Closing the first-hour gap: nurse- and midwife-led interventions during the golden hour after birth and their impact on maternal and newborn outcomes

G. S. Nithya; Manjula A. K.; Neeta Devi; K. G. Jaganathan; N. Vedavathi; Neeraj; Renuka S.; Indumathi R.; Snehal Rajendra Londhe; Vimal Kumar Suthar; Mahaveer Bairag; Mohammed Umar

doi:10.18203/2349-3291.ijcp20263823

Authors

G. S. Nithya Department of Obstetrics and Gynaecological Nursing, K.G. College of Nursing, Coimbatore, Tamil Nadu, India
Manjula A. K. Department of Obstetrics and Gynaecological Nursing, Government College of Nursing, Kodagu Institute of Medical Sciences, Madikeri, Karnataka, India
Neeta Devi Department of Obstetrics and Gynaecological Nursing, National Institute of Nursing Education, P.G.I.M.E.R., Chandigarh, Punjab, India
K. G. Jaganathan Department of Medical Surgical Nursing, Sakthi College of Nursing, Coimbatore, Tamil Nadu, India
N. Vedavathi Department of Obstetrics and Gynaecological Nursing, Chettinad College of Nursing, Kelambakkam, Tamil Nadu, India
Neeraj Department of Mental Health Nursing, College of Nursing, Lady Hardinge Medical College, New Delhi, India
Renuka S. Department of Obstetrics and Gynaecological Nursing, K.M.C.H. College of Nursing, Coimbatore, Tamil Nadu, India
Indumathi R. Department of Obstetrics and Gynaecological Nursing, K.M.C.H. College of Nursing, Coimbatore, Tamil Nadu, India
Snehal Rajendra Londhe Department of Obstetrics and Gynaecological Nursing, Sindhutai Vikhe Patil College of Nursing, Nashik, Maharashtra, India
Vimal Kumar Suthar Department of Child Health Nursing, Genius College of Nursing, Bhilwara, Rajasthan, India
Mahaveer Bairag Department of Child Health Nursing, Genius College of Nursing, Bhilwara, Rajasthan, India
Mohammed Umar Department of Nursing, Uttar Pradesh University of Medical Sciences (U.P.U.M.S.), Saifai, Etawah, Uttar Pradesh, India

DOI:

https://doi.org/10.18203/2349-3291.ijcp20263823

Keywords:

Golden hour, Nursing care, Midwifery, Skin-to-skin contact, Early breastfeeding, Delayed cord clamping, Essential newborn care, Maternal outcomes, Neonatal outcomes, Systematic review

Abstract

The first hour after birth, commonly referred to as the golden hour, is a critical period for implementing evidence-based interventions that optimize maternal recovery and neonatal physiological adaptation. Nurses and midwives play a central role in delivering timely, coordinated care during this period through interventions such as immediate skin-to-skin contact, early initiation of breastfeeding, delayed umbilical cord clamping, thermal protection, maternal surveillance, infection prevention, and parental education. This systematic review aimed to synthesize current evidence on the effectiveness of nurse- and midwife-led golden hour interventions and their impact on maternal and newborn outcomes. A comprehensive search of PubMed, Scopus, Web of Science, CINAHL, and the Cochrane Library was conducted for studies published between January 2015 and June 2026, following the PRISMA 2020 guidelines. Eligible studies included randomized controlled trials, quasi-experimental studies, cohort studies, and observational studies evaluating golden hour interventions delivered by nurses or midwives. The evidence consistently demonstrated that these interventions improve breastfeeding initiation, neonatal thermoregulation, cardiorespiratory stability, maternal satisfaction, mother-infant bonding, and early detection of postpartum complications while reducing neonatal hypothermia, hypoglycemia, preventable morbidity, and unnecessary neonatal intensive care admissions. Delayed umbilical cord clamping also improved neonatal hemoglobin concentration and iron stores without increasing maternal adverse outcomes. Overall, nurse- and midwife-led golden hour care represents a safe, effective, and evidence-based approach to improving maternal and newborn health. Strengthening standardized protocols, workforce training, and implementation strategies may further enhance the quality, safety, and equity of postnatal care worldwide.

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