Australian Women's Experiences of Establishing Breastfeeding after Caesarean Birth

Q: How does the type of caesarean delivery influence the timing of breastfeeding initiation?

Based on this study's findings, women undergoing non-elective caesarean births had half the odds (OR = 0.50) of early breastfeeding initiation compared to elective cases. This delay is often linked to the increased physical and emotional stress associated with emergency surgical procedures.

Q: What was the likelihood of a negative birth experience following an unplanned caesarean section?

The researchers found that women who had a non-elective caesarean birth were ten times more likely to report a negative birth experience (OR = 10.2). This significant statistical finding highlights the psychological impact of emergency surgical interventions on postpartum recovery.

Q: Why was a mixed-methods approach used to evaluate the experiences of Australian mothers?

The study used a mixed-methods design to combine quantitative multivariable models with qualitative inductive thematic analysis. This enabled the researchers to identify statistical associations, such as higher formula use in private hospitals (OR = 1.67), while capturing personal barriers like conflicting clinical care.

Q: To what extent was skin-to-skin contact achieved during the first feeding in this study?

The findings are constrained by the observation that fewer than 50% of the 961 participants reported skin-to-skin contact (SSC) during breastfeeding initiation. This indicates that the results primarily reflect experiences where this standard practice was not consistently implemented after surgical birth.

Q: What changes to clinical care do the authors recommend to support post-surgical lactation?

The study's authors propose that clinical staffing and care protocols should be modified to ensure mothers have full access to partner support. This recommendation aims to address the specific physical needs, such as reduced mobility and pain, that hinder breastfeeding after a caesarean birth.

Sharon L Perrella^1,2,3, Sarah G Abelha^1,4, Philip Vlaskovsky⁵

¹School of Molecular Sciences, The University of Western Australia, Crawley, WA 6009, Australia.

International Journal of Environmental Research and Public Health

|March 28, 2024

Breastfeeding exclusivity and duration rates are lower after caesarean birth, yet the factors contributing to these are not well understood. This mixed-methods study used an anonymous online questionnaire to examine the facilitators and barriers to establishing breastfeeding as identified by Australian women after a caesarean birth. Quantitative data were reported using descriptive statistics, and multivariable models were used to determine the factors associated with breastfeeding outcomes including the timing of breastfeeding initiation, birth experience, and commercial infant formula use. Qualitative data were analysed using an inductive thematic analysis. Data were obtained for N = 961 women, of which <50% reported skin-to-skin contact during breastfeeding initiation. The barriers to breastfeeding included aspects of clinical care and reduced mobility, while unrushed care, partner support, and physical help with picking up the baby were helpful. Following a non-elective caesarean birth, women had half the odds of early breastfeeding initiation (OR = 0.50; 95% CI: 0.36, 0.68; p ≤ 0.001) and 10 times the odds to report a negative birth experience (OR = 10.2; 95% CI: 6.88, 15.43; p < 0.001). Commercial milk formula use was higher in primiparous women (OR = 2.16; 95% CI: 1.60, 2.91; p < 0.001) and in those that birthed in a private hospital (OR = 1.67; 95% CI: 1.25, 2.32; p = 0.001). Pain and reduced mobility, as well as conflicting and rushed care, negatively impacted breastfeeding after a caesarean birth, while delayed breastfeeding initiation, higher pain ratings, and negative birth experiences were more common for women that birthed by non-elective caesarean. This study adds valuable insights into the physical, emotional, and clinical care needs of women in establishing breastfeeding after a surgical birth. Clinical staffing and care should be modified to include full access to partner support to meet the specific needs of breastfeeding women after a caesarean birth.

Keywords:

birth breastfeeding caesarean lactation midwifery postpartum

Frequently Asked Questions

Based on this study's findings, women undergoing non-elective caesarean births had half the odds (OR = 0.50) of early breastfeeding initiation compared to elective cases. This delay is often linked to the increased physical and emotional stress associated with emergency surgical procedures.

The researchers found that women who had a non-elective caesarean birth were ten times more likely to report a negative birth experience (OR = 10.2). This significant statistical finding highlights the psychological impact of emergency surgical interventions on postpartum recovery.

The study used a mixed-methods design to combine quantitative multivariable models with qualitative inductive thematic analysis. This enabled the researchