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Barriers to Skin-to-Skin Care During the Postpartum Stay

Ferrarello, Debi MSN, MS, RN, IBCLC, RLC; Hatfield, Linda PhD, NNP-BC

MCN, The American Journal of Maternal/Child Nursing: January/February 2014 - Volume 39 - Issue 1 - p 56–61
doi: 10.1097/01.NMC.0000437464.31628.3d

Purpose: To determine both mothers' and nurses' understanding of barriers to skin-to-skin care (SSC) during the postpartum hospital stay.

Study Design: Mixed-method study including surveys and focus groups with both nurses working in a postpartum unit, and mothers who had recently given birth.

Methods: Fourteen nurses and 15 mothers completed surveys. Survey questions related to beliefs about SSC as well as perceived barriers and were drawn from the literature. Additionally, several focus groups with nurses and one focus group with new mothers explored attitudes, beliefs, and practices related to SSC, barriers, and potential interventions.

Results: All nurses indicated that SSC was important for both mothers and infants, and identified perceived barriers to the practice. By a large margin, visitors in the patient room and others wanting to hold the baby were the most frequently cited barriers to SSC. Most nurses believed that mothers were unaware of the benefits of SSC and did not spend enough time SSC, yet most mothers said that they were aware of the importance of SSC and that they had spent enough time SSC. Barriers most often identified by mothers were visitors in the room, other people wanting to hold the baby, and safety concerns related to feeling groggy.

Clinical Implications: Identifying barriers to SSC and intervening to reduce them may have implications for both maternal role development and breastfeeding success, thus positively impacting long-term health of mother and child. Studies such as this should be conducted with other populations in other centers.

A lot of research has been done on immediate skin to skin care after birth, but what do we know about skin to skin care on the postpartum unit?

Debi Ferrarello is Director of Family Education, Pennsylvania Hospital, Philadelphia, PA. She can be reached via e-mail at

Linda Hatfield is Director of Research and Evidence-Based Practice, Pennsylvania Hospital, and Assistant Professor of Evidence-Based Practice at the University of Pennsylvania, Philadelphia, PA.

The authors declare no conflict of interest.

© 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins.