Influence of Language Contact on English Language

To what extent has language contact affected the English language?
In discussing the influence of other languages on the English language, the term ‘language contact’ may be defined as “the impact of other languages on English as a result of socio-historical interaction” (Márquez 90). Languages are dynamic entities, which are constantly evolving to reflect our needs and the state of the societies that we live in (Bex 26). This is certainly the case for the English language, which has been heavily influenced by many languages throughout history as a result of numerous invasions, proselytism, interest in so-called ‘prestigious’ languages, and many other factors, with the code-switching that ensued as a result of these having a profound impact on English. Therefore, this essay will illustrate the enduring impact that language contact has had by looking at how aspects of the English language like lexicon, orthography, phonology and place-names have been greatly affected by English’s interaction with other languages, with particular focus on the influence of the Italic languages of Latin and French.

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Regarding lexicon and place-names, Latin has undeniably left a lasting impression on the English language. For instance, Jonathan Culpeper states that the Romans’ most successful raid under Emperor Claudius in AD 43 was what successfully laid the foundation for the partial Latinisation of many of Britain’s Celtic place-names (2, 3). While it remained rare for British place-names to be mostly derived from Latin origins, rare exceptions such as “Speen” from the Latin “Spinis” do exist; however, one of the most prominent legacies that Latin left occurred through compounding, with certain elements of the names of numerous cities and towns having Latin roots (Nielsen 154, 155). For instance, the suffix “-wich” in place-names such as “Greenwich” was derived from the Latin “vicus,” meaning “village” (Ayers and Cherry 7).
Regardless, while Latin certainly had an impact on many British place-names, it also left a more general mark on the English language in the form of borrowed lexicon and loanwords. According to Culpeper, while early Christian missionaries introduced approximately four hundred and fifty Latin words into Old English through religious texts, and thousands of Latin loans entered the English Language during the Middle English period from areas “such as religion, science, law and literature,” it was not until the sixteenth century that borrowing from Latin and Greek became extremely popular (36, 37), which became a defining feature of Early Modern English (c.1500 – 17000). This may be explained by the influence of the Renaissance (c. 1300 – 1600), which was a time of significant interest in the sciences and arts, and which led to a renewed interest in Latin as the language of “scholars, scientists and philosophers” (Minkova and Tunberg xxvi). However, as there were no English equivalents for many of the complex scholarly terms featured in these texts, approximately seven-thousand Latin loanwords entered the English language, which often represented abstract concepts, unlike English words of Germanic origins (Culpeper 39). Also, several Latinate roots have been borrowed numerous times, resulting in doublets; for instance, the Latin word “sal” has inspired numerous English words, including “saline” and “salary” (Green 35). Nonetheless, borrowing from Latin decreased after the seventeenth century, mainly due to English’s newfound prestige and status as the language of scholarship (Culpeper 37, 38). Regardless, it is clear to see that Latin has had a profound impact on the English lexicon through thousands of loanwords.
On the other hand, because of the Norman invasion of 1066, French became the official language of law and administration in England and, due to its prestigious status as the language of the upper class and the code-switching that occurred after the invasion, approximately ten-thousand French words “associated with warfare, rule, law and fashion” (Millar 126) were adopted into the English language during the Middle English period (c. 1100-1500) (Mellinkoff 97). However, while some Norman-French terms completely replaced their Old English counterparts, such “fortune” replacing “wyrd,” semantic change occurred when both terms survived, with an example being the distinction between the Old English “house” and the French loan “mansion” (Culpeper 37). However, much like Latin, French borrowing has been in decline since the upper class stopped speaking French and English became regarded as the new language of administration (Culpeper 37, 38), yet the influence of French has lived on in various levels of borrowings, such as through borrowed food-related lexis like “poultry,” phrases such as “ménage à trois,” and bound morpheme suffixes like “-ible” (Fromkin et al. 358, 505). Unlike the written lexis of Latin, the fact that French influenced English mostly through spoken vocabulary is significant because it places French loanwords between Germanic and Latinate lexis in that they may convey a mixed register and refer both concrete and abstract concepts (Culpeper 39).
