Changing practice, changing lives : an action research project to implement skin-to-skin contact at birth and improve breastfeeding practice in a North West United Kingdom hospital maternity unit

Changing Practice: Changing Lives. An action research project to implement skin-to-skin contact at birth and improve breastfeeding practice in a North West United Kingdom hospital maternity unitBreastfeeding has health benefits for mothers and babies. An action research project was undertaken to improve knowledge of breastfeeding and implement evidence based practice, that of uninterrupted skin-to-skin contact between mother and baby at birth. The beliefs underpinning the project were informed by critical inquiry, dialectics and feminist theory. Data was collected by means of field notes, participant observation, focus groups and semi- structured interviews. Analysis during the project using critical reflection was ongoing and collaborative, feeding back into the action research cycles, so guiding the changes.Before successful change in practice can occur, practitioners need to be convinced of its value, involved in the change process and facilitated to incorporate it into practice. Hospitals tend to reinforce the power of professionals by their adherence to historical routines and institutionalised practices which lead to compliance thus hindering change. The strategic use of power by midwives was apparent, constructing people's world view, thus reinforcing the power structure.Empowerment of women and midwives was necessary to the success of the project by education, support, role modelling, strategies for remembering and the active participation of midwives. Theories of change were used to illuminate challenging issues from the project.Early contact between mother and baby at birth is an area generating a large volume of literature. Skin-to-skin contact was disrupted by technology, time limits and the social norm of separation. Interviews with women and midwives allowed a deeper insight into the experience of skin-to-skin contact, giving more value to the change. Further issues to emerge were the implications of separation, the social construction of time, embodied praxis and love.Recommendations are made for the more effective action research approach to implementing change, and personal empowerment as the basis for improving the experience of birth