Midwifes’ Opinions about Reinforcing Factors in Skin to Skin Contact, Immediately After Delivery: A Descriptive Study

Authors
1 Department of Health Education and Promotion, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
2 Director of Department of Neonatal Health, Ministry of Health & Medical Education, Iran and Maternal, Fetal and Neonatal Research Center (MFNRC) Tehran University of Medical Sciences
3 Department of Biostatistics, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
Abstract
Aim: Benefits of Skin-to-Skin Contact (SSC) between mother and her newborn, specifically when it is conducted immediately after birth, have been recognized for more than 40 years. To determine why SSC is not conducted, the present study considers the opinions of the labor working midwifes about the reinforcing factors in SSC immediately after birth in Tehran's hospitals in 2012-2013. Methods: In this descriptive study, we have employed the reinforcing factors of the phase 3 of PRECEDE-PROCEED model. The samples consisted of 292 midwifes who were responsible for delivery or for newborns immediately after birth in 18 hospitals of Tehran. The sampling was firstly performed using stratified and then simple random manner. They were classified into educational, social security, and private hospitals. Data collection instrument was a self-developed questionnaire consisting of demographic characteristics, social support and midwifes' motivation to conduct the reinforcing factors in the SCC at birth. It was derived from a qualitative study. Internal consistency of the questionnaire was assessed using Cronbach's alpha coefficient. Data analysis was conducted through applying the SPSS version 18. Findings: The results show that 93.8% of midwifes had a good idea about social support of the midwifes with Cronbach's alpha 0.744 and 96.6% of them believed in the Midwifes ' motivation in skin contact effects with Cronbach's 0.773. Conclusions: The midwives believed in the key role of reinforcing factors such as social support and their own motivation in successful and standard SSC. Therefore, further studies are suggested on exploring the opinions of pediatric, obstetrics and anesthesia specialists, midwives, mothers and their husbands concerning the SSC.

Keywords


References
[1]      It’s my birthday, give me hug! Skin-to-Skin Contact for you and your baby. Massachusetts Breastfeeding Coafition. 254 Conant Road, Weston, MA 02493, 2005; Available at: http://starsnursingcentre.com/SkinToSkin.pdf
[2]               Moore ER, Anderson GC, Bergman N, Dowswell T. Early skin-to-skin contact for mothers and their healthy newborn infants. Cochrane Database Syst Rev 2012; 16: 5.
[3]      Kennell JH, McGrath SK. Beneficial effects of postnatal skin-to-skin contact. Acta Paediatr 2003, 92(3): 272
[4]      McGrathSK, Kennell JH. Extended mother-infant skin-to-skin contact and prospect of breastfeeding. Acta Paediatr 2002; 91(12): 1288-9.
[5]      Uvnas-Moberg K. Neuroendocrinology of the mother-child interaction. Trends Endocrinol Metab 1996; 7(4): 126-31
[6]      Tessier R, Cristo M, Velez S, Giron M, de Calume ZF, Ruiz-Palaez JG, Charpak Y, Charpak N. Kangaroo mother care and the bonding hypothesis. Pediatrics. 1998; 102(2): e17.
[7]      Anderson GC, Moore E, Hepworth J, Bergman N. Early skin-to-skin contact for mothers and their healthy newborn infants. Cochrane Database Syst Rev 2003; (2): CD003519.
[8]      Moore ER, Anderson GC, Bergman N. Early skin-to-skin contact for mothers and their healthy newborn infants. Cochrane Database Syst Rev 2007: 18; (3):CD003519.
[9]      Larry Gray, Lisa Watt and Elliott M. Blass .Skin-to-Skin Contact Is Analgesic in Healthy Newborns. Pediatrics 2000; 105: e14.
[10]  Michelsson K, Christensson K, Rothganger H, Winberg J. Crying in separated and non-separated newborns: sound spectrographic analysis. Acta Paediatr 1996; 85(4): 471-5
[11]  Ferber SG, Makhoul IR. The effect of skin-to-skin contact (kangaroo care) shortly after birth on the neurobehavioral responses of the term newborn: a randomized, controlled trial. Pediatrics 2004; 113: 858-65.
[12]  Klaus M. Mother and infant: early emotional ties. Pediatrics 1998; 102(5 Suppl E): 1244-6.
[13]  Klaus MH, Jerauld R, Kreger NC, McAlpine W, Steffa M, Kennell JH. Maternal Attachment - Importance of the First Post-Partum Days. N Engl J Med 1972; 286: 460-3.
[14]  Widstrom AM, Lilja G, Aaltomaa-Michalias P, Dahllof A, Lintula M, Nissen E. Newborn behaviour to locate the breast when skin-to-skin: a possible method for enabling early self-regulation. Acta Paediatrica 2011; 100: 79-85.
[15]  Ransjo-ArvidsonAB, Matthiesen AS, Lilja G, Nissen E, Widström AM, Uvnas-Moberg K. Maternal analgesia during labor disturbs newborn behavior: effects on breastfeeding, temperature, and crying. Birth 2001; 28(1): 5-12.
[16]  Karl D. Using principles of newborn state organization to facilitate breastfeeding. MCN 2004; 29: 292-8.
[17]  Widstrom AM, Ransjo-ArvidsonAB, Christensson K, MatthiesenAS, Winberg J, Uvnas-Moberg K. Gastric suction in healthy newborn infants: Effects on circulation and developing feeding behaviour. Acta Paediatr Scand 1987; 76(4): 566-72.
[18]  Baby-Friendly USA. The ten steps to successful breastfeeding final report. Massachusetts. 2003; http://www.pdf-finder.com/The-Ten-Steps-to-Successful-Breastfeeding.html.
[19]  Gartner LM, Morton J, Lawrence RA, Naylor AJ, O'Hare D, Schanler RJ, Eidelman AI. AmericanAcademy of Pediatrics Section on Breastfeeding. Breastfeeding and the use of human milk. Pediatrics. 2005; 115(2): 496-506.
http://pediatrics.aappublications.org/content/115/2/496.full.html
[20]  Mikiel-Kostyra K, Mazur J, Bołtruszko I. Effect of early skin-to-skin contact after delivery on duration of breastfeeding: a prospective cohort study. Acta Paediatr 2002, 91(12): 1301-6.
[21]  Robert TC. Theory at a glance: a guide for health promotion practice. 2nd Edition U.S. Department of Health and Human Services National Institutes of Health, National Cancer Institute 2005; p: 46-54.
[22]  Glanz K, Rimer BK, Viswanath K. 14th Editors Health Behavior and Health Education: Theory, Research, and Practice. John Wiley & Sons, 2008; p: 404-33.
[23]  Green LW, Kreuter MW. Health Program Planning: An educational and ecological approach. 4th Edition, Boston, London, Montreal, New York: MC Graw Hill co, 2005.
[24]  Munhall PL. Nursing Research: A Qualitative Perspective. Sudbury, MA: Jones & Bartlett Publishers, 2006.
[25]  Wood L, Haberd G. Nursing research: methods, clinical appraisal, and utilization. 5th Edition, St. Louis: Mosby co, 2002.
[26]  Ali Abadi H, Ravaipour M, Karimollahi M, Yousefi H. Nursing Qualitative research methodology. Tehran: Boshra 2006. (Persian)
[27]  Hajizadeh E, Asghari M. Statistical Methods and Analyses in Health and Biosciences, A Research Methodological Approach, Using SPSS Practical guide. Tehran: Jahade Daneshgahi 2011; p: 395-448.
[28]  Hyrkas K, AppelqvistSK, Oksa L. Validating an instrument for clinical supervision using an expert panel. Int J Nurs Stud 2003; 40(6): 619-25.
[29]  Lawshe CH. A quantitative approach to content validity. Personnel Psychology. 1975; 28: 563-75.
[30]  Waltz CF, Bausell RB. Nursing research: Decision statistics and computer analysis. Philadelphia: Fa Davis Co, 1983.
[31]  Juniper EF, Guyott GH, Streiner DL. Clinical impact versus factor analysis for quality of life questionnaire construction. Clin Epide J1997; 50(3): 233-8.
[32]  Lacasse Y, Godbout C, Series F. Health-related quality of life in obstructive sleep apnoea. Eur Respi J. 2002; 19(3): 499-503.
[33]  Broder HL, McGrth C, Cisneros GJ. E Questionnaire development: face validity and item impact testing of the child oral Heath impact profile. Community Dent Oral Epidemiol 2007; 35(Supple): 8-19.
[34]  Glanz K, Rimer B,Viswanath K. Health Behavior and Health Education Theory, Research, and Practice. (Using the PRECEDE-PROCEED Model) 2008, 5; 404-433.
[35]  Lawrence W. Green, Marshall W, Kreuter: Health Program Planning: An educational and ecological approach. 4th Edition. MC Graw Hill co: 2005.