Skin-to-Skin Contact, Cheek Contact and Episiotomy Pain Control

This randomized controlled experimental study was conducted at Izmir Bakircay University Cigli Regional Training and Research Hospital in Türkiye. A total of 155 healthy women who had spontaneous vaginal birth at term (≥37 weeks) and their healthy newborns were included. Eligible participants were aged 18 years and older, had no medical complications, and had newborns with Apgar scores ≥7 at 1 and 5 minutes. Participants were recruited during active labour and randomly assigned to three groups: kangaroo care group (skin-to-skin contact, n=50), cheek-to-cheek contact group (n=50), and control group receiving standard postpartum care (n=55). Randomization was performed using a computer-generated random number sequence, with allocation concealed in sealed, opaque envelopes. The kangaroo care group received immediate skin-to-skin contact between mother and newborn. The cheek-to-cheek contact group received structured cheek-to-cheek contact. The control group received routine postpartum care according to hospital protocols. Primary outcomes included pain levels assessed after episiotomy repair and at the 6th and 12th hours postpartum using the Verbal Rating Scale. Secondary outcomes included breastfeeding frequency, amount of local anesthesia used, and maternal satisfaction. Data were collected using structured questionnaires on sociodemographic and obstetric characteristics. Statistical analyses were performed using descriptive statistics, chi-square tests, one-way ANOVA, and Bonferroni post-hoc tests. All participants provided written informed consent prior to participation. The study was approved by the Izmir Bakircay University Non-Interventional Clinical Research Ethics Committee and conducted in accordance with the Declaration of Helsinki.

Inclusion criteria

• Women aged 18 years or older

Able to speak and understand Turkish

Singleton pregnancy at ≥37 gestational weeks

Spontaneous vaginal birth with mediolateral episiotomy

Mother and newborn clinically stable after birth

Newborn APGAR score ≥7 at 1 and 5 minutes

Willingness to participate and provision of informed consent

Exclusion criteria

• Operative vaginal birth (vacuum or forceps)

Third- or fourth-degree perineal tear or extensive perineal laceration

Epidural analgesia during labor

Maternal or neonatal complications requiring medical intervention

Conditions requiring maternal-infant separation after birth

Refusal to participate in the study