urgent caregiver interruptions including weighing the baby or facilitating the mother to shower. Key conclusion: Health services must strategically address the institutional processes which delay and/or interrupt skin-to-skin contact and breastfeeding in birth suite and operating theatre settings. Implications for practice: Midwives and midwifery students providing continuity of carer are best placed to provide pronurturance to mothers and babies. Caregivers should educate women about pronurturance antenatally, and actively support immediate, uninterrupted mother/baby skin-to-skin contact and breastfeeding after birth. (C) 2019 Elsevier Ltd. All rights reserved.