Practices of obstetricians regarding early mother‐to‐newborn skin‐to‐skin contact, early initiation of breastfeeding and delayed cord clamping

Abstract

Early mother‐to‐newborn skin‐to‐skin contact (SSC) promotes early initiation of breastfeeding (EIBF), which in turn decreases neonatal mortality. Delayed cord clamping (DCC) improves iron status of infants, but may be erroneously regarded as incompatible with early SSC. Despite international recommendations for these evidence‐based practices, data are lacking on their adoption by obstetricians. We conducted a survey of 142 obstetricians from 60 countries who attended the 2009 FIGO World Congress of Gynecology and Obstetrics. Although early SSC and BF within 1 h of birth were facilitated by 79% and 82%, respectively, of the obstetricians, adherence to DCC practice was lower (12%). World region Early SSC (%) BF within 1 h (%) DCC ≥ 3 min (%) Africa 81 87 5 Americas 87 80 20 Eastern Mediterranean 39 46 0 Europe 90 88 27 Southeast Asia 60 90 5 Western Pacific 91 73 0 Total 79 82 12 Significant regional variation was observed for each of these practices, with p values of .001, .014 and .009 respectively for early SSC, EIBF and DCC. Facilitation of early SSC was > 90% in both Europe and Western Pacific region, but adherence to DCC was more common in Europe. We conclude that DCC has not been well integrated into current obstetric practice. Identification of the obstacles preventing integration and implementation of these three practices is needed, especially in regions with high neonatal morbidity and mortality.Supported by UC Davis