Skin-To-Skin Contact Implementation in Cesarean Deliveries: A Systematic Review
DOI:
https://doi.org/10.31436/ijcs.v8i2.457Keywords:
Skin-to-skin contact, Caesarean delivery, Breastfeeding initiation, Maternal-infant bonding, Healthcare provider perspective, Best practicesAbstract
ABSTRACT
Background: Skin-to-skin contact (SSC) is a proven, cost-effective intervention that enhances neonatal outcomes, maternal-infant bonding, and breastfeeding success. However, its implementation during caesarean deliveries remains inconsistent due to various barriers. This systematic mapping review aimed to identify barriers and facilitators to SSC implementation during caesarean sections, evaluate its impact on maternal and neonatal outcomes, and synthesize global best practices adaptable to local contexts.
Methods: A systematic search was conducted across six major databases, including PubMed, CINAHL, and Scopus, focusing on studies published within the last five years. Fourteen qualitative studies from eight countries met inclusion criteria. Thematic content analysis was used to identify major patterns and findings.
Results: Key barriers included logistical constraints in the operating theatre, healthcare provider attitudes, institutional policies, and sociocultural factors. Facilitators involved supportive hospital policies, staff training, and awareness of SSC benefits. SSC was associated with improved breastfeeding initiation, maternal satisfaction, emotional well-being, and neonatal health outcomes. Conclusion: Effective SSC implementation during caesarean deliveries requires addressing logistical, institutional, and cultural challenges. Aligning local practices with global recommendations and investing in staff education are essential steps toward optimizing maternal and newborn outcomes.
References
Junk-Wilson JS, King EK, Murphy LM, Raza H. Skin-to-skin contact during cesarean birth in the United States over the last decade. journals.lww.comJS Junk-Wilson, EK King, LM Murphy, H RazaMCN: The American Journal of Maternal/Child Nursing, 2024•journals.lww.com [Internet]. 2024 Jan 1 [cited 2025 Jul 22];49(1):8–14. Available from: https://journals.lww.com/mcnjournal/fulltext/2024/01000/skin_to_skin_contact_during_cesarean_birth_in_the.3.aspx
Balatero JS, Spilker AF, Mcniesh SG. Barriers to Skin-to-Skin Contact after Cesarean Birth. MCN The American Journal of Maternal/Child Nursing [Internet]. 2019 May 1 [cited 2025 Jul 23];44(3):137–43. Available from: https://journals.lww.com/mcnjournal/fulltext/2019/05000/barriers_to_skin_to_skin_contact_after_cesarean.2.aspx
Festin MR, Laopaiboon M, Pattanittum P, Ewens MR, Henderson-Smart DJ, Crowther CA, et al. Caesarean section in four South East Asian countries: reasons for, rates, associated care practices and health outcomes. Springer [Internet]. 2009 May 9 [cited 2025 Jul 23];9. Available from: https://link.springer.com/article/10.1186/1471-2393-9-17
Umar B, Biology MHA in H, 2022 undefined. Growing concern over rising caesarean section rates: is it a problem for low-and middle-income countries only? journals.lww.com [Internet]. [cited 2025 Jul 23]; Available from: https://journals.lww.com/adhb/fulltext/2022/12020/Growing_Concern_Over_Rising_Caesarean_Section.2.aspx
Aboagye RG, Boah M, Okyere J, Ahinkorah BO, Seidu AA, Ameyaw EK, et al. Mother and newborn skin-to-skin contact in sub-Saharan Africa: prevalence and predictors. gh.bmj.com [Internet]. 2022 Mar 16 [cited 2025 Jul 23];7(3):7731. Available from: https://gh.bmj.com/content/7/3/e007731
Machold CA, O’Rinn SE, McKellin WH, Ballantyne G, Barrett JFR. Women’s experiences of skin-to-skin cesarean birth compared to standard cesarean birth: a qualitative study. cmajopen.caCA Machold, SE O’Rinn, WH McKellin, G Ballantyne, JFR BarrettCanadian Medical Association Open Access Journal, 2021•cmajopen.ca [Internet]. 2021 Jul 1 [cited 2025 Jul 23];9(3):E834–40. Available from: https://www.cmajopen.ca/content/9/3/E834.short
Schorn MN, Moore E, Spetalnick BM, Morad A. Implementing family?centered cesarean birth. Wiley Online LibraryMN Schorn, E Moore, BM Spetalnick, A MoradJournal of midwifery & women’s health, 2015•Wiley Online Library [Internet]. 2015 Nov 1 [cited 2025 Jul 22];60(6):682–90. Available from: https://onlinelibrary.wiley.com/doi/abs/10.1111/jmwh.12400
Smith J, Plaat F, Fisk NM. The natural caesarean: a woman?centred technique. Wiley Online Library [Internet]. 2008 [cited 2025 Jul 23];115(8):1037–42. Available from: https://obgyn.onlinelibrary.wiley.com/doi/abs/10.1111/j.1471-0528.2008.01777.x
Zavala-Soto JO, Hernandez-Rivero L, Tapia-Fonllem C. Pro-lactation cesarean section: Immediate skin-to-skin contact and its influence on prolonged breastfeeding. Frontiers in Sociology. 2022 Sep 27;7:908811.
Moran-Peters J, Zauderer C, … SGN for women’s, 2014 undefined. A quality improvement project focused on women’s perceptions of skin-to-skin contact after cesarean birth. ElsevierJA Moran-Peters, CR Zauderer, S Goldman, J Baierlein, AE SmithNursing for women’s health, 2014•Elsevier [Internet]. [cited 2025 Jul 22]; Available from: https://www.sciencedirect.com/science/article/pii/S1751485115300908
Beiranvand S, Valizadeh F, Hosseinabadi R, Pournia Y. The effects of skin?to?skin contact on temperature and breastfeeding successfulness in full?term newborns after cesarean delivery. Wiley Online LibraryS Beiranvand, F Valizadeh, R Hosseinabadi, Y PourniaInternational journal of pediatrics, 2014•Wiley Online Library [Internet]. 2014 [cited 2025 Jul 22];2014:1–7. Available from: https://onlinelibrary.wiley.com/doi/abs/10.1155/2014/846486
Taha Z, Wikkeling-Scott L. Review of kangaroo mother care in the Middle East. mdpi.comZ Taha, L Wikkeling-ScottNutrients, 2022•mdpi.com [Internet]. 2022 Jun 1 [cited 2025 Jul 23];14(11). Available from: https://www.mdpi.com/2072-6643/14/11/2266
Stevens J, Schmied V, Burns E, Dahlen H. Immediate or early skin?to?skin contact after a C aesarean section: a review of the literature. Wiley Online LibraryJ Stevens, V Schmied, E Burns, H DahlenMaternal & child nutrition, 2014•Wiley Online Library [Internet]. 2014 Oct 1 [cited 2025 Jul 23];10(4):456–73. Available from: https://onlinelibrary.wiley.com/doi/abs/10.1111/mcn.12128
Widström AM, Brimdyr K, Svensson K, Cadwell K, Nissen E. Skin?to?skin contact the first hour after birth, underlying implications and clinical practice. Wiley Online LibraryAM Widström, K Brimdyr, K Svensson, K Cadwell, E NissenActa Paediatrica, 2019•Wiley Online Library [Internet]. 2019 Jul 1 [cited 2025 Jul 23];108(7):1192–204. Available from: https://onlinelibrary.wiley.com/doi/abs/10.1111/apa.14754
Pérez-Jiménez JM, Luque-Oliveros M, Gonzalez-Perez D, Rivera-Sequeiros A, Rodriguez-Blanco C. Does immediate skin?to?skin contact at caesarean sections promote uterine contraction and recovery of the maternal blood haemoglobin levels? A randomized. Wiley Online Library [Internet]. 2023 Feb 1 [cited 2025 Jul 23];10(2):649–57. Available from: https://onlinelibrary.wiley.com/doi/abs/10.1002/nop2.1331
Feng X, Zhang Y. Effects of mother–infant skin-to-skin contact on mother–infant relationship and maternal psychology feelings: A qualitative study. Nurs Open [Internet]. 2024 Jun 1 [cited 2025 Jul 23];11(6):e2181. Available from: /doi/pdf/10.1002/nop2.2181
Montealegre-Ramón M del P, Martínez-Fuentes MT, Pérez-López J, Sierra-García P. Maternal sensitivity, early interactions and infant attachment: a systematic review. Early Child Dev Care [Internet]. 2024 Sep 9 [cited 2025 Jul 23];194(11–12):1093–108. Available from: https://www.tandfonline.com/doi/abs/10.1080/03004430.2024.2386324
Bigelow AE, Power M. Mother–Infant Skin-to-Skin Contact: Short? and Long-Term Effects for Mothers and Their Children Born Full-Term. Front Psychol [Internet]. 2020 Aug 28 [cited 2025 Jul 23];11:515068. Available from: www.frontiersin.org
McGlothen-Bell K, Recto P, … JMA in N, 2021 undefined. Recovering together: Mothers’ experiences providing skin-to-skin care for their infants with NAS. journals.lww.com [Internet]. [cited 2025 Jul 23]; Available from: https://journals.lww.com/advancesinneonatalcare/fulltext/2021/02000/Recovering_Together__Mothers__Experiences.5.aspx
Feng X, Zhang Y. Effects of mother–infant skin?to?skin contact on mother–infant relationship and maternal psychology feelings: A qualitative study. Wiley Online Library [Internet]. 2024 Jun 1 [cited 2025 Jul 23];11(6). Available from: https://onlinelibrary.wiley.com/doi/abs/10.1002/nop2.2181
Shattnawi KK, Al-Shdayfat NM, Joseph RA. Maternal Experiences of Providing Skin-to-Skin Contact to Preterm Infants in a Neonatal Intensive Care Unit in Jordan. researchgate.net [Internet]. 2022 Mar 1 [cited 2025 Jul 23];1(1):64–74. Available from: https://www.researchgate.net/profile/Khulood-Shattnawi/publication/367071358_Maternal_Experiences_of_Providing_Skin-to-Skin_Contact_to_Pre-term_Infants_in_a_Neonatal_Intensive_Care_Unit_in_Jordan/links/63f8e360b1704f343f7c96d3/Maternal-Experiences-of-Providing-Skin-to-Skin-Contact-to-Pre-term-Infants-in-a-Neonatal-Intensive-Care-Unit-in-Jordan.pdf
