Barriers and Facilitators to Skin-to-Skin Contact After Caesarean Section: A Qualitative Study

Despite its proven benefits, skin-to-skin contact (SSC) after caesarean section faces significant barriers to implementation. Complementing two previous randomised controlled trials conducted by our group, this descriptive qualitative study aimed to identify barriers and facilitators experienced by multidisciplinary healthcare teams, providing frontline insights into factors contributing to the inconsistent implementation of SSC.

Following a phenomenological approach and the COREQ guidelines, 40 semi-structured interviews were conducted with healthcare professionals involved in caesarean care at a Spanish tertiary hospital, including anaesthetists, gynaecologists, neonatologists, midwives, nurses and nursing assistants. The data were thematically categorised at the semantic and pragmatic levels using MAXQDA software.

SSC implementation remains inconsistent in routine care. Despite the existence of an established institutional protocol, systematic adherence is hindered by high clinical workload, infrastructure constraints and inconsistent dissemination of guidelines. Professional barriers included gaps in training and entrenched routines, while attitudinal barriers stemmed from safety concerns following major abdominal surgery. Key facilitators included the absence of clinical complications and the positive emotional impact of SSC on family bonding. These findings provide critical diagnostic insights into implementation barriers, informing future strategies to enhance adherence to established institutional protocols.

Although safe and feasible, post-caesarean SSC remains inconsistently implemented due to addressable barriers. Its routine adoption requires targeted multidisciplinary training, commitment from healthcare teams and infrastructural adaptations in post-anaesthesia care units (PACU).