Who is holding the baby? Women's experiences of contact with their baby immediately after birth: An Australian population-based survey

doi:10.1016/j.wombi.2015.05.001

Women and Birth

Volume 28, Issue 4, December 2015, Pages 317-322

https://doi.org/10.1016/j.wombi.2015.05.001 Get rights and content

Abstract

Background

Seeing and holding their baby immediately after the birth is the pinnacle of the childbearing process for parents. Few studies have examined women's experiences of seeing and holding their baby immediately after birth. We investigated women's experiences of initial contact with their newborns using data from an Australian population-based survey.

Methods

All women who gave birth in September/October in 2007 in two Australian states were mailed questionnaires six months following the birth. Women were asked three questions about early newborn contact including where their baby was held in the first hour after birth and whether they were able to hold their baby as soon and for as long as they liked. We examined the association between model of maternity care and early newborn contact stratified by admission to SCN/NICU.

Results

The majority (92%) of women whose babies remained with them reported holding their babies as soon and for as long as they liked in the first hour after birth. However, for women whose babies were admitted to SCN/NICU only a minority (47%) reported this. Women in public models of care (with the exception of primary midwifery care) whose babies remained with them were less likely to report holding their babies as soon and for as long as they liked compared to women in private care.

Conclusion

Our findings suggest that there is potential to increase the proportion of mothers and fathers who get to hold their baby immediately after the birth by modifying birth suite and operating room practices.

Section snippets

Background

Seeing and holding their baby immediately after the birth is the pinnacle of the childbearing process for parents. Following the seminal work of Klaus and Kennell in the 1970s and 80s,1, 2 the salience of the immediate post-birth period and the impact of maternal–infant interaction during this sensitive period on subsequent behaviour were universally acknowledged. Hospital practices related to the early newborn period have changed dramatically in the ensuing decades. However, institutional

Sample

Questionnaires were mailed to all women who gave birth in Victoria and South Australia in September/October 2007, excluding those who had a stillbirth, or whose baby was known to have died. All hospitals with births in the study period (n = 110) agreed to mail questionnaires to women at 5–6 months postpartum, however one hospital later withdrew. The invitation package included a covering letter, a copy of the questionnaire, and a reply paid envelope for returning the questionnaire to the research

Results

Questionnaires were mailed to 8597 women. The adjusted response fraction excluding questionnaires ‘returned to sender’, duplicate responses and women who gave birth outside the study period was 52% (4366/8468).

Discussion

This study examined the experiences of women regardless of whether their babies remained with them or were admitted to a Special Care Nursery or Neonatal Intensive Care Unit.

The proportion of women reporting that their baby was held in mother's/father's arms in the first hour after birth was high with almost 81% overall reporting that this occurred. When we examined the reports of women whose babies were not admitted to SCN/NICU we found 90% reported that their babies were held in

Strengths and limitations

This study is the first to report on whether model of maternity care is associated with women getting to see and hold their babies in the immediate period after birth. Data are drawn from a large population based survey of women giving birth in all hospitals in Victoria and South Australia. In our study, a total of 17.1% of women reported that their baby was admitted to a SCN/NICU. In 2007 in Victoria 15.3% of babies were admitted to a neonatal unit and in South Australia 16.3%.²⁵

The response

Conclusions

The majority of women were able to hold their babies as soon and for as long as they liked in the first hour after birth. However, only a minority of women whose babies were admitted to a neonatal unit reported holding their babies as soon and for as long as they liked. We found that the model of maternity care was associated with this outcome with women in public models of care (with the exception of primary midwifery care) less likely to report holding their babies as soon and for as long as

Funding

We acknowledge the funding provided by the National Health and Medical Research Council (ID: 433012), the Victorian Department of Human Services, and the South Australian Department of Health.

