Skin-to-skin contact implementation in cesarean deliveries: a systematic review

Abstract

Background: Skin-to-skin contact (SSC) is a proven, cost-effective intervention that enhances neonatal outcomes, maternal-infant bonding, and breastfeeding success. However, its implementation during caesarean deliveries remains inconsistent due to various barriers. This systematic mapping review aimed to identify barriers and facilitators to SSC implementation during caesarean sections, evaluate its impact on maternal and neonatal outcomes, and synthesize global best practices adaptable to local contexts. Methods: A systematic search was conducted across six major databases, including PubMed, CINAHL, and Scopus, focusing on studies published within the last five years. Fourteen qualitative studies from eight countries met inclusion criteria. Thematic content analysis was used to identify major patterns and findings. Results: Key barriers included logistical constraints in the operating theatre, healthcare provider attitudes, institutional policies, and sociocultural factors. Facilitators involved supportive hospital policies, staff training, and awareness of SSC benefits. SSC was associated with improved breastfeeding initiation, maternal satisfaction, emotional well-being, and neonatal health outcomes. Conclusion: Effective SSC implementation during caesarean deliveries requires addressing logistical, institutional, and cultural challenges. Aligning local practices with global recommendations and investing in staff education are essential steps toward optimizing maternal and newborn outcome