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. 2025 Jul 30;13(15):1866.
doi: 10.3390/healthcare13151866.

Beyond Pain Management: Skin-to-Skin Contact as a Humanization Strategy in Cesarean Delivery: A Randomized Controlled Trial

José Miguel Pérez-Jiménez  1   2   3 , Rocío de-Diego-Cordero  1   3 , Álvaro Borrallo-Riego  1   4 , Manuel Luque-Oliveros  1   2 , Domingo de-Pedro-Jimenez  5 , Manuel Coheña-Jimenez  6   7 , Patricia Bonilla Sierra  8 , María Dolores Guerra-Martín  1   4
Affiliations

Beyond Pain Management: Skin-to-Skin Contact as a Humanization Strategy in Cesarean Delivery: A Randomized Controlled Trial

José Miguel Pérez-Jiménez et al. Healthcare (Basel). .

Abstract

Background: Postoperative pain management after a cesarean section remains a significant challenge, as inadequate control can delay maternal recovery and hinder early bonding and breastfeeding. While multimodal analgesia is the standard approach, non-pharmacological strategies like immediate skin-to-skin contact (SSC) are often underused despite their potential benefits in reducing pain, improving uterine contractions, and increasing maternal satisfaction.

Objective: To evaluate the effects of immediate SSC on postoperative pain perception, uterine contraction quality, and maternal satisfaction, and to explore ways to incorporate SSC into routine post-cesarean care to promote recovery and humanized care.

Method: A randomized clinical trial was conducted with 80 women undergoing elective cesarean sections, divided into two groups: SSC (40 women) and control (40 women). Postoperative pain was measured using the Visual Analog Scale (VAS) at various intervals, while uterine contraction quality and maternal satisfaction were assessed through clinical observation and a Likert scale, respectively.

Results: We found that women in the SSC group experienced significantly lower pain scores (VAS2 and VAS3, p < 0.001), stronger infraumbilical uterine contractions (92.5%, p < 0.001), and higher satisfaction levels (average 9.98 vs. 6.50, p < 0.001). An inverse correlation was observed between pain intensity and satisfaction, indicating that SSC enhances both physiological and psychological recovery.

Conclusions: Immediate SSC after cesarean is an effective, humanizing intervention that reduces pain, supports uterine contractions, and boosts maternal satisfaction. These findings advocate for integrating SSC into standard postoperative care, aligning with ethical principles of beneficence and autonomy. Further research with larger samples is necessary to confirm these benefits and facilitate widespread adoption in maternity protocols.

Keywords: cesarean section; humanized care; maternal satisfaction; postoperative pain; skin–to–skin contact; uterine contraction.

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Conflict of interest statement

The author(s) declare no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1
Figure 1
Relationship between mother’s satisfaction and VAS3 in the SSC group.
Figure 2
Figure 2
Uterine contraction in relation to VAS3.
Figure 3
Figure 3
Uterine contraction in relation to VAS2.
See this image and copyright information in PMC

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