Golden Hour perception in a public maternity hospital: challenges and potentialities under a multi-professional team’s vision

Dias, Juliana Rodrigues; Valete, Cristina Ortiz Sobrinho

doi:10.1590/1984-0462/2025/43/2025158

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ORIGINAL ARTICLE • Rev. paul. pediatr. 43 • 2025 • https://doi.org/10.1590/1984-0462/2025/43/2025158 linkcopy

Golden Hour perception in a public maternity hospital: challenges and potentialities under a multi-professional team’s vision

Percepção da Golden Hour numa maternidade pública: desafios e potencialidades sob o olhar de uma equipe multiprofissional

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective: The aim of this study was to investigate the self-perception of health professionals regarding the difficulties in the implementation of breastfeeding, skin-to-skin contact, and delayed cord clamping in the delivery room, and how difficulties and practices are related.

Methods: This is an observational, cross-sectional, and quantitative study conducted with health professionals who work in the delivery room in a public maternity hospital in the state of São Paulo. The questionnaire was self-answered in January 2025. The epidemiological characteristics of health professionals, and questions related to breastfeeding, skin-to-skin contact, and delayed cord clamping in the delivery room were analyzed. Descriptive statistics were performed. The cutoff to consider an item as a difficulty was an agreement below 50%. Difficulties with breastfeeding, skin-to-skin contact, and delayed cord clamping were analyzed through multiple correspondence analyses.

Results: A total of 75 health professionals were included. The lack of health professionals (38%), inadequate physical space (36%), and low adherence of obstetricians (34%) were considered difficulties. Correspondence analysis revealed that difficulties did not correspond to practices. Inadequate physical space and a lack of health professionals were correlated. When doctors indicate breastfeeding, they indicate delayed cord clamping, suggesting that these practices go hand in hand.

Conclusions: The findings suggest a lack of alignment among health professionals. Insufficient numbers of health professionals, physical limitations, and non-adherence of obstetricians are barriers to overcome. Breastfeeding and delayed cord clamping appear to be integrated practices. Other factors may influence these practices, as difficulties did not correspond with them.

Keywords:
Umbilical cord clamping; Breastfeeding; Humanizing delivery

Variable
Age in years (median /IQR)	32 (28-37)
Female sex (n/%)	69 (92)
Area of activity
Nurse (n/%)	11 (15)
Nursing assistant (n/%)	5 (7)
Nursing technician (n/%)	16 (21)
Physician (n/%)	43 (57)
Years of experience in the delivery room (n/%)
<1	16 (21)
1 to 2	13 (17)
2 to 10	37 (50)
>10	9 (12)
The highest level of training in the area (n/%)
Technician	21 (28)
Under graduation	34 (45)
Post-graduation lato sensu	16 (21)
Post-graduation stricto sensu	4 (6)

Variable	Agree (n/%)
Do you know the institutional GH protocol?	70 (93)
Do you think GH interventions are important?	74 (98)
Have you received any training about GH in the last year?	38 (50)
When the neonate does not need resuscitation, can the umbilical cord be clamped after 1–3 min?	71 (94)
Immediately after birth, should the neonate be put on skin-to-skin contact during the first hour?	70 (93)
Doctors generally recommend breastfeeding within the first hour	67 (89)
Doctors usually recommend skin-to-skin contact within the first hour	54 (72)
Doctors often recommend delayed cord clamping	57 (76)
Obstetricians generally request GH to be performed	26 (34)
Pediatricians generally request GH to be performed	50 (66)
Is the room temperature appropriate?	40 (53)
Is the number of health professionals adequate?	29 (38)
Is the physical space of the delivery room adequate for skin-to-skin contact and breastfeeding in the first hour? n (%)	27 (36)
Rarely, the clinical conditions of the neonate do not allow for delayed cord clamping	49 (65)
Rarely, the clinical conditions of the neonate do not allow skin-to-skin in the first hour of life	58 (77)
Rarely, the clinical conditions of the neonate do not allow breastfeeding in the first hour of life	50 (66)
Cesarean section should not prevent GH	64 (85)
The mother’s sedation does not interfere with GH. Mothers are not over-sedated	43 (57)
Mothers are tested for HIV; this is done at the hospital, and does not interfere with GH	50 (66)
Do you think women want to put their babies in skin-to-skin contact during the first hour?	53 (70)

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[1] IQR: Interquartile range.