Review of DVD "Skin to Skin in the First Hour After Birth"

I am the professional outreach coordinator for my local breastfeeding coalition. At our last meeting, we discussed how to spend funds from a breastfeeding grant we're applying for. We came up with several ideas:

• Provide copies of Thomas Hale's Medications and Mothers' Milk: A Manual of Lactational Pharmacology to local pharmacies, obstetricians, pediatricians, and family practice groups
• Give copies of Linda Smith's Impact of Birthing Practices on Breastfeeding to local L&D units and obstetricians
• Donate consumer-oriented breastfeeding books and videos to local libraries

I suggested providing copies of the DVD "Skin to Skin in the First Hour After Birth: Practical Advice for Staff after Vaginal and Cesarean Birth" to our three local hospitals. I first learned about this DVD at this years' Lamaze Conference in Milwaukee. Linda Smith showed excerpts of it during her presentation on how birthing practices affect breastfeeding. I loved what I saw and asked the producers, Healthy Children, for a review copy. The DVD just came out in 2010 and teaches hospital staff how and why to provide immediate, uninterrupted skin-to-skin contact after birth.

The DVD has three main sections. Section 1, "Advantages of Skin to Skin in the First Hour and Examples of the Baby's Stages" (15 minutes) first reviews the short- and long-term benefits of skin-to-skin care for both mothers and babies. Next, this section explains the 9 observable stages of a newborn placed skin-to-skin in the first hour of life. These stages usually occur in the following order: Birth Cry, Relaxation, Awakening, Activity, Rest, Crawling, Familiarization, Suckling, and Sleeping. Each of these stages is illustrated with video footage and explained by the narrator. We see several different mother-baby pairs going through these stages with both cesarean and vaginally born babies, and we see how many minutes after birth each stage typically occurs.

Section 2, "Skin to Skin after a Vaginal Birth" (9 minutes), instructs staff how to prepare parents for skin-to-skin contact during prenatal visits and upon labor admission. Next, this section offers several practical instructions for how to facilitate skin-to-skin contact. The advice addresses topics ranging proper maternal clothing, routine infant care and admission procedures (which should be done while the baby is on the mother's chest, and with the goal of disturbing the baby as little as possible), keeping the mother-baby pair covered with warm blankets as necessary, and providing supports for the baby's head and mother's arms.

Section 3, "Skin to Skin after a Cesarean Birth" (11 minutes), offers instruction for facilitating immediate skin-to-skin contact after a cesarean section. Some of the advice is the same as for vaginal births (prenatal counseling, maternal clothing during the delivery, supports for the mother's arms, or keeping baby and mother skin-to-skin with warm, dry blankets on top as needed). Other advice is specific to cesarean surgeries, such as keeping surgical equipment away from the baby, positioning the baby properly in relation to the surgical drape and the mother's body, or transporting mother and baby together skin-to-skin from the OR to the recovery room. As with the section on vaginal birth, we see the different newborn stages illustrated in the video footage, along with how many minutes it took for that particular baby to reach the stage.

Both sections 2 and 3 have extensive video footage showing care providers how skin-to-skin care works in a "real life" hospital environment. These two sections also address providing skin-to-skin care if either the mother or baby needs special assistance. In many cases, the baby can be cared for directly on the mother's chest. If the mother needs medical attention and cannot hold the baby, the father or partner should provide skin-to-skin care until the mother is stable. We see fathers doing skin-to-skin after both vaginal and cesarean births  when the mother could not have the baby on her chest for medical reasons.

My thoughts and reactions
Even though I am used to seeing mothers and babies skin-to-skin after birth (most of the births I attended as a doula were at home, where the practice is routine), I was still impressed with how much the pace just...slowed...down in Skin to Skin in the First Hour After Birth. I've seen lots of immediate skin-to-skin care, but not necessarily baby-led breast crawls. I would like to try this with my next baby. I wonder if I'll have the patience to do so!

I highly recommend this DVD, especially for those wishing to implement skin-to-skin care in a hospital setting. The DVD is short, easy to understand, and affordable. I anticipate that this DVD would be a tremendous help in overcoming care provider & staff resistance to doing skin-to-skin care, especially after cesarean sections. Once you see it in practice, you realize how simple it really is. Baby goes on mom, mom and baby rest and relax together, and the staff easily perform any necessary procedures with the baby and mom right in the same place.

My only suggestion for improvement would be to make the DVD easier to find and purchase. It is sold through  Healthy Children's online bookstore and is easy to miss as you're scrolling down the page. You can't order it directly online; instead, you have to mail, fax, or phone in your order. I would recommend making the DVD easier to find on the bookstore page--perhaps with some pictures of the cover and embedded excerpts from the DVD--and adding a Paypal button so people can purchase it immediately online. I would also love to see this DVD sold on Amazon.

Healthy Children is just about to release another DVD about skin-to-skin care aimed at parents, called The Magical Hour: Holding Your Baby Skin to Skin for the First Hour After Birth. I hope to review this DVD as soon as it is available!

Other reviews of this DVD are located at Lamaze's Science & Sensibility.

Skin to Skin in the First Hour After Birth
Executive producer and videographer: Kajsa Brimdyr, PhD, CLC
Executive and content producers: Kristin Svensson, RN, PhD (cand.) and Ann-Marie Widström, PhD, RN, MTD.
DVD, 2010
39 minutes
$39.00
Click here to download an order form (PDF). You may also order by phone (508-888-8044) or fax (508-888-8050).