Skin-to-skin during caesarean section: Assessment of professional practices

Background. - Considering its benefits, immediate skin-to-skin should be applied irrespective of the way of delivery. While it is increasingly applied in case of vaginal delivery, it remains difficult to implement in case of caesarean section. Objective. - To estimate the degree of implementation of skin-to-skin in case of caesarean section. Methods. - Survey in immediate postpartum with a continuous series of patients having given birth by caesarean - whether scheduled or not - in a level 3 hospital systematically realizing skin-to-skin in case of vaginal delivery. The patients were included if the caesarean section had been realized between 16/11/17 and 28/11/17. Results. - Thirty-five women gave birth by caesarean section during the period of study, among which 26 were planned (74%). The emergency levels were varied: 18 had a green code (51%), 12 an orange code (34%) and 5 a red code (14%). Forty-six percent of the newborn children were placed skin-to-skin. The frequency of skin-to-skin was closely linked to the planned character of the caesarean section (89 vs. 31%, P = 0.005), as well as its color code (green 72%, orange 25%, red 0%). In case of impossibility to realize skin-to-skin in the course of the caesarean, the reasons were mainly related to the maternal state (63%) (malaise, bleeding, pain). In this situation, skin-to-skin was proposed to the spouse in 83% of cases and realized in recovery room with the mother in 82% of the cases. Conclusion. - Skin-to-skin is feasible during caesarean section, regardless of the color code of the procedure. (C) 2019 Elsevier Masson SAS. All rights reserved.