THE IMPORTANCE OF THE INITIAL POSTPARTUM/ POSTNATAL HOUR AND SKIN-TO-SKIN CONTACT – A TIME FOR CHANGE IN BULGARIA.

Abstract

INTRODUCTION: This paper explores the practices surrounding skin-to-skin contact of mother and child immediately after birth within Bulgarian maternity wards and describes women`s experiences. It takes into consideration the research of Bulgarian experts in breastfeeding and contemporary recommendations for postnatal care worldwide. Obstetric practices in local maternity wards are reviewed and evidenced by the research findings. The results put into perspective the different experiences that Bulgarian mothers have in local wards, and the authors explore these women`s attitudes towards the routine implementation of skin-to-skin contact in postnatal care. The paper also outlines setbacks for introducing the practice in Bulgarian maternity wards due to the lack of midwife-led care and the importance of specialized care in optimizing health and a better understanding of skin-to-skin care. OBJECTIVES: Purposes of this research are: (1) to explore women’s knowledge about skin-to-skin benefits, including their past experiences with the practice, and (2) to assess their own personal motivation and willingness to engage in the practice themselves. METHODS: The methodology applied includes an online-based anonymous survey that aims to explore parents’ current levels of knowledge and gather their viewpoints regarding the practice. The research has been conducted on social media channels between the 26th of January 2020 and the 26th of February 2020 and includes women from varying local parent support groups: both respondents from a focus group, the area of Ruse, Bulgaria, and respondents from other major Bulgarian cities. The research findings are illustrated herein, and the authors discuss attitudes, as evidenced by the respondents’ opinions, expressed through the survey. RESULTS: A total of 771 cases are included, which come from both groups. The research demonstrates common practices in local hospital wards are inconsistent with WHO recommendations and evidence-based medicine. Skin-to-skin care is practically a non-existent practice within immediate postnatal care, with most mothers separated from their baby during this crucial first hour(s). Almost all the women surveyed are willing to engage in, and embrace, skin-to-skin practices to be introduced as part of the routine within local maternity wards. CONCLUSION: Midwives’ numbers in hospitals are dwindling, and women identify this is a worrying trend for the success of skin-to-skin bonding for new mothers. Evidence-based medical research and parental opinion compel us to rethink current postnatal practices, and therefore it is logical to suggest sustainable and realistic strategies for promoting and implementation of effective guidelines.