Does immediate skin-to-skin contact at caesarean sections promote uterine contraction and recovery of the maternal blood haemoglobin levels? A randomized clinical trial.

The trial was small and single centre, so chance and local practice could affect the results. Participants knew their group, and pain, satisfaction and newborn crying were subjective outcomes, so blinding could not control for expectation. Urgent or complicated caesarean sections were excluded, so the results do not apply to women or newborns with serious complications. Baseline differences between groups were reported, including pre-surgery haemoglobin, maternal height, newborn sex, newborn weight and education level, which could influence outcomes. Some results were inconsistent between the text and table, such as breastfeeding at 1 month and newborn crying. The hospital facilities were not fully prepared for skin-to-skin contact, and a postpartum room was adapted, which may limit transferability.

The authors declared no conflicts of interest.

Do not read this as proof that skin contact alone prevents postpartum haemorrhage in all caesarean births. The trial was small, unblinded, excluded urgent or complicated caesareans, and delivered a bundled care protocol with companion presence and newborn care on the mother's chest. The contribution of any single component cannot be separated.