Who owns the baby? A video ethnography of skin-to-skin contact after a caesarean section

Problem: Providing skin-to-skin contact in the operating theatre and recovery is challenging. Background: Barriers are reported in the provision of uninterrupted skin-to-skin contact following a caesarean section. Aim: To explore how health professionals' practice impacts the facilitation of skin-to-skin contact within the first 2 h following a caesarean section. Methods: Video ethnographic research was conducted utilising video recordings, observations, field notes, focus groups and interviews. Findings: The maternal body was divided in the operating theatre and mothers were perceived as 'separate' from their baby in the operating theatre and recovery. Obstetricians' were viewed to 'own' the lower half of women; anaesthetists were viewed to 'own' the top half and midwives were viewed to 'own' the baby after birth. Midwives' responsibility for the baby either negatively or positively affected the mother's ability to 'own' her baby, because midwives controlled what maternal-infant contact occurred. Mothers desired closeness with their baby, including skin-to-skin contact, however they realised that 'owning' their baby in the surgical environment could be challenging. Discussion: Health professionals' actions are influenced by their environment and institutional regulations. Further education can improve the provision of skin-to-skin contact after caesarean sections. Skin-to-skin contact can help women remain with their baby and obtain a sense of control after their caesarean section. Conclusion: Providing skin-to-skin contact in the first 2 h after caesarean sections has challenges. Despite this, health professionals can meet the mother's desire to 'own' her baby by realising they are one entity, encouraging skin-to-skin contact and avoiding maternal and infant separation. (c) 2018 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.