Effect of Companion Presence during Skin-to-Skin Contact on Maternal Anxiety: A Randomized Clinical Trial

Abstract

Objective: To compare the effect of companion presence versus midwife presence during skin-to-skin contact (SSC) at birth on maternal anxiety and satisfaction, and neonatal physiological parameters.

Methods: A randomized controlled trial was conducted on 92 pregnant women who were randomized to provide SSC to their newly borns for one hour postpartum, in the presence of a companion (study group) or a midwife (control group). Maternal anxiety (using the Visual Analogue Scale) and the neonatal physiological parameters (including temperature, heart rate, and oxygen saturation) were assessed in four stages viz., immediately after birth, and at 30, 60 and 90 minutes after birth. Maternal satisfaction was also evaluated after transferring the mother to the postpartum ward.

Results: We analyzed 86 mother-infant dyads (43 per group). Having a companion significantly reduced maternal anxiety after birth as compared to having a midwife at 30, 60, and 90 minutes after birth (P = 0.04, P = 0.01, and P = 0.04, respectively). There was also a small to medium effect size of the presence of companion compared to midwife in terms of maternal anxiety at 30 minutes (Cohen's d = 0.45; 95% CI = 0.02, 0.87), 60 minutes (Cohen's d = 0.52; 95% CI = 0.08, 0.94) and 90 minutes after birth (Cohen's d = 0.45; 95% CI = 0.02, 0.88). However, there was no significant effect of the same on neonatal physiological parameters. Having a companion versus a midwife led to higher maternal satisfaction rates (P = 0.02); 65.1% of mothers in the study group and 37.2% of mothers in the control group were desirous of the same care in future (P = 0.02).

Conclusion: Companion presence during SSC leads to a significant reduction in maternal anxiety compared to midwife presence.