The Sacred Hour

Uninterrupted Skin-to-Skin Contact Immediately After Birth

Raylene Phillips MD, IBCLC, FAAP

Disclosures

NAINR. 2013;13(2):67-72. 

In This Article

Abstract and Introduction

Abstract

The manner in which a new baby is welcomed into the world during the first hours after birth may have short- and long-term consequences. There is good evidence that normal, term newborns who are placed skin to skin with their mothers immediately after birth make the transition from fetal to newborn life with greater respiratory, temperature, and glucose stability and significantly less crying indicating decreased stress. Mothers who hold their newborns skin to skin after birth have increased maternal behaviors, show more confidence in caring for their babies and breastfeed for longer durations. Being skin to skin with mother protects the newborn from the well-documented negative effects of separation, supports optimal brain development and facilitates attachment, which promotes the infant's self-regulation over time. Normal babies are born with the instinctive skill and motivation to breastfeed and are able to find the breast and self-attach without assistance when skin-to-skin. When the newborn is placed skin to skin with the mother, nine observable behaviors can be seen that lead to the first breastfeeding, usually within the first hour after birth. Hospital protocols can be modified to support uninterrupted skin-to-skin contact immediately after birth for both vaginal and cesarean births. The first hour of life outside the womb is a special time when a baby meets his or her parents for the first time and a family is formed. This is a once-in-a-lifetime experience and should not be interrupted unless the baby or mother is unstable and requires medical resuscitation. It is a "sacred" time that should be honored, cherished and protected whenever possible.

Introduction

The power of first impressions is well known. None may be more significant than the first experiences of a newborn baby exiting mother's womb. Our first impression of life outside the womb, the welcome reception we receive immediately after birth, may color our perceptions of life as difficult or easy, hostile or safe, painful or comforting, frightening or reassuring, cold and lonely or warm and welcoming. The events surrounding birth have the potential to set the stage for patterns of subconscious thought processes and behaviors that persist for a lifetime.

Second only to the experience of dying, the experience of being born may be the most mysterious. Since most adults have no conscious memory of what it was like to be a newly born infant, let alone what it was like to be a fetus in the womb, most have not bothered to speculate about the birth process from the baby's perspective. Yet, when the unconscious memory is open to recall during hypnosis, vivid and detailed memories of prenatal life, the birth experience and early events as a newborn infant readily emerge for many.

While the mechanism for how a fetus or a newborn can create such fully formed memories with such immature brains remains unknown, the reality of prenatal, birth and newborn memories cannot be denied. There are many accounts of young children (usually up to about age 3–5 years) who remember events that occurred around the time of their birth and feelings they experienced. The perceptions and interpretations are sometimes skewed, but the vividness and accuracy of specific details and events are often astounding.

In his groundbreaking book, "Babies Remember Birth," David Chamberlain, PhD, shares his research, which compared the birth stories of 10 different mothers with the birth memories of their children. During separate sessions under hypnosis, mothers and their children were asked to describe the birth process. Although the children, some now adults, had not been told about their birth history, their accounts of the events surrounding their births contained many specific and unique details in common with their mother's accounts, validating the accuracy of the children's birth memories.[1] Dr. Chamberlain's newest book, "Windows to the Womb" documents the large body of research exploring the many and varied ways that unborn and newly born babies are able to show us their capacities for learning and memory.[2]

Why is this important? If babies and even fetuses are, indeed, capable of forming memories that remain in their subconscious for life, how they are treated at birth and their early experiences outside the womb matter much more than we have been led to believe!

Because the first hour after birth is so momentous, we have named it "The Sacred Hour" at our hospital. Every culture has occasions and ceremonies it holds sacred that are honored, cherished and protected. In most cultures, for example, a wedding ceremony is considered a sacred occasion. This special event honors the symbolic union of two individuals who have chosen to share their lives together. No one would think of interrupting a wedding ceremony to give the bride and groom details about the flight arrangements for their honeymoon. Everyone recognizes that this information can wait until after the ceremony is completed. Birth is another sacred event. It is a time when a new member of the family arrives, is greeted for the first time and welcomed by his or her parents. Yet, in many hospital settings, this once-in-a-lifetime process is routinely interrupted for details that can easily wait until after the new baby has had time to adjust to life outside the womb in the loving arms of the mother, and after the baby and parents have had time to meet each other as a new family.

What might the first moments after birth be like for the newborn infant? If a fetus has been fortunate enough to spend his fully allotted 266 days in the womb since conception, he has had the luxury of having all his emerging developmental needs met. The uterus and the placenta have provided warmth, protection, nutrition and oxygen, as well as close and continual proximity to the mother's heart and voice. Being in the womb is the "natural habitat" for the unborn fetus. After birth, the mother's body and breasts take over the function of the uterus and placenta in providing warmth, protection, nutrition, and support for optimal oxygenation, as well as close and continual proximity to the mother's heart and voice. Being skin to skin with the mother is the newborn infant's "natural habitat" — the one place where all his needs are met.

This is true for all mammals and can readily be seen in the animal world. Everywhere one looks in nature, mother and newborn mammals are as close as they can get to each other skin to skin or fur to fur. Nature is wise and provides instincts that drive behaviors designed to assure survival of the species.

There are many well-documented benefits of skin-to-skin contact between a newborn infant and its mother. Skin-to-skin contact improves physiologic stability for both mother and baby in the vulnerable period immediately after birth, increases maternal attachment behaviors, protects against the negative effects of maternal–infant separation, supports optimal infant brain development, and promotes initiation of the first breastfeeding, resulting in increased breastfeeding initiation and duration rates. Although a complete review of all the benefits of early postpartum skin-to-skin contact between mother and newborn is beyond the scope of this article, we will briefly explore several of them.

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