Facilitating Skin-to-Skin Contact in the Operating Room After Cesarean Birth

摘要

We implemented an evidence-based practice change to provide early skin-to-skin contact (SSC) in nonemergent, full-term cesarean surgical births among low-risk healthy women. There were three aims of this project: (1) To develop a protocol for health care professionals' roles in providing SSC in the operating room; (2) To implement the protocol; and (3) To evaluate the process of implementation of the evidence-based intervention. The "champion team" concept was crucial to the projects success. In a Cochrane systematic review, Moore, Anderson, Bergman, and Dowswell (2012) reported evidence that skin-to-skin contact (SSC) after birth provides many benefits to women and newborns, such as supporting newborns' physiologic adaptation to the extra uterine environment, providing maternal and newborn analgesia with decreased pain, increasing parental bonding and interaction, providing opportunities for breastfeeding and decreasing maternal depression and anxiety. SSC should be initiated immediately after birth in vaginal births and as soon as the mother is alert and responsive after cesarean surgical birth (World Health Organization [WHO] & UNICEF, 2009). Separation of mothers and newborns after cesarean birth prevents SSC and is associated with delayed breastfeeding, decreased maternal satisfaction and decreased chance for neurobehavioral and physiological benefits for women and newborns (Gouchon et al., 2010; Hung & Berg, 2011; Lutz, 2013; Nolan & Lawrence, 2009; Prior et al., 2012; Zanardo et al., 2011; Zauderer & Goldman, 2012). Many national and international pediatric and women's health organizations, such as the American Academy of Pediatrics (AAP, 2012), the American College of Obstetricians and Gynecologists (ACOG, 2007), the Association of Women's Health, Obstetric and Neonatal Nurses (AWHONN, 2004), the National Association of Neonatal Nurses (NANN, 2004), the Academy of Breastfeeding Medicine (ABM, 2008) and the WHO (2003,2006), endorse SSC as an important intervention postbirth regardless of method of delivery.