However, while Norman-French generally had a small impact on place-names as most British places already had established names by 1066, some elements of French did inspire certain naming practices. For example, the French-speaking aristocracy routinely named castles and estates like “Belvoir” and “Malpas” directly after landmarks and places in France, Norman scribes substituted sounds for some more familiar to French (which is reflected in the spelling and pronunciation of places such as “Cambridge”), and the prevalence of double-barrelled named manors like “Kingston Lacy” can also be attributed to the French aristocracy, who often gave their properties recognisable names to distinguish their manors from others (Mills xvi). Consequently, much like Latin, it is undeniable that French has had an impact on the place-names and lexicon of the English language.
Moreover, it may be argued that both languages have had a significant impact on the orthography and, in turn, the phonology of the English language. The fact that English spellings are not always phonemic, for example, may be attributed partly to the move from the Runic alphabet to the Latin alphabet used by the Romans during the Conversion Period (c. AD 597 – AD 735), which meant that there were not enough orthographic counterparts for all of the Old English phonemes, as the Latin alphabet consisted of only twenty-three letters (Culpeper 22). Also, Doreen Scott-Dunne has noted that Latin impacted English orthography and phonology through etymological respellings. For instance, because of the renewed interest in Latin and Greek texts, many Renaissance scholars decided to respell certain words to make them orthographically resemble their Latin origins, which is evident in the change of words like the Middle English “det” to the modern “debt,” which now more closely resembles the Latin “debitum” (62). However, while this simply resulted in the addition of silent letters to many words (Scott-Dunne 62), other Latin-inspired spelling changes were mirrored by significant changes in pronunciations. For example, Renaissance scholars often added the letter after in words to make English appear as prestigious as Latin, which changed lexis like the Old French loan “trone” to “throne” (Algeo and Butcher 155).  This resulted in a change of pronunciation, with the word’s first phoneme shifting from [t] to [θ]; nonetheless, this was not a universal change for all words that contained the letter , and words like “Anthony” did not always change in pronunciation in British English, which exemplifies the fact that language contact can often result in a lack of regularity (Algeo and Butcher 155).
Furthermore, French scribes during the Middle English period may have caused English spelling variations (House 243), which often led to phonological changes. For instance, the runic symbol , which represented the phoneme [w], was scarcely used after 1300, due to it being replaced by the symbols or , which originated in northern France (Culpeper 22). Also, the letter represented a vowel in Middle English, but a consonantal that was pronounced as [dÊ’] appeared during the Middle English period, which is often attributed to the influence of Norman-French (House 241). However, another significant phonological impact occurred because the importation of French lexis during the Middle Ages encouraged a “separation of voiced and unvoiced fricatives into separate phonemes” (Millar 126). While Old English had simply represented [f] and [v] as at the start of words and in other positions, the importation of French lexis like “voice” that began with the phoneme [v], along with the desire to speak with a ‘prestigious’ French accent, meant that graphological distinctions between the phonemes naturally occurred (Millar 126).
Similarly, while lexis such as “centre” was borrowed from the Latin “centrum,” the influence of French meant that the grapheme started to represent the phoneme [s] instead of [k] in some words (Culpeper 26), leading to a lack of regularisation. Additionally, while Old English had a strict stress pattern, in which stress fell on “the first central (not prefix) syllable,” the stress pattern of French was variable depending on each word and, therefore, prosodic changes had to take place during the Middle Ages so that French loanwords could be smoothly integrated into English (Millar 126). However, while etymological respellings of some words took place to show their French origins, scribes sometimes incorrectly assumed the etymology of words like “island,” meaning a was added to the Middle English “iland” to make resemble the Old French “isle”, even though the word was originally from the Old English “iegland”, and therefore had Germanic roots (Horobin 112, 113).
By and large, the profound influence of Latin and French on the English language exemplifies the fact that languages are not static, and continuously evolve organically in order to meet our linguistic and societal needs. In fact, English itself has already split into separate variations like American English and Australian English, which each have unique variations based on their contact history. Moreover, due to advances in travel and technology, English continues to be shaped and changed by more languages in our modern world, as evidenced by recent additions to the Oxford English Dictionary such as “dopiaza” (“dopiaza, n.”) and “maitake” (“maitake, n.”), which have Hindi and Japanese roots, respectively. Therefore, while syntagmatic, paragigmatic, social and technological changes (including scientific discoveries and the development of the internet) are arguably the primary causes of language change in the twenty-first century (Algeo and Butcher 10), language contact has undeniably had a significant impact on the English language overall, and will most likely continue to play a role in influencing various aspects of the English language for years to come.