Acknowledgments

We are most grateful to the thousands of women who participated in the survey at a particularly busy time of their lives, and to the hospitals in South Australia and Victoria who helped in mailing out questionnaires. We are grateful to the following large team of study investigators who have contributed to the development of the research protocol and conduct of the study: Peter Baghurst, Jane Gunn, Jeffrey Robinson, Georgie Stamp, Euan Wallace; and acknowledge with gratitude the significant

References (25)

J.C. dos Santos Monteiro et al.
Women's feelings about early contact with their infants on the labour ward
Midwifery
(2011)
R. Phillips
The sacred hour: uninterrupted skin-to-skin contact immediately after birth
Newborn Infant Nurs Rev
(2013)
M. Redshaw et al.
Holding the baby: early mother–infant contact after childbirth and outcomes
Midwifery
(2014)
S.J. Brown et al.
Women's views and experiences of postnatal hospital care in the Victorian Survey of Recent Mothers 2000
Midwifery
(2005)
M.H. Klaus et al.
Maternal attachment: Importance of the First Post-Partum Days
N Engl J Med
(1972)
M.H. Klaus et al.
Parent–infant bonding
(1982)
E.R. Moore et al.
Early skin-to-skin contact for mothers and their healthy newborn infants
Cochrane Database Syst Rev
(2012)
P. De Chateau et al.
Long-term effect on mother infant behaviour of extra contact during the first hour postpartum. 1. First observations at 36 hours
Acta Paediatr Scand
(1997)
A.-L. Fransson et al.
Temperature variation in newborn babies: importance of physical contact with the mother
Arch Dis Child Neonatal Ed
(2005)
K. Bystrova et al.
Early contact versus separation: effects on mother-infant interaction one year later
Birth
(2009)

H. Niela-Vilen et al.

Early contact between a mother and her NICU-infant in two university hospitals in Finland

Midwifery

(2013)

K. Mehler et al.

Mothers seeing their VLBW infants within 3 h after birth are more likely to establish a secure attachment behaviour: evidence of a sensitive period with preterm infants?

J Perinatol

(2011)

Cited by (8)

