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Skin to Skin after Caesarean Section
Obstetrics 

C-section-surg-885

 

After a baby is born, one of the simplest things that can be done to assist in their transition to life outside the womb is to initiate skin to skin contact between the baby and their mother. A recent review in the Cochrane Library (1) showed that there were distinct benefits to initiating early skin to skin contact after birth including

  • Greater interaction between mother and baby
  • Less crying (baby that is)
  • Greater likelihood of initiation of breastfeeding
  • Greater length of breastfeeding

Importantly, there were no negative impacts of initiation of early skin to skin contact.

As mentioned above, initiation of early skin to skin contact is usually easily achieved after a normal vaginal delivery, presuming that both mum and baby are well and don’t require any immediate medical attention that would require them to be separated (e.g. prematurity, concerns about baby’s breathing or heart rate), but what about skin to skin after a caesarean section?

Clearly there are some practical issues that may make the initiation of skin to skin a little more difficult or cause it to be delayed in the context of an elective or emergency caesarean section.  These issues include;

  • Babies who are born by caesarean section are delivered into a sterile operative field. This means that the obstetrician or their assistant will generally be the one who cuts the cord and then pass baby to a midwife or paediatrician for initial assessment.
  • If it is an emergency caesarean section for fetal distress, baby may require medical attention and possibly be taken directly to the nursery
  • After baby has been assessed and is well enough to be brought back to mum, most often the operation is still in progress. There is only so much room under the drapes and it can sometimes be a little awkward to find space for baby on mum’s chest.
  • If the caesarean has been performed under a general anaesthetic (certainly the exception to the rule these days) then obviously mum can’t look after baby until she is awake

Even taking these things into consideration, while it may be delayed by a few minutes, initiation of skin to skin in the operating theatre should be encouraged where possible – even skin to skin with dad or another support person if it is not possible with mum may have advantages.

This important early contact can then be continued in the recovery room where further help with initiating breast feeding can be given if needed.

 

(1). Moore ER, Anderson GC, Bergman N, Dowswell T. Early skin-to-skin contact for mothers and their healthy newborn infants. Cochrane Database of Systematic Reviews 2012, Issue 5. Art. No.: CD003519. DOI: 10.1002/14651858.CD003519.pub3 – See more at: http://summaries.cochrane.org/CD003519/early-skin-to-skin-contact-for-mothers-and-their-healthy-newborn-infants#sthash.Gx0fLwZS.dpuf

 

Download a PDF of this article here

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