In recent years we’ve seen an emphasis on immediate skin-to-skin contact for mothers and babies.
We’ve learned about the benefits of an undisturbed first hour after birth – with much of the focus being on the benefits, some of which include bonding and helping to establish breastfeeding.
If there are benefits to immediate skin-to-skin contact, are there risks in not having skin-to-skin contact?
Immediate skin-to-skin contact might seem like a recent trend, but until the switch to hospital births in the 20th century, mother-baby pairs experienced little, if any separation.
Immediate interaction between mother and baby seemed to be a natural transition from the womb to the world. When we interfere with a physiological process we run the risk of negative effects.
The Danger Of Interrupting Skin-To-Skin
A recent study found women who did not have immediate skin-to-skin contact and breastfeeding within the first 30 minutes following birth were twice as likely to experience one type of serious birth complication.
Double The Risk Of Postpartum Haemorrhage
Women who did not have immediate skin-to-skin contact and breastfeeding were found to be twice as likely to experience a postpartum haemorrhage (PPH) than women who did have skin-to-skin contact and breastfeeding.
A postpartum hemorrhage is a serious birth complication, where a woman loses 500ml or more of blood, following birth. This can be the result of birth interventions, placental complications, or anaemia, and sometimes the culprit is unknown. However, what this study suggests is that in some cases a lack of naturally released oxytocin could be to blame.
How Can Skin-To-Skin Reduce The Risk Of PPH?
Birth involves several hormones, including the well-known oxytocin. Oxytocin is released when we feel good and when we have skin-to-skin contact – including during breastfeeding. Latching brings about the release of oxytocin, which triggers the let down reflex; this is why early breastfeeding, and not only skin-to-skin, helps reduce the risk of PPH by increasing the flow of oxytocin.
This hormone plays a significant role in birth by:
- Causing uterine contractions, which dilate the cervix
- Providing a ‘feel good' sensation, and even euphoria, to cope with contractions
- Causing uterine contractions that cause the placenta to detach and be expelled
- Causing uterine contractions to help the uterus shrink and clamp down, to reduce the blood flow from where the placenta was attached
- Encouraging bonding
- Triggering the milk let down reflex
What Is Significant About This Study?
There are times when a mother and baby need to be separated, for the health of either one – but this is usually the exception and not the rule. When there was a cultural shift from birthing in the home to birthing in the hospital, there was also an increase in mother-baby separation.
It became common for babies to be whisked away for weight check, or newborn exams, and they even spent the majority of time in the nursery, so mothers could rest and recover. What we thought would be helpful – allowing mothers to rest – turned out to be interference in the natural transition for both mother and baby.
What we are now learning is that interfering with the birth process, including the third stage (expulsion of the placenta) and immediately postpartum, comes with risks. Mothers’ and babies’ bodies are designed to work together during the birth process, providing each other with necessary hormones to make the transition safe.
When mothers and babies aren’t able to practise skin-to-skin we interfere with the natural release of oxytocin that hasn’t yet completed its job. While the birth itself might be finished, oxytocin still needs to flow to ensure the uterus clamps down.
Although the study found women at all risk levels gained from immediate skin-to-skin and breastfeeding, the greatest benefits were for low-risk women. A reason this is significant is it could lead to a reduction in the rate of active management in low-risk births.
Active management is when mothers receive synthetic oxytocin to aid in the birth of the placenta or to help the uterus clamp down. This is done to prevent PPH, and in some places is routine, even among low-risk women. Synthetic oxytocin is a great tool to stop PPH, but if mothers are able to avoid PPH through the simple act of being in contact with their babies, we might see lower rates of active management among low-risk women.
In some situations, mother-baby separation occurs because medical intervention is necessary, such as in the case of premature birth. However, routine exams and weight checks can safely be delayed, and anything that cannot be delayed can often be done on or near the new mother – except in the case of serious medical complications.
While we are seeing a rise in immediate skin-to-skin, perhaps it will become the expected norm, for the safety of mothers, and not only a social trend. The more we learn about birth the more we realise just how intricately designed the birth process is, and how interference is not without risk.