Clinical audit of skin-to-skin contact and initiation of breastfeeding after birth.

Despite the well-established benefits of mother-infant skin-to-skin contact, the absence of immediate postnatal skin-to-skin contact and the separation of mothers and newborns appear to remain common practices in hospitals. This study was conducted to perform a clinical audit of skin-to-skin contact and the initiation of breastfeeding following birth. This cross-sectional study was conducted on 53 employed midwives and 265 postpartum mothers in two hospitals (Imam Sajjad and Shahid Akbarabadi) in Tehran Province. A census sampling method was applied. Data collection instruments included a demographic questionnaire and the national guideline checklist. Data were gathered through observation and interviews. For data analysis, descriptive statistics as well as the Chi-square and Fisher's exact tests were employed using SPSS (version 22). A significance level of less than 0.05 was considered in all analyses. The results showed that 69.8% of midwives had an acceptable level of awareness regarding the standards of the guideline for establishing immediate postnatal skin-to-skin contact and initiating breastfeeding within the first hour of birth. The educational performance of all midwives was deemed unsatisfactory. The practical performance of 84.9% of midwives, as observed, was reported as unacceptable, and midwives in Imam Sajjad Hospital demonstrated better practical performance compared to those in Shahid Akbarabadi Hospital (36.4% vs. 0%), which was statistically significant (P = 0.001). Furthermore, midwives' awareness was more acceptable in the age groups of 35-39 years (87.5%) and 40 years and above (100%), and this difference was statistically significant (P = 0.014).