Dissertations OD, Vittner DJ. Enhancing developing relationships with skin-to-skin contact. 2016 [cited 2025 Jul 23]; Available from: https://digitalcommons.lib.uconn.edu/dissertations/1280/
Ionio C, Ciuffo G, Landoni M. Parent–infant skin-to-skin contact and stress regulation: A systematic review of the literature. mdpi.com [Internet]. 2021 May 1 [cited 2025 Jul 23];18(9). Available from: https://www.mdpi.com/1660-4601/18/9/4695
Vallie S. Literature Analysis Comparing Mother-Newborn Skin-to-Skin Contact Following Cesarean Section and Vaginal Births. 2019 [cited 2025 Jul 23]; Available from: https://our.oakland.edu/bitstream/10323/6726/1/Thesis%20Draft%20Two.pdf
Balatero J, … ASMTA, 2019 undefined. Barriers to skin-to-skin contact after cesarean birth. journals.lww.com [Internet]. [cited 2025 Jul 23]; Available from: https://journals.lww.com/mcnjournal/abstract/2019/05000/barriers_to_skin_to_skin_contact_after_cesarean.2.aspx
Deys L, Wilson PV, Meedya DS. What are women’s experiences of immediate skin-to-skin contact at caesarean section birth? An integrative literature review. Elsevier [Internet]. 2021 Oct 1 [cited 2025 Jul 23];101. Available from: https://www.sciencedirect.com/science/article/pii/S026661382100142X
Stevens J, Schmied V, Burns E, Dahlen HG. Skin-to-skin contact and what women want in the first hours after a caesarean section. Elsevier [Internet]. 2019 Jul 1 [cited 2025 Jul 23];74:140–6. Available from: https://www.sciencedirect.com/science/article/pii/S0266613819300786
Xu J, Zhang M, Li Y, Gu S. Implementation of early essential neonatal care for newborns delivered by cesarean section in Jiaxing: a single-center prospective randomized controlled trial. SpringerJ Xu, M Zhang, Y Li, S GuInternational Breastfeeding Journal, 2024•Springer [Internet]. 2024 Dec 1 [cited 2025 Jul 23];19(1):31. Available from: https://link.springer.com/article/10.1186/s13006-024-00635-y
Siqueira Prado D, Barbosa R, Ii M, Queiroz R, Iii G, Daniel De Carvalho I, et al. The influence of mode of delivery on neonatal and maternal short and long-term outcomes. SciELO Public HealthDS Prado, RB Mendes, RQ Gurgel, IDC Barreto, R Cipolotti, RQ GurgelRevista de saude publica, 2018•SciELO Public Health [Internet]. 2018 [cited 2025 Jul 23];52. Available from: https://www.scielosp.org/article/ssm/content/raw/?resource_ssm_path=/media/assets/rsp/v52/0034-8910-rsp-52-87872018052000742.pdf
Zarshenas M, Zhao Y, Binns CW, Scott JA. Determinants of in?hospital feeding practices in Shiraz, Iran: Results of a prospective cohort study. Wiley Online LibraryM Zarshenas, Y Zhao, CW Binns, JA ScottBirth, 2019•Wiley Online Library [Internet]. 2019 Mar 1 [cited 2025 Jul 23];46(1):137–45. Available from: https://onlinelibrary.wiley.com/doi/abs/10.1111/birt.12385
Crenshaw JT, Adams ED, Gilder RE, Debuty K, Scheffer KL. Effects of skin-to-skin care during cesareans: A quasiexperimental feasibility/pilot study. liebertpub.comJT Crenshaw, ED Adams, RE Gilder, K DeButy, KL SchefferBreastfeeding Medicine, 2019•liebertpub.com [Internet]. 2019 Dec 1 [cited 2025 Jul 23];14(10):731–43. Available from: https://www.liebertpub.com/doi/abs/10.1089/bfm.2019.0202
Johar N, Mohamad N, … NSK journal of, 2020 undefined. Factors associated with early breastfeeding initiation among women who underwent cesarean delivery at tertiary hospitals in Kelantan, Malaysia. pmc.ncbi.nlm.nih.govN Johar, N Mohamad, N Saddki, TAT Ismail, Z SulaimanKorean journal of family medicine, 2020•pmc.ncbi.nlm.nih.gov [Internet]. [cited 2025 Jul 23]; Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC8010441/
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 INTERNATIONAL JOURNAL OF CARE SCHOLARS

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.