Works cited:
Algeo, John, and Carmen A. Butcher. The Origins and Development of the English Language. Seventh ed. Boston, MA: Cengage Learning, 2013. Print.
Ayers, Donald M., and R. L. Cherry. English Words from Latin and Greek Elements. Second ed. Ed. Thomas D. Worthen. Tucson, AZ: University of Arizona Press, 1986. Print.
Bex, Tony. Variety in Written English: Texts in Society: Societies in Text. London, England: Routledge, 1996. Print.
Culpeper, Jonathan. History of English. Second ed. London, England: Routledge, 2005. Print.
“dopiaza, n.” OED Online. Oxford University Press, December 2016. Web. Accessed 30 December 2016.
Fromkin, Victoria, Robert Rodman, and Nina Hyams. An Introduction to Language. Ninth ed. Boston, MA: Cengage Learning, 2010. Print.
Green, Tamara M. The Greek & Latin Roots of English. Fifth ed. Lanham, MD: Rowman & Littlefield, 2014. Print.
Horobin, Simon. Does Spelling Matter?. Oxford, England: Oxford University Press, 2013. Print.
House, Linda I. Introductory Phonetics and Phonology: A Workbook Approach. Mahwah, NJ: Lawrence Erlbaum Associates, Inc., 1998. Print.
“maitake, n.” OED Online. Oxford University Press, December 2016. Web. Accessed 30 December 2016.
Márquez, Miguel Fuster. Working with Words: An Introduction to English Linguistics. Eds. Miguel Fuster Márquez and Antonia Sánchez. València, Spain: University of València, 2011. Print.
Mellinkoff, David. The Language of the Law. Eugene, OR: Wipf and Stock Publishers, 2004. Print.
Millar, Robert McColl. English Historical Sociolinguistics. Edinburgh, England: Edinburgh University Press, 2012. Print.
Mills, A. D. A Dictionary of British Place-Names. Fourth ed. Oxford, England: Oxford University Press, 2011. Print.
Minkova, Milena, and Terence Tunberg. Latin for the New Millennium: Level 2: Student Text. Vol. 5. Mundelein, IL: Bolchazy-Carducci Publishers, 2009. Print.
Nielsen, Hans Frede. The Continental Backgrounds of English and its Insular Development until 1154. Vol. 1. Odense, Denmark: Odense University Press, 1998. Print.
Scott-Dunne, Doreen. When Spelling Matters: Developing Writers Who Can Spell and Understand Language. Ontario, Canada: Pembroke, 2012. Print.

Skin to Skin Contact in Nursing

Introduction
Nowadays, separation of mothers from their newborn babies at delivery has become a usual practice despite the escalating evidence that this may have negative effects on the newborn. A growing volume of research supports skin to skin contact between the mother and the newborn in the immediate post-delivery period. Skin to skin contact is defined as placing the naked newborn baby, prone covered across the back with a warm blanket, on the mother’s bare chest instantaneously following birth.

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A substantial number of studies showed that early skin to skin contact between the mother and the newborn is beneficial to the newborn. Some of the benefits of skin to skin contact include stabilization of the newborn’s body temperature through thermoregulation, regulation of heart rate and regulation of respiratory rate (Wallace & Marshal, 2001). Additionally, early skin to skin contact facilitates the initiation of breastfeeding, helps neonatal thermoregulation and promotes maternal-infant bonding (Dabrowski, 2007; Wallace & Marshal, 2001). Skin to skin contact may also ensure colonization of the baby with the mother’s own skin flora, for which the child will have some resistance (Wallace & Marshal, 2001).
Despite its aforementioned benefits and despite the UNICEF’s Baby Friendly best practice campaign which calls for early skin to skin contact, this practice is still not being implemented in the labor room in Bahrain. This can be due to lack of labor room nurses knowledge about the benefits of skin to skin contact. Therefore, the purpose of this study is to assess the current knowledge level of labor room nurses about skin to skin contact. The problem statement is: what is the perception of labor room nurses towards skin to skin contact between mother and the newborn? The research questions are (1) what do labor room nurses know about skin to skin contact?, (2) what are the factors labor room nurses identify as barriers to implementation of skin to skin contact, (3) what are the factors labor room nurses identify as facilitators to implementation of skin to skin contact?
