4.0 Postnatal Interventions
Step 7: Enable mothers and their infants to remain together and to practise rooming-in 24 hours a day
(Canada) Step 7: Promote and support mother-infant togetherness.

Separation of mother/birthing parent and newborn
From an evolutionary perspective, skin-to-skin care is the norm. Routine separation of the newborn from its mother/birthing parent soon after birth is unique to the 20th Century and beyond. At the risk of laboring the point, separating the mother/birthing parent and baby after birthing for any reason, other than a medical emergency, is NOT applying best practice care. All indicators of infant well-being and successful extrauterine adaptation are stabilized better and faster when the newborn is in skin-to-skin contact with its mother/birthing parent from immediately after birth for the first few hours, or at least until after the first breastfeeding.
Because of human infants' extreme immaturity at birth, infants depend on the caregiving context for relatively long periods of time, during which they require specific environmental inputs for the regulation of their biological and behavioral systems.

Note the protest response being exhibited by this newborn.
© Cecilia Finoli
When the mother/birthing parent and infant are separated, the infant's innate behaviors are changed. The infant firstly exhibits distress cries, followed by what is described as "protest-despair" behavior.
Separated newborns make 10 times more crying signals than babies in skin-to-skin care, and their cries have a completely different character. During the "protest" response there is intense activity seeking the mother/birthing parent, followed by "despair" behavior which sees the baby withdraw with decreased heart rate and temperature, mediated by a massive rise in stress hormones.
Maternal-neonate separation results in a physiological stress-response and has a profoundly negative impact on quiet sleep duration.
Effect on oxytocin

Oxytocin levels are highest around the time of birthing. Oxytocin cannot cross from the peripheral circulation into the brain; therefore it is only naturally occurring oxytocin released by the posterior pituitary gland that will have an effect on the mother's/birthing parent's temperament, ie. not oxytocin administered to the mother/birthing parent.
Oxytocin causes,
increased uterine contraction limiting postpartum blood loss,
the temperature of the mother's/birthing parent's breast to rise, providing warmth for the infant,
an anti-stress effect, reducing maternal blood pressure and cortisol levels and releasing gastrointestinal hormones,
a state of calmness and social responsiveness,
bonding with their infant, and enhanced maternal behaviors,
milk ejection; important at this time prior to it becoming conditioned by the suckling stimulus.
During the time the infant in skin-to-skin contact after birthing is making massage-like movements on the mother's/birthing parent's chest and breasts the maternal serum oxytocin levels rise. The infant begins these hand movements soon after birth and continues until he self-attaches and suckles.
The work of Michel Odent is well recognized by those involved in obstetrics. Odent's studies of the effects of oxytocin and other hormones of birthing are worthwhile following.
The age of cesarean sections on request, epidurals and drips of oxytocin is a turning point in the history of childbirth. Until recently women could not give birth without releasing a complex cocktail of 'love hormones'. Today, in many countries, most women have babies without releasing these specific hormones. The questions must be raised in terms of civilization. This turning point occurs at the very time when several scientific disciplines suggest that the way human beings are born has long-term consequences, particularly in terms of sociability, aggressiveness or, in other words, 'capacity to love'.
Michel Odent, 2001
Birth is a sensitive period
The first hour after birth is a sensitive period for both the infant and the mother. Through an enhanced understanding of the newborn infant's instinctive behaviour, practical, evidenceāinformed suggestions strive to overcome barriers and facilitate enablers of knowledge translation. This time must be protected by evidenceābased routines of staff.
With this in mind, the importance of skin-to-skin contact for mothers/birthing parents and infants who experience assisted births appears to be even more important.

Importance of skin-to-skin following assisted birth.
© Cecilia Finoli