title: Midwives' experiences with mother-infant skin-to-skin contact after a caesarean section: 'fighting an uphill battle'.
abstract: OBJECTIVE
  to explore midwives' experiences and perceptions of skin-to-skin contact between mothers and their healthy full-term infants immediately and during the first day after caesarean section.
  
  
  METHODS
  qualitative interviews with semi-structured questions.
  
  
  METHODS
  eight midwives at three different hospitals in Stockholm participated in the study. All participants provided care for mothers and their newborn infants after caesarean birth.
  
  
  METHODS
  transcribed material was analysed and interpreted using qualitative content analysis. The analysis yielded the theme 'fighting an uphill battle'.
  
  
  RESULTS
  skin-to-skin contact was considered to be important, and something that midwives strove to implement as a natural element of postnatal care. However, in daily practice, midwives experienced many obstacles to such care, such as lack of knowledge among parents and other professionals about the benefits of skin-to-skin contact, the mother's condition after the caesarean section, and other organisational difficulties (e.g. collaboration with other professionals, lack of time). Introducing more skin-to-skin care was a challenge for the midwives, who sometimes felt both dismissed and disappointed when they tried to communicate the benefits of this type of care.
  
  
  CONCLUSIONS
  skin-to-skin contact is not prioritised because many health care practitioners are unaware of its positive effects, and their care reflects this lack of knowledge. There is a need for education among all health care practitioners involved in caesarean procedures. Another difficulty is that many parents are unaware of the benefits of skin-to-skin contact. Maternity outpatient clinics need to inform parents about the benefits of such care, so mothers will understand the importance of skin-to-skin contact.
authors.affiliation: Department of Women׳s and Children׳s Health, Division of Reproductive and Perinatal Health, Karolinska Institutet, Stockholm, Sweden; Department of Obstetrics, Karolinska University Hospital, Solna, Stockholm, Sweden. Electronic address: sofia.zwedberg@zp.se.
authors.forename: Sofia
authors.initials: S
authors.lastname: Zwedberg
authors.affiliation: Division of Obstetrics and Gynaecology, Danderyd Hospital, Stockholm, Sweden.
authors.forename: Josefin
authors.initials: J
authors.lastname: Blomquist
authors.affiliation: Department of Obstetrics, Karolinska University Hospital, Huddinge, Stockholm, Sweden.
authors.forename: Emelie
authors.initials: E
authors.lastname: Sigerstad
mesh_terms: D002585:Cesarean Section / Q000523:psychology*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008425:Maternal Behavior / Q000523:psychology*; D009034:Mother-Child Relations; D009721:Nurse Midwives; D011181:Postnatal Care / Q000379:methods
keywords: Caesarean section; Content analysis; Midwives׳ experiences; Obstacles; Post partum care; Skin-to-skin