Effects of skin-to-skin contact and breastfeeding at birth on the incidence of PPH: A physiologically based theory |
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Authors: | Anne Saxton Kathleen Fahy Carolyn Hastie |
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Affiliation: | 1. Etlik Zubeyde Hanim Women''s Health Training and Research Hospital, Department of Obstetrics and Gynecology, Ankara, Turkey;2. Recep Tayyip Erdogan University School of Medicine, Department of Obstetrics and Gynecology, Rize, Turkey;3. Gulhane Military Medical Academy, Department of Epidemiology, Ankara, Turkey;4. St. Luke''s Roosevelt Hospitals, Department of Obstetrics and Gynecology, New York, NY, United States;1. Department of Obstetrics and Gynaecology, OLVG, Oosterpark 9, 1091 AC Amsterdam, The Netherlands;2. Department of Obstetrics and Gynaecology, University of Amsterdam, Amsterdam UMC, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands;3. Department of Psychiatry, University of Amsterdam, Amsterdam UMC, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands;4. Arq Psychotrauma Expert Group, Nienoord 5, 1112 XE Diemen, The Netherlands;1. Vanderbilt University School of Nursing, 517 Godchaux Hall, 461 21st Ave South, Nashville, TN 37240, USA;2. Vanderbilt University School of Nursing, 345 Frist Hall, Nashville, TN 37240, USA;3. Middle Tennessee School of Anesthesia, 315 Hospital Drive, Madison, TN 37116, USA;1. Elizabeth Garrett Anderson Wing, University College Hospital, 25 Grafton Way, London, WC1E 6DB, UK;2. Women & Children''s Department, Gloucestershire Royal Hospital, Great Western Road, Gloucester, GL1 3NN, UK |
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Abstract: | BackgroundThe importance of optimising maternal/baby psychophysiology has been integrated into contemporary midwifery theories but not in the detail required to really understand the underpinning biological basis.MethodThe functioning of the autonomic nervous system, as it relates to the uterus is reviewed. The physiology of myometrial cell contraction and relaxation is outlined. The main focus is on the factors that affect the availability and uptake of oxytocin and adrenaline/noradrenaline in the myometrial cells. These are the two key neuro-hormones, active in the 3rd and 4th stages of labour, that affect uterine contraction and retraction and therefore determine whether the woman will have an atonic PPH or not.DiscussionThe discussion explains and predicts the physiological functioning of the uterus during the 3rd and 4th stages of labour when skin-to-skin contact and breastfeeding occurs and when it does not.ConclusionThis biologically based theory hypothesises that to achieve and maintain eutony and eulochia, midwives and birthing women should ensure early, prolonged and undisturbed skin-to-skin contact for mother and baby at birth including easy access for spontaneous breastfeeding. |
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Keywords: | Labour, third stage PPH Physiology Oxytocin Uterus |
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