Effect of Immediate Postpartum Skin-to-Skin Contact Between Mothers and Newborns on Episiotomy Pain: A Randomized Controlled Trial
DOI:
https://doi.org/10.31584/jhsmr.2023978Keywords:
episiotomy pain after delivery, skin-to-skin contact, vaginal deliveryAbstract
Objective: To determine the effect of immediate skin-to-skin contact (SSC) between mothers and their newborns on episiotomy pain.
Material and Methods: This randomized controlled trial enrolled 60 participants who underwent vaginal delivery. The participants were divided into two groups: an immediate SSC group and a no SSC group (n=30 for each group). SSC was initiated within 10 minutes after birth with a contact duration of at least 30 minutes. Episiotomy pain severity was evaluated using a visual analog scale (VAS) at one hour after birth in both groups. The pain scores were analyzed using the Mann-Whitney U test and the optimum contact time for reducing episiotomy wound pain was evaluated by a receiver operating characteristic (ROC) curve.
Results: The median VAS of episiotomy pain at one hour after delivery in the SSC group was statistically significantly lower than the no SSC group (1.9 (0.8-3.1) vs. 3.4 (2-5.2) cm, p-value<0.001). The contact time for optimal pain reduction was at least 30 minutes of SSC.
Conclusion: Immediate SSC contact between a mother and her neonate after delivery can effectively reduce episiotomy pain.
References
Gregory KD, Jackson S, Korst L, Fridman M. Cesarean versus vaginal delivery: whose risks? whose benefits? Am J Perinatol 2012;29:7-18.
Graham ID, Carroli G, Davies C, Medves JM. Episiotomy rates around the world: an update. Birth 2005;32:219-23.
Goldberg J, Hyslop T, Tolosa JE, Sultana C. Racial differences in severe perineal lacerations after vaginal delivery. Am J Obstet Gynecol 2003;188:1063-7.
Lam KW, Wong HS, Pun TC. The practice of episiotomy in public hospitals in Hong Kong. Hong Kong Med J 2006;12:94-8.
Banta D, Thacker SB. The risks and benefits of episiotomy: a review. Birth 1982;9:25-30.
Jiang H, Qian X, Carroli G, Garner P. Selective versus routine use of episiotomy for vaginal birth. Cochrane Database Syst Rev 2017;2:Cd000081.
Jahani Shoorab N, Ebrahimzadeh Zagami S, Nahvi A, Mazluom SR, Golmakani N, Talebi M, et al. The effect of virtual reality on pain in primiparity women during episiotomy repair: a randomize clinical trial. Iran J Med Sci 2015;40:219-24.
Stevens J, Schmied V, Burns E, Dahlen H. Immediate or early skin-to-skin contact after a Caesarean section: a review of the literature. Matern Child Nutr 2014;10:456-73.
Lee JH. The effects of music on pain: a meta-analysis. J Music Ther 2016;53:430-77.
Simavli S, Kaygusuz I, Gumus I, Usluogulları B, Yildirim M, Kafali H. Effect of music therapy during vaginal delivery on postpartum pain relief and mental health. J Affect Disord 2014;156:194-9.
Şolt Kırca A, Kanza Gül D. The effect of music and skin contact with the newborn on pain and anxiety during episiotomy repair in primiparous women: a double-blind randomized controlled study. Explore (NY) 2022;18:210-6.
East CE, Dorward ED, Whale RE, Liu J. Local cooling for relieving pain from perineal trauma sustained during childbirth. Cochrane Database Syst Rev 2020;10:Cd006304.
WHO Guidelines Approved by the Guidelines Review Committee. Guideline: Protecting, Promoting and Supporting Breastfeeding in Facilities Providing Maternity and Newborn Services. Geneva: World Health Organization;2017.
Bigelow A. Effect of mother/infant skin-to-skin contact on postpartum depressive symptoms and maternal physiological stress. J Obstet Gynecol Neonatal Nurs. 2012;41:369-82.
Hubbard JM, Gattman KR. Parent-infant skin-to-skin contact following birth: history, benefits, and challenges. Neonatal Netw 2017;36:89-97.
Karimi FZ, Heidarian Miri H, Salehian M, Khadivzadeh T, Bakhshi M. The effect of mother-infant skin to skin contact after birth on third stage of labor: a systematic review and meta-analysis. Iran J Public Health 2019;48:612-20.
Vamour C, De Jonckheere J, Mestdagh B, Storme L, Richart P, Garabedian C, et al. Impact of skin-to-skin contact on maternal comfort in patients with elective caesarean section: A pilot study. J Gynecol Obstet Hum Reprod 2019;48:663-8.
Nersesyan Y, Demirkhanyan L, Cabezas-Bratesco D, Oakes V, Kusuda R, Dawson T, et al. Oxytocin modulates nociception as an agonist of pain-sensing TRPV1. Cell Rep 2017;21:1681-91.
Machin A, Dunbar R. The brain opioid theory of social attachment: a review of the evidence. Behaviour 2011;148:985-1025.
Birnie KA, Chambers CT, Spellman CM. Mechanisms of distraction in acute pain perception and modulation. Pain 2017;158:1012-3.
Sharma A. Efficacy of early skin-to-skin contact on the rate of exclusive breastfeeding in term neonates: a randomized controlled trial. Afr Health Sci 2016;16:790-7.
Zou Y, Li Y, Jiang M, Liu X. Effect of early skin-to-skin contact after vaginal delivery on pain during perineal wound suturing: a randomized controlled trial. J Obstet Gynaecol Res 2022;48:729-38.
Gosnell ES, Thikkurissy S. 7 - Assessment and management of pain in the pediatric patient. In: Nowak AJ, Christensen JR, Mabry TR, Townsend JA, Wells MH, editors. Pediatric Dentistry 6th ed. Philadelphia: Elsevier; 2019;p.97-115.
Soma LR, You Y, Robinson MA, Boston RC. Pharmacokinetics of intravenous, subcutaneous, and topical administration of lidocaine hydrochloride and metabolites 3-hydroxylidocaine, monoethylglycinexylidide, and 4-hydroxylidocaine in horse. J Vet Pharmacol Ther 2018;41:825-37.
Kelly AM. Does the clinically significant difference in visual analog scale pain scores vary with gender, age, or cause of pain? Acad Emerg Med 1998;5:1086-90.
Marín Gabriel MA, Llana Martín I, López Escobar A, Fernández Villalba E, Romero Blanco I, Touza Pol P. Randomized controlled trial of early skin-to-skin contact: effects on the mother and the newborn. Acta Paediatr 2010;99:1630-4.
Abdulghani N, Edvardsson K, Amir LH. Worldwide prevalence of mother-infant skin-to-skin contact after vaginal birth: a systematic review. PLoS One 2018;13:e0205696.
Downloads
Published
How to Cite
Issue
Section
License
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.