Implementing Skin-to-Skin Contact for Cesarean Birth.

Early skin-to-skin (STS) contact in the OR facilitates the development of mothering behaviors, breastfeeding success, and newborn adaptation to extrauterine life. A team at my institution performed a quality improvement project to implement a standard of care for STS contact in the OR during and after cesarean birth. Thirty-seven of 50 mother-infant dyads experienced STS contact in the OR or in the postanesthesia care unit. Twenty-five mothers and newborns who experienced STS contact did so on the OR bed. The median time newborns spent engaged in STS contact with their mothers was 42 minutes and 30 seconds. Developing and using a standard of care to implement this evidence-based practice facilitated acceptance of this intervention. Obstacles that staff members encountered included maternal or neonatal instability, equipment problems, and nurse staffing issues. Staff members addressed these obstacles through creative problem-solving.