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Skin to Skin Following Cesarean Delivery: Is it good for mothers too?
Abstract Number: SA-22
Abstract Type: Original Research
Intro: Early skin-to-skin (STS) contact after delivery has important neonatal benefits. Early STS contact is a “Healthy Birth Practice” and is routine in many institutions after vaginal delivery. Research characterizing maternal benefits of STS contact is limited. Cesarean section (C/D) remains a barrier to STS contact. The purpose of this study was to compare the impact of STS contact in the operating room (OR) on pain scores maternal satisfaction, and opiate use in the first 24 hours postdelivery with routine care.
Methods: After IRB approval and informed consent, we enrolled 55 English speaking, ASA 1 or 2 elective C/D pts under spinal anesthesia with neuraxial morphine. Enrolled patients had their neonate placed STS when both were deemed stable. The baby remained STS through the C/D unless removed by request or necessity. This STS intervention group was compared to 55 women, matched by surgical group, who received routine care, with partner holding the neonate nearby. All participants rated their pain and satisfaction at 24 hours using a sliding visual analog scale, recorded as 0-100. Charts were reviewed to determine medication administration over 24 hours. Welch’s independent samples t-tests or Pearson’s chi squared test were used to detect differences in pain scores, morphine equivalent consumption, maternal satisfaction, and need for intraoperative analgesic supplementation.
Results: Average time to initiation of STS following delivery was 10.45 mins (range 3-15). There was no significant difference between groups in need for intraop supplementation of spinal anesthesia (χ2=0.72, p=0.40) or 24 hr morphine equivalents (t=0.66, p=0.51). Reported pain scores (resting, evoked, average and worst pain over 24 hours) were not statistically different between groups (Table). Both groups were similarly satisfied with pain control and anesthesia care. The STS pts did report significantly higher satisfaction with the OR atmosphere compared to controls, specifically greater “sense of control” and “ability to bond with the baby"(Table).
Conclusion: This study demonstrates improved maternal satisfaction with the operative experience with earlier STS contact compared to routine care. Given improved satisfaction and known neonatal benefits, early STS contact after C/D should be considered for routine application in the OR. In our experience, staff availability and willingness to facilitate are possible barriers to routine implementation.