Abstract
Introduction
Literature supports numerous benefits of skin-to-skin contact for neonatal adaptation to extrauterine life and bonding/attachment, but few studies explore the effects of skin-to-skin contact on maternal outcomes. This review aims to map the evidence on skin-to-skin contact in the third stage of labor for postpartum hemorrhage prevention.
Methods
Scoping review, which covered stages recommended by the Institute Joanna Briggs, including studies from the PubMed, EMBASE, CINAHL, LILACS, Web of Science, and Scopus databases, using the descriptors “Postpartum hemorrhage”, “Labor stages, third”, “Prevention” and “Kangaroo care/Skin-to-skin”.
Results
100 publications on the subject found, 13 articles met the inclusion criteria, with 10,169 dyads were assessed in all studies. Publications from 2008 to 2021 were mostly written in English and designed as a randomized controlled trial. Skin-to-skin contact was effective and significant in: reducing the duration of the third stage of labor; placenta delivery; uterine contractility and physiological involution; absence of atony, decreasing blood loss with lower rates of erythrocyte and hemoglobin drop; reducing the need for synthetic oxytocin and/or ergometrine to control bleeding; and reducing changing pads per period and length of stay.
Discussion
Skin-to-skin contact was considered an effective, low-cost, and safe strategy, with positive effects already established in the literature for infants and extremely favorable results in postpartum hemorrhage prevention cases, being highly recommended in assistance for the dyad. Open Science Framework Registry (https://osf.io/n3685).
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References
Abdelmenem, E., Ahmed, M., & Belal, G. (2019). Effect of early maternal and newborn skin to skin contact after birth on the duration of third stage of labor and initiation of breastfeeding. Tanta Scientific Nursing Journal, 17(2), 123–147. https://doi.org/10.21608/tsnj.2019.71528
Abujarad, S., Ahmad, M., Aziati, A., & FarajAllah, H. (2018). Management of postpartum haemorrhage reduction by the effective practices in the scope of midwife: A review. Advanced Science Letters, 24, 9320–9323.
Al-Morbaty, H. Y., Ashmauey, A. A., & Al-Ghandi, A. A. (2017). The effect of mother and newborn early skin-to-skin contact on the duration of separation and expulsion of the placenta. Journal of Nursing and Health Studies. https://doi.org/10.21767/2574.2825.100016
Almutairi, W. M. (2021). Literature review: Physiological management for preventing postpartum hemorrhage. Healthcare, 9, 658. https://doi.org/10.3390/healthcare9060658
Almutairi, W. M., Ludington, S. M., Quinn Griffin, M. T., Burant, C. J., Al-Zahrani, A. E., Alshareef, F. H., & Badr, H. A. (2021). The role of skin-to-skin contact and breastfeeding on atonic postpartum hemorrhage. Nursing Reports, 11, 1–1. https://doi.org/10.3390/nursrep11010001
Aromataris, E., & Munn, Z. (Eds.). (2020). JBI manual for evidence synthesis. JBI. https://doi.org/10.46658/JBIMES-20-01
Begley, C. M., Gyte, G. M. L., Delvane, D., McGuire, W., Weeks, A., & Biesty, L. M. (2019). Active versus expectant management for women in the third stage of labour. The Cochrane Database of Systematic Reviews. https://doi.org/10.1002/14651858.CD007412.pub5
Cadwell, K., & Brimdyr, K. (2017). Intrapartum administration of synthetic oxytocin and downstream effects on breastfeeding: elucidating physiologic pathways. Annals of Nursing Research and Practice, 2(3), 1–8.
Charles, D., Anger, H., Dabash, R., Darwish, E., Ramadan, M. C., Mansy, A., & Winikoff, B. (2019). Intramuscular injection, intravenous infusion, and intravenous bolus of oxytocin in the third stage of labor for prevention of postpartum hemorrhage: a three-arm randomized control trial. BMC Pregnancy Childbirth, 19(1), 38. https://doi.org/10.1186/s12884-019-2181-2
Dahlo, R. H. T., Gulla, K., Saga, S., Kristoffersen, L., & Eilertsen, M. E. B. (2018). Sacred hours: Mothers’ experiences of skin-to-skin contact with their infants immediately after preterm birth. International Journal of Pediatrics & Neonatal Care, 4, 1–7. https://doi.org/10.15344/2455-2364/2018/139
Dashtinejad, E., Abedi, P., & Afshari, P. A. (2018). Comparison of the effect of breast pump stimulation and oxytocin administration on the length of the third stage of labor, postpartum hemorrhage, and anemia: A randomized controlled trial. BMC Pregnancy and Childbirth, 18(1), 293. https://doi.org/10.1186/s12884-018-1832-z
Diaz, V., Abalos, E., & Carroli, G. (2018). Methods for blood loss estimation after vaginal birth. The Cochrane Database of Systematic Reviews, 2018(9), CD010980.