Identifying knowledge level of labor room nurses will help in designing and implementing in-service education programs to educate nurses about the importance of skin to skin contact. Additionally, identifying the barriers and facilitators of skin to skin contact will help in designing interventions to decrease the barriers and increase the factors that will facilitate skin to skin contact. Increasing knowledge level of labor room nurses, decreasing the barriers and increasing the factors that facilitate skin to skin contact will help in increased implementation of skin to skin contact in the labor rooms in Bahrain.
Conceptual definition:
1. Skin to skin contact: Placing the naked newborn on the mother’s bare chest immediately after birth.
2. Knowledge: Information about skin to skin contact
3. Barriers: Factors that decrease the likelihood of implementing skin to skin contact
4. Facilitators: Factors that encourage the implementation of skin to skin contact
Operational definition:
1. Skin to skin contact: placing the naked newborn baby, on his/her stomach covered across the back with a warm blanket, on the mother’s bare chest for at least 15 minutes starting immediately after birth.
2. Knowledge: the amount of information labor room nurses have about how to implement skin to skin contact and the benefits of skin to skin contact.
3. Barriers: the factors that prevent labor room nurses from implementing skin to skin contact.
4. Facilitators: the factors that help labor room nurses to implement skin to skin contact.
One limitation of this study was the difficulties we encountered in trying to meet with the key stakeholders. Their busy schedules prevented them from devoting enough time to understanding our study. Another limitation was the fact that our group could not meet as frequently as we would have liked. Carrying out as group had several limitations due to other commitments it was difficult to meet frequently. 

Benefits of Early Skin-to-Skin Contact Following Cesarean Delivery

Introduction
In 1991, the Baby-Friendly Hospital Initiative was launched by the United Nations Children’s Fund (UNICEF) and the World Health Organization (WHO), with the WHO (2018) stressing on the importance of “immediate and uninterrupted skin-to-skin contact and initiation of breastfeeding within the first hour after birth” (p.1). Breastfeeding has been associated with the child’s immunity against infection, an improved cognitive development, a lower probability of chronic illnesses later in life, and a reduction in mortality until 5 years of age (Victora et al., 2016).

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Skin-to-skin contact, also known as kangaroo care, occurs as the newborn is positioned prone directly against the mother’s belly or chest without any clothes or towels between them. Cohen et al. (2018) noted that while early skin-to-skin contact had increased the likelihood of breastfeeding initiation and continuation, breastfeeding was also more likely to happen following vaginal compared with cesarean deliveries. A survey conducted by the Centers for Disease Control and Prevention (CDC, 2015) revealed that only 78% of cesarean births in California established initial skin-to-skin contact for at least 30 minutes within 2 hours of delivery, while 94% of vaginal births implemented it within an hour of delivery. Boundy, Perrine, Barrera, Li, and Hamner (2018) also found that the rate of early skin-to-skin contact was lower after a cesarean birth compared to an uncomplicated vaginal birth. This may be attributed to medical conditions in the mother or the baby, the mother’s incapacity to perform skin-to-skin contact safely as a result of the medications received during the operation, and a disruption in the natural process of birth that results in a prolonged separation between mother and child.
There was a lower rate of cesarean deliveries from 32.0% in 2017 to 31.9% in 2018 here in the United States (Martin, Hamilton, Osterman, and Driscoll, 2019, p.6), but it is still much higher than the ideal rate of 10-15% proposed by the international healthcare community (WHO, 2015). While most studies focus on the effects of early skin-to-skin contact following a natural vaginal birth, this paper aims to explore its benefits after cesarean delivery.
The Interview
During my clinical rotations in the nursery and labor and delivery departments of the Total Birth Care Center unit at Loma Linda University Children’s Hospital, I was able to observe how the newborns were managed right after delivery. As the baby is born vaginally, the naked child is placed prone on top of the mother’s abdomen while routine care is done. After the cord is clamped and separated from the placenta, the baby is usually transferred from the mother’s abdomen to her chest. When I asked the nurses about this, I was told that immediate skin-to-skin can often be done after most vaginal deliveries because the mother and baby are usually stable; and having the baby in direct contact with the mother does not interfere with routine care. In addition to this, immediate skin-to-skin contact improved the likelihood of maternal and child bonding and helped establish breastfeeding earlier.
I asked if skin-to-skin contact is less effective after a cesarean delivery since it occurs much later than if the baby was born vaginally. The nurses told me that skin-to-skin contact is still effective if it happens within an hour after delivery. They also said that cesarean deliveries will most likely indicate some degree of maternal or fetal complication, so it’s even more important that skin-to-skin contact and early breastfeeding is established to help combat these problems.