Mothers’ perceptions and experiences of skin-to-skin contact after vaginal birth in Saudi Arabia: A cross-sectional study
2022, Women and Birth
Citation Excerpt :
Recently, researchers and clinicians have shown an increased interest in mothers’ perceptions and experiences of SSC after vaginal birth in many countries including Australia, Norway, Sweden, United Kingdom [4–8] and after caesarean section [9,10]. Evidence has shown that mothers generally desire to have SSC immediately after birth [5,6,9,10]. Skin-to-skin contact provides mothers with immediate contact with their newborn which facilitates emotional and physical connection with their babies and helps them to initiate breastfeeding [11].
The World Health Organization recommends immediate skin-to-skin contact after birth, however, worldwide, separation of mothers and infant is common.
In Saudi Arabia, there is a lack of research exploring mothers’ experiences of skin-to-skin contact after birth.
To estimate the rate of skin-to-skin contact and describe mothers’ perceptions and experiences of immediate skin-to-skin contact after vaginal birth in two largest hospitals in Jeddah, Saudi Arabia.
A cross-sectional study conducted in 2017. A total of 254 mothers completed the survey on the postnatal ward (92 % response rate). The survey consisted of 36 closed and open-ended items. Data were described using summary statistics and free text comments were analysed using content analysis.
The rate of direct skin-to-skin contact was 15%. A further 54% of mothers had the baby placed on their chest/abdomen but with a sheet/gown between them. Mothers reported favourable perceptions towards skin-to-skin contact and reported the practice as acceptable (67%). Most mothers did not express concerns about feeling exposed (85%) or that skin-to-skin contact was inconsistent with norms of modesty or culture (87%). The free text comments indicated that most mothers felt positive about their experience of skin-to-skin contact, while some mothers felt overwhelmed and unprepared.
Skin-to-skin contact was not routinely implemented after birth and the rate was low. Mothers held positive perceptions and wanted to practice skin-to-skin contact. Policy makers and clinicians should acknowledge mothers’ needs and feelings by facilitating skin-to-skin contact to achieve optimal outcomes for mothers and infants.
Immediate, uninterrupted skin-to-skin contact and breastfeeding after birth: A cross-sectional electronic survey
2019, Midwifery
Citation Excerpt :
The present study was designed to address the gaps in the current research specifically regarding the combination of immediate, uninterrupted SSC and BF along with the factors associated with deficits in SSC immediacy and duration. Deficits within the currently available research include studies that: focused on baby holding rather than SSC (Biro et al., 2015; Sheridan, 2010); did not distinguish between which parent ‘held the baby’ (Biro et al., 2015); and those that did not report immediacy or duration beyond 30 min (Saxton et al., 2015), or whose definition was too broad (within 10 min, within 5 min) (Moore et al., 2016; Redshaw et al., 2014). One study did examine the combination of timing, duration and SSC but did not specifically investigate factors related to interruption of SSC and it only measured exposure to breastmilk or colostrum rather than the act of BF (Redshaw et al., 2014).
To determine the incidence of immediate, uninterrupted skin-to-skin contact and breastfeeding after birth; and which factors are associated with it.
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.
Australia.
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.
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.
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.
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.
Providing Evidence-Based Care During the Golden Hour
2017, Nursing for Women's Health
Citation Excerpt :
Critically, women who experience skin-to-skin contact with their newborns have reduced postpartum bleeding and a decreased risk for postpartum hemorrhage, as well as more rapid passing of the placenta compared with women who do not hold their newborns skin to skin (Moore et al., 2016). Increased oxytocin levels also promote maternal attachment to the newborn, which can improve mother–newborn bonding, lower a woman’s plasma cortisol levels, and protect the neonate from the effects of sudden separation from the mother, a phenomenon noted to be similar to drug withdrawal (Biro et al., 2015; Moore et al., 2016; Redshaw et al., 2014). A study of Australian women’s immediate postpartum experiences identified eight variables that are associated with a greater likelihood of holding a newborn skin to skin during the Golden Hour (see Box 1; Biro et al., 2015).
The Golden Hour encompasses a set of evidence-based practices that contribute to the physiologic stabilization of the mother–newborn dyad after birth. Important elements of the Golden Hour include delayed cord clamping, skin-to-skin contact for at least an hour, the performance of newborn assessments on the maternal abdomen, delaying non-urgent tasks (e.g., bathing the newborn) for 60 minutes, and the early initiation of breastfeeding. The Golden Hour contributes to neonatal thermoregulation, decreased stress levels in a woman and her newborn, and improved mother–newborn bonding. Implementation of these actions is further associated with increased rates and duration of breastfeeding. This article explores the evidence supporting the Golden Hour and provides strategies for successfully implementing a Golden Hour protocol on a hospital-based labor and delivery unit.
Becoming a mother in the neonatal intensive care unit: A narrative review
2021, Journal of Occupational Science
Psychometric properties of the Mackey Childbirth Satisfaction Rating Scale cross-culturally adapted to Brazilian Portuguese
2021, Journal of Maternal-Fetal and Neonatal Medicine
Content and Face Validity of the Mackey Childbirth Satisfaction Rating Scale Questionnaire Cross-culturally Adapted to Brazilian Portuguese
2019, Revista Brasileira de Ginecologia e Obstetricia

View all citing articles on Scopus

View full text

ORIGINAL RESEARCH – QUANTITATIVEWho is holding the baby? Women's experiences of contact with their baby immediately after birth: An Australian population-based survey

Abstract

Background

Methods

Results

Conclusion

Section snippets

Background

Sample

Results

Discussion

Strengths and limitations

Conclusions

Funding

Acknowledgments

Midwifery

Newborn Infant Nurs Rev

Midwifery

Midwifery

Maternal attachment: Importance of the First Post-Partum Days

N Engl J Med

Parent–infant bonding

Early skin-to-skin contact for mothers and their healthy newborn infants

Cochrane Database Syst Rev

Long-term effect on mother infant behaviour of extra contact during the first hour postpartum. 1. First observations at 36 hours

Acta Paediatr Scand

Temperature variation in newborn babies: importance of physical contact with the mother

Arch Dis Child Neonatal Ed

Early contact versus separation: effects on mother-infant interaction one year later

Birth

Early contact between a mother and her NICU-infant in two university hospitals in Finland

Midwifery

Mothers seeing their VLBW infants within 3 h after birth are more likely to establish a secure attachment behaviour: evidence of a sensitive period with preterm infants?

J Perinatol

ORIGINAL RESEARCH – QUANTITATIVE
Who is holding the baby? Women's experiences of contact with their baby immediately after birth: An Australian population-based survey