IMPROVING THE IMPLEMENTATION OF EARLY SKIN-TO-SKIN CONTACT IN THE LABOR ROOM: A QUALITY IMPROVEMENT INITIATIVE

Abstract

Background: Early skin-to-skin contact (SSC) immediately after birth promotes thermoregulation, bonding, and early breastfeeding initiation. However, implementation is often suboptimal, especially after cesarean deliveries.
Objectives: To identify barriers to early SSC and improve the proportion of eligible neonates receiving SSC within the first hour of birth.

Methods: This quasi-experimental quality improvement (QI) study was conducted in the labor room of a tertiary care center over 20 months. A baseline audit revealed only 30% of eligible neonates received SSC within one hour, all following vaginal deliveries. Root cause analysis using Fishbone diagrams identified barriers in four domains: people, policies, procedures, and place. Targeted interventions were introduced through four PDSA (Plan-Do-Study-Act) cycles involving staff training, protocol integration, role designation, and parental sensitization.

Results: SSC rates improved from 30% to 66%, including neonates born via cesarean section. No adverse events were reported. Improvements were sustained for over 6 weeks post-intervention.
Conclusion: Structured QI interventions can effectively enhance early SSC practices in both vaginal and cesarean births. This model is scalable and sustainable across similar settings.