While some of the nurses mentioned that this intervention was taught and encouraged early in school, one of them said that she learned this from undergoing education and training when the hospital implemented the Baby-Friendly Hospital Initiative. The hospital also holds conferences and creates policies that ensure better outcomes for the mother and the child. When I asked about alternative methods to skin-to-skin contact following delivery, one of them mentioned the baby having skin-to-skin contact with the father instead, but that she hasn’t experienced it herself.
I was told, however, that there are instances where skin-to-skin cannot be done immediately, such as when the baby, mother, or both are experiencing any medical complications that require more intensive care and management. They said that skin-to-skin contact should still be done as soon as both parties are stable. If the mother refuses, or if there are medical complications that are too severe (baby may be transferred to NICU), skin-to-skin contact may not be done at all.
Locating Policy in the Clinical Setting
Loma Linda University Children’s Hospital has an operating policy under clinical management entitled, “Breastfeeding/infant feeding.” The policy (code CH-M-135) is checked and revised accordingly every 2 years. Its most current update is in June of 2019, with its prior revision in October of 2017. It provides guidelines that promote exclusive breastfeeding as well as practices that support optimal maternity care and infant feeding. Among these practices is the inclusion of skin-to-skin contact that should be done immediately after birth, regardless of its mode of delivery. The newborn is placed naked against the mother’s naked ventral surface. There should be no clothing between the mother and the baby except for a diaper or a hat, if deemed necessary. Routine assessment procedures can be performed while the infant is skin to skin with the mother, while routine newborn procedures are not done until the first breastfeeding is completed. After a cesarean birth, mothers and their infants should be placed in continuous, uninterrupted skin-to-skin contact as soon as the mother is responsive and alert.
The policy takes its roots from UNICEF’s and WHO’s Baby-Friendly Hospital Initiative; Baby Friendly USA and their Ten Steps to Successful Breastfeeding; the American Academy of Pediatrics (AAP) with its policy on Breastfeeding and the Use of Human Milk, and; the Academy of Breastfeeding Medicine’s (ABM) Model Maternity Policy Supportive of Breastfeeding.
Research
Studies regarding early skin-to-skin contact following cesarean delivery are scarce but are also beginning to pique interest among the health care community, partly as a result of the higher rate of cesarean deliveries compared to the last decades (Menacker and Hamilton, 2010).
Schneider, Crenshaw, and Gilder (2016) conducted a study on newborns who were provided with immediate skin-to-skin contact following cesarean delivery and their rate of transfer to the NICU thereafter. While the hospital had been designated as Baby-Friendly in 2009, immediate skin-to-skin contact in the operating room right after cesarean births only began implementation in 2013. Prior to this, skin-to-skin contact was performed after the operation had completed and when the mother had been moved to the recovery room. To determine the effect of immediate skin-to-skin contact after a cesarean birth to the rate of transfer of newborns to the NICU for observation, they collected data of all scheduled and nonemergent cesarean births between 37- and 42-weeks’ gestation between 2011 and 2015. They found that there was a lower rate of NICU transfers when the baby received immediate skin-to-skin contact during cesarean deliveries from 5.6% (January 2011 to December 2012) to 1.75% (January 2013 to December 2015). While skin-to-skin contact was practiced throughout the entire duration of the study, their findings suggest the beneficial effect of skin-to-skin contact done at an earlier time.
Guala et al. (2017) sought to determine the rate of exclusive breastfeeding at discharge and its continuity 6 months after when skin-to-skin contact between parent and child was done during a cesarean delivery compared to those who had not. The study included over 252 women who underwent a cesarean delivery at a Baby-Friendly hospital from January 2012 through December 2012. They were at least 37-weeks’ gestation, the newborn had an APGAR of >7 at the 5-minute mark, and the partners were included for when the mothers were unable to do skin-to-skin contact right away. Data was collected at the time of discharge, 3 months after, and 6 months after. They found that mothers who had done skin-to-skin contact with their babies after a cesarean delivery had a higher rate of establishing exclusive breastfeeding at the time of discharge compared to having skin-to-skin contact with the father or none at all. They also had a higher rate of continued breastfeeding at 3 and 6 months. While the rate of exclusive breastfeeding and continued breastfeeding was higher for paternal-newborn skin-to-skin contact than for babies who had not received it from either parent, it was not statistically significant enough for them to conclude the father’s influence in breastfeeding practices. They, did, however, still recommend that fathers be encouraged to provide skin-to-skin contact with their babies if the mother is unable to do it because of the opportunity to improve bonding.
Huang, Chen, and Zhang (2019) organized a study to determine the effects of skin-to-skin contact done between the father and the newborn. In 2015, the hospital started father-newborn skin-to-skin contact after cesarean delivery as an alternative when the mother is unable to perform it safely. The study collected data from newborns who were born between 37- and 42-weeks’ gestation by planned cesarean deliveries between February to June 2016 and from their respective fathers. They found that newborns had more stable heart rates, cried for a shorter amount of time, and were more likely to start crawling in search of the nipple when they had been subjected to earlier skin-to-skin contact with the father as opposed to just receiving routine care and having skin-to-skin contact with the mother much later. They also noted that the fathers who performed skin-to-skin contact with the newborn were less anxious and more likely to accept their paternal roles, resulting in more involvement with the care of the baby.
Comparison of Research and Protocol
While all of the research and Loma Linda University Children’s Hospital’s protocol promote skin-to-skin contact regardless of the mode of delivery, the hospital policy does not go into detail as to when skin-to-skin contact should be started after cesarean delivery or for how long it should be maintained uninterrupted to ensure its benefits on the mother and infant. There is also no mention of paternal skin-to-skin contact.
During my time at the Total Birth Care Center Unit, all the nurses I observed were able to carry out skin-to-skin contact between the mother and the baby immediately after a vaginal delivery and within 30 minutes after a cesarean delivery.
After a cesarean birth, the baby was first received by the pediatrician and then examined under an infant radiant warmer. Once the baby was assessed and considered stable, the baby was snugly wrapped in a blanket with its head kept warm with a cap, and then handed over to the nursery nurse. While the operation was continuing, the nurse brought the baby over to the mother’s side, kept the cap in place, unwrapped the blanket, and gently positioned the baby perpendicular to the mother’s spine, prone and skin-to-skin over her chest. The baby’s head was tilted sideways with the mouth and nose visible to ensure adequate ventilation. Finally, a warm blanket was placed across the baby’s back. The mother held the baby with one arm over the blanket while the nurse observed them and ensured their safety. Once the operation was completed, at least 30 minutes of undisturbed skin-to-skin contact had already passed. The baby was then temporarily separated from the mother so that both could be safely transported to the recovery room. If breastfeeding had been established while she was still in the OR, routine newborn procedures (measurement of length, weight, and head circumference; giving eye ointment, vitamin K, and hepatitis B vaccine) were done before skin-to-skin contact was reestablished. The mother was educated on the benefits of skin-to-skin contact, including thermoregulation, bonding, and early initiation of breastfeeding.
Plan for Improvement
New research regarding skin-to-skin contact immediately after a cesarean delivery should be explored and incorporated more thoroughly into the hospital’s policy to motivate nurses to educate and encourage women to perform this intervention in the operating room. Aspects that can be focused on include the recommended onset or initiation of skin-to-skin contact following delivery (vaginal and cesarean), frequency, and duration of uninterrupted contact. Maternal complications and contraindications could also be explained in more detail to improve clinical judgment with the implementation of this intervention.
Barriers that hinder this practice like the risk of compromising the sterile field, the possibility of the baby falling while skin-to-skin contact is being done in an ongoing operation, the lack of adequate space at the front of the operating table, and the parent’s lack of awareness can all be minimized or prevented if proper measures are taken. The policy could be updated to include a step-by-step outline for how skin-to-skin should be established correctly and safely at the operating room. Having the father perform skin-to-skin contact with the baby if it is not safe for the mother to do it herself should also be an alternative method the hospital can take into consideration.
Reflective Thinking
There was a point where I saw skin-to-skin contact as an intervention that has been studied too many times and is already so well-established since the last few decades that there’d be no reason to investigate it further. Health and medicine change and evolve every day, and even though I hear that all the time, it is so easy to forget. I realized that it’s always important to keep an open mind and have that strong desire to improve health care for everyone. Now knowing the high rate of cesarean deliveries, I see the need to increase focus on skin-to-skin contact in the operating room with an emphasis on its advocation and safe practice. I also understood that the birth of a child does not only include the care of the newborn, but the mother and the father as well. Getting the partner to accept and transition into fatherhood this early through paternal-newborn skin-to-skin contact was something that had never crossed my mind. This involvement might help the mother by allowing her to see the father’s participation as the unit that, together with her, makes the family whole and complete.
Conclusion
Because vaginal births occur more frequently than cesarean births, there are not enough studies that focus on skin-to-skin contact after a cesarean delivery. Regardless, current studies that are available indicate that skin-to-skin contact that is established early has shown benefits for the newborn, the mother, and the father after a vaginal or cesarean birth.
Allowing skin-to-skin contact between parent and child at the operating room as soon as possible aids the baby in transitioning from intrauterine to extrauterine life. Exclusive breastfeeding with its continuity is also more likely to occur. Although further studies may be needed to make a more substantial conclusion with the baby benefitting from skin-to-skin contact with the father, it should still be promoted as an option when the mother cannot do it herself because of the psychologic benefits it can provide the rest of the family.
With the advent of the Baby-Friendly Hospital Initiative that highlights, among others, the need to establish immediate skin-to-skin contact, the same intervention should be enforced and safely practiced in all clinical settings, including the operating room after a cesarean birth.
References

Boundy, E., Perrine, C., Barrera, C., Li, R., and Hamner, H. (2018). Trends in maternity care practice skin-to-skin contact indicators: United States, 2007-2015. https://doi.org/10.1089/bfm.2018.0035
Centers for Disease Control and Prevention. (2016). California 2015 report, CDC survey of maternity practices in infant nutrition and care (mPINC). Retrieved from https://www.cdc.gov/breastfeeding/data/mpinc/state_reports.html
Cohen, S., Alexander, D., Krebs, N., Young, B., Cabana, M., Erdmann, P., Hays, N., Bezold, C., Levin-Sparenberg, E., Turini, M., and Saavedra, J. (2018). Factors associated with breastfeeding initiation and continuation: a meta-analysis. The journal of pediatrics, 203, 190-196. e.21. https://doi.org/10.1016/j.jpeds.2018.08.008
Geneva: World Health Organization. (2018). Implementation guidance: protecting, promoting and supporting breastfeeding in facilities providing maternity and newborn services – the revised baby-friendly hospital initiative. Retrieved from https://apps.who.int/iris/bitstream/handle/10665/272943/9789241513807-eng.pdf?ua=1
Guala, A., Boscardini, L., Visentin, R., Angellotti, P., Grugni, L., Barbaglia, M., Chapin, E., Castelli, E., and Finale, E. (2017). Skin-to-skin contact in cesarean birth and duration of breastfeeding: a cohort study. The scientific world journal, 2017, 1940756. https://doi.org/10.1155/2017/1940756
Huang, X., Chen, L., and Zhang, L. (2019). Effects of paternal skin-to-skin contact in newborns and fathers after cesarean delivery. The journal of perinatal and neonatal nursing, 33 (1), 68-73. https://doi.org/10.1097/jpn.0000000000000384
Martin, J., Hamilton, B., Osterman, M., and Driscoll, A. (2019). Births: final data for 2018 National vital statistics reports, 68 (13), 6-7. Retrieved from https://www.cdc.gov/nchs/data/nvsr/nvsr68/nvsr68_13-508.pdf
Menacker, F. and Hamilton, B. (2010) Recent trends in cesarean delivery in the United States. National center for health statistics data brief, 35. Retrieved from https://www.cdc.gov/nchs/data/databriefs/db35.pdf
Schneider, L., Crenshaw, J., and Gilder, R. (2016). Influence of immediate skin-to-skin contact during cesarean surgery on rate of transfer of newborns to NICU for observation. Nursing for women’s health, 21 (1), 28-33. https://dx.doi.org/10.1016/j.nwh.2016.12.008
Victora, C., Bahl, R., Barros, A., Franca, G., Horton, S., Krasevec, J., Murch, S., Sankar, M., Walker, N., and Rollins, N. (2016). Breastfeeding in the 21st century: epidemiology, mechanisms, and lifelong effect. https://doi.org/10.1016/S0140-6736(15)01024-7
World Health Organization. (2015). WHO statement on cesarean section rates. Retrieved from https://apps.who.int/iris/bitstream/handle/10665/161442/WHO_RHR_15.02_eng.pdf?sequence=1