Evaluation of the Effect of Immediate and Early Skin-to-Skin Contact After Cesarean on Maternal and Neonatal Parameters in the First 24 Hours: A Quasi-Experimental Study Design

Purpose and type of study This research is a quasi-experimental study conducted to examine the effects of immediate and early skin-to-skin contact between mother and newborn after cesarean section on the mother's breastfeeding, anxiety, bleeding, and newborn health in the first 24 hours.

Universe and sample The study was conducted in the postpartum clinics and cesarean section operating room of a private hospital in Ankara. The study was carried out between September 2018 and November 2019 after obtaining the necessary written permissions. To determine the sample number for the study, a pilot study was performed with a total of 15 mother-infant pairs, with 5 pairs in each group. As a result of the pilot study, using the G*Power 3.0.10 program with 80% power, 5% error and the determined 0.15 effect size, at least 87 mother-infant pairs were found to be sufficient for the total study sample size (n1:29; n2:29; n3:29). The sample for the study included a total number of 92 mother-infant pairs with 30 in the ISSC group, 29 in the ESSC group and 33 in the control group. Considering possible losses, the sample included 5% more mother-infant pairs than the lower limit of the sample number.

Women who presented for cesarean section and met the sampling criteria were identified. After being informed of the study's purpose and importance, they agreed to participate. Assignment of women to groups was done using sealed envelopes. For this purpose, one envelope contained a slip of paper labeled "immediate skin-to-skin contact group," another "early skin-to-skin contact group," and a third "control group." Participants were asked to draw a slip of paper from a single envelope to determine their study group. Based on the results, participants were assigned to the immediate skin-to-skin contact group, the early skin-to-skin contact group, and the control group. The study sample consisted of 92 mother-baby pairs in total: 30 in the early skin-to-skin contact group, 29 in the late skin-to-skin contact group, and 33 in the control group. A total of 247 cases were interviewed during the study. A total of 155 cases were lost due to reasons such as the cases not meeting the study criteria (n:98), not volunteering to participate in the study (n:34), the newborn going to the intensive care unit (n:5), the newborn being placed in a post-natal hood (a transparent box in which the entire head of the newborn is placed, most commonly used in neonatal oxygen therapy) (n:10), the mother having nausea, vomiting and pain (n:6), and the mothers forgetting to collect the sanitary pads (n:2).

Inclusion and Exclusion Criteria for the Study

Inclusion criteria for mothers: