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Does skin-to-skin contact and breast feeding at birth affect the rate of primary postpartum haemorrhage: Results of a cohort study

Saxton, Anne, Fahy, Kathleen, Rolfe, Margaret L., Skinner, Virginia and Hastie, Carolyn (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.

Document type: Journal Article
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IRMA ID 84377429xPUB72
Title Does skin-to-skin contact and breast feeding at birth affect the rate of primary postpartum haemorrhage: Results of a cohort study
Author Saxton, Anne
Fahy, Kathleen
Rolfe, Margaret L.
Skinner, Virginia
Hastie, Carolyn
Journal Name Midwifery
Publication Date 2015
Volume Number 31
Issue Number 11
ISSN 0266-6138   (check CDU catalogue  open catalogue search in new window)
Scopus ID 2-s2.0-84945466870
Start Page 1110
End Page 1117
Total Pages 8
Place of Publication United Kingdom
Publisher Churchill Livingstone
Field of Research 111006 - Midwifery
HERDC Category C1 - Journal Article (DIISR)
Abstract Objective
to examine the effect of skin-to-skin contact and breast feeding within 30 minutes of birth, on the rate of primary postpartum haemorrhage (PPH) in a sample of women who were at mixed-risk of PPH.

Design
retrospective cohort study.

Setting
two obstetric units plus a freestanding birth centre in New South Wales (NSW) Australia.

Participants
after excluding women (n=3671) who did not have opportunity for skin to skin and breast feeding, I analysed birth records (n=7548) for the calendar years 2009 and 2010. Records were accessed via the electronic data base ObstetriX.

Intervention
skin to skin contact and breast feeding within 30 minutes of birth.

Measures
outcome measure was PPH i.e. blood loss of 500 ml or more estimated at birth. Data was analysed using descriptive statistics and logistic regression (unadjusted and adjusted).

Findings
after adjustment for covariates, women who did not have skin to skin and breast feeding were almost twice as likely to have a PPH compared to women who had both skin to skin contact and breast feeding (aOR 0.55, 95% CI 0.41–0.72, p<0.001). This apparently protective effect of skin to skin and breast feeding on PPH held true in sub-analyses for both women at ‘lower’ (OR 0.22, 95% CI 0.17–0.30, p<0.001) and ‘higher’ risk (OR 0.37 95% CI 0.24–0.57), p<0.001.

Key conclusions and implication for practice
this study suggests that skin to skin contact and breastfeeding immediately after birth may be effective in reducing PPH rates for women at any level of risk of PPH. The greatest effect was for women at lower risk of PPH. The explanation is that pronurturance promotes endogenous oxytocin release. Childbearing women should be educated and supported to have pronurturance during third and fourth stages of labour.
Keywords Skin to skin
Breast feeding
Postpartum haemorrhage
Oxytocin
Cohort study
DOI http://dx.doi.org/10.1016/j.midw.2015.07.008   (check subscription with CDU E-Gateway service for CDU Staff and Students  check subscription with CDU E-Gateway in new window)
 
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