Dordevic, G., Jovanovic, B., & Dordevic, M. (2008). An early contact with the baby—Benefit for the mother. Medicinski Pregled, 61(11–12), 576–579. https://doi.org/10.2298/mpns.0812576
Erickson, E. N., Lee, C. S., Grose, E., & Emeis, C. (2019). Physiologic childbirth and active management of the third stage of labor: A latent class model of risk for postpartum hemorrhage. Birth, 46(1), 69–79. https://doi.org/10.1111/birt.12384
Essa, R. M., & Ismail, N. I. A. A. (2015). Effect of early maternal/newborn skin-to-skin contact after birth on the duration of the third stage of labor and initiation of breastfeeding. Journal of Nursing Education and Practice, 5(4), 98–107. https://doi.org/10.5430/jnep.v5n4p98
Federación Latinoamericana de Asociaciones de Sociedades de Obstetricia y Ginecología. (2018). Hemorragia Postparto.Donde estamos y hacia donde vamos? Retrieved from https://www.flasog.org/static/libros/Hemorragia-Postparto-17OCTUBRE.pdf
Karimi, F. Z., Heidarian Miri, H., Salehian, M., Khadivzadeh, T., & Bakhshi, M. (2019). The effect of mother-infant skin to skin contact after birth on third stage of labor: A systematic review and meta-analysis. Iranian Journal of Public Health, 48(4), 612–620.
Khadivzadeh, T., Karimi, F. Z., & Tara, F. (2018). Effects of early mother-neonate skin-to-skin contact on the duration of the third stage of labor: A randomized clinical trial. Iranian Journal of Obstetrics, Gynecology and Infertility., 21(2), 23–29.
Kearney, L., Kynn, M., Reed, R., Davenport, L., Young, J., & Schafer, K. (2018). Identifying the risk: A prospective postpartum haemorrhage in a regional Australian health service. BMC Pregnancy and Childbirth, 18, 214. https://doi.org/10.1186/s12884-018-1852-8
Kuzume, A., Sugimi, S., Suga, S., Yamashita, H., & Yasuhi, I. (2017). The routine use of prophylactic oxytocin in the third stage of labor to reduce maternal blood loss. Journal of Pregnancy. https://doi.org/10.1155/2017/3274901
Marin Gabriel, M. A., Martin, I. L., Escobar, A. L., Villalba, E. F., Blanco, I. R., & Pol, P. T. (2013). Randomized controlled trial of early skin-to-skin contact: Effects on the mother and the newborn. Acta Paediatrica, 99, 1630–1634. https://doi.org/10.1111/j.1651-2227.2009.01597.x
Mejbel, M. K., & Ali, R. M. (2012). Effectiveness of skin-to skin contact on duration of third stage of labor in Baghdad teaching hospital: Comparative study. Kufa Journal of Nursing Sciences, 2(3), 1–13.
Moore, E. R., Bergman, N., Anderson, G. C., & Medley, N. (2016). Early skin-to-skin contact for mothers and their healthy newborn infants. Cochrane Database of Systematic Reviews, 2016(11), Art. No.: CD003519. https://doi.org/10.1002/14651858.CD003519.pub4
Olza-Fernández, I., Marín Gabriel, M. A., Gil-Sanchez, A., Garcia-Segura, L. M., & Arevalo, M. A. (2014). Neuroendocrinology of childbirth and mother-child attachment: The basis of an etiopathogenic model of perinatal neurobiological disorders. Frontiers in Neuroendocrinology, 35(4), 459–472. https://doi.org/10.1016/j.yfrne.2014.03.007
Organização Pan-Americana da Saúde. (2018). Recomendações assistenciais para prevenção, diagnóstico e tratamento da hemorragia obstétrica. Retrieved from https://iris.paho.org/bitstream/handle/10665.2/34879/9788579671241-por.pdf?sequence=1&isAllowed=y
Osanan, G. C., Padilla, H., Reis, M. I., & Tavares, A. B. (2018). Strategy for zero maternal deaths by hemorrhage in Brazil: A multidisciplinary initiative to combat maternal morbimortality. Revista Brasileira de Ginecologia e Obstetrícia, 40(3), 103–105. https://doi.org/10.1055/s-0038-1639587
Page, M. J., McKenzie, J. E., Bossuyt, P. M., Boutron, I., Hoffmann, T. C., Mulrow, C. D., & Moher, D. (2021). The PRISMA 2020 statement: An updated guideline for reporting Systematic Reviews. BMJ, 372, 71. https://doi.org/10.1136/bmj.n71
Parik, P. M., Agrawal, S. P., Vyas, R. C., Shah, S. P., & Joshi, K. P. (2018). Effect of early maternal newborn skin to skin contact in labour room on third stage of labour and sucess at breastfeeding. International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 7(12), 5011–5015. https://doi.org/10.18203/2320-1770.ijrcog.20184957
Paris, A., & Maloof-Bury, E. R. (2013). Implementing a birth kangaroo care policy in labor and delivery: Bringing evidence-based practice to the bedside. Journal of Obstetric, Gynecologic & Neonatal Nursing, 42(Suppl 1), S9–S10. https://doi.org/10.1111/1552-6909.12059
Pazandeh, F., Huss, R., Hirst, J., House, A., & Baghban, A. A. (2015). An evaluation of the quality of care for women with low risk pregnanacy: The use of evidence-based practice during labour and childbirth in four public hospitals in Tehran. Midwifery, 31(11), 1045–1053. https://doi.org/10.1016/j.midw.2015.07.003
Peters, M. D. J., Godfrey, C., McInerney, P., Munn, Z., Tricco, A. C., & Khalil, H. (2020). Scoping reviews (2020 version). In E. Aromataris & Z. Munn (Eds.), JBI manual for evidence synthesis. JBI. https://doi.org/10.46658/JBIMES-20-12
Safari, K., Saeed, A. A., Hasan, S. S., & Moghaddam-Banaem, L. (2018). The effect of mother and newborn early skin-to-skin contact on initiation of breastfeeding, newborn temperature and duration of third stage of labor. International Breastfeeding Journal, 13, 32. https://doi.org/10.1186/s13006-018-0174-9
Salam, R. A., Mansoor, T., Mallick, D., Lassi, Z. S., Das, J. K., & Bhutta, Z. A. (2014). Essential childbirth and postnatal interventions for improved maternal and neonatal health. Reproductive Health, 11(Suppl 1), S3. https://doi.org/10.1186/1742-4755-11-S1-S3
Saxton, A., Fahy, K., & Hastie, C. (2014). Effects of skin-to-skin contact and breastfeeding at birth on the incidence of PPH: A physiologically based theory. Women and Birth: Journal of the Australian College of Midwives, 27(4), 250–253. https://doi.org/10.1016/j.wombi.2014.06.004
Saxton, A., Fahy, K., Rolfe, M., Skinner, V., & Hastie, C. (2015). Does skin-to-skin contact and breast feeding at birth affect the rate of primary postpartum haemorrhage: Results of a cohort study. Midwifery, 31(11), 1110–1117. https://doi.org/10.1016/j.midw.2015.07.008
Saxton, A., Fahy, K., & Hastie, C. (2016). Pronurturance plus at birth: A risk reduction strategy for preventing postpartum haemorrhage. Women and Birth: Journal of the Australian College of Midwives, 29(3), 279–284. https://doi.org/10.1016/j.wombi.2015.11.007
Suzuki, S. (2013). Effect of early skin-to-skin contact on breast-feeding. Journal of Obstetrics and Gynaecology, 33, 695–696. https://doi.org/10.3109/01443615.2013.819843
Turan, Z., & Erenel, A. S. (2019). Effect of skin-to-skin contact on the placental separation time, mother’s oxytocin and pain levels: Randomized controlled trial. Turkish Journal of Biochemistry, 44(5), 706–713. https://doi.org/10.1515/tjb.2018-0145
Uvnäs-Moberg, K. (1998). Oxytocin may mediate the benefits of positive social interaction and emotions. Psychoneuroendocrinology, 23(8), 819–835. https://doi.org/10.1016/s03064530(98)00056-0
Westhoff, G., Cotter, A. M., & Tolosa, J. E. (2013). Prophylactic oxytocin for the third stage of labour to prevent postpartum haemorrhage. The Cochrane Database of Systematic Reviews, (10), CD001808.
World Health Organization. (2006). Baby friendly hospital initiative, revised, updated and expanded for integrate care, Section 1, Background and Implementation. 2006.
World Health Organization. (2013). WHO recommendations for the prevention and treatment of postpartum haemorrhage. Retrieved from https://apps.who.int/iris/bitstream/handle/10665/75411/9789241548502_eng.pdf
World Health Organization. (2018). WHO recommendations in intrapartum care for a positive pregnancy experience. Retrieved from https://www.who.int/publications/i/item/9789241550215
World Health Organization. (2019). Trends in maternal mortality 2000 to 2017: estimates by WHO, UNICEF, UNFPA, World Bank Group and the United Nations Population Division. Retrieved from https://www.unfpa.org/sites/default/files/pubpdf/Maternal_mortality_report.pdf
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Ruiz, M.T., Azevedo, N.F., Raponi, M.B.G. et al. Skin-to-Skin Contact in the Third Stage of Labor and Postpartum Hemorrhage Prevention: A Scoping Review. Matern Child Health J 27, 582–596 (2023). https://doi.org/10.1007/s10995-022-03582-4
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DOI: https://doi.org/10.1007/s10995-022-03582-4