A juxtaposition of birth and surgery : providing skin-to-skin contact in the operating theatre and recovery

Objective: to provide insight into the facilitators and barriers of providing skin-to-skin contact in the operating theatre and recovery. Design: ethnographic study utilising video recordings, field notes, focus groups and interviews. Setting: a metropolitan public hospital in Sydney, Australia. Participants: 21 low-risk mothers having a repeat caesarean section, 26 support people, >125 staff members involved in their care and 43 staff members involved in focus groups/interviews. Data collection and analysis: collecting video footage and field notes for up two hours post caesarean section births, interviews at six weeks post partum and staff focus groups/interviews. Data was entered into NVivo10 and analysed using critical ethnographic techniques. Findings: providing skin-to-skin contact in the operating theatre and recovery presents unique challenges due to the 'juxtaposition' of providing social and emotional care in an intrinsically medicalised setting. Staff members suggest that skin-to-skin contact in this environment can be improved by increasing staff and parent knowledge, writing and implementing a policy, addressing staffing issues, improving staff communication, addressing time constraints, adjusting the placement of equipment in the environment and making small changes to the way equipment is utilised. Conclusions and implications for practice: our findings show that skin-to-skin contact can be successfully implemented in the operating theatre and recovery room with staff members input into adjustments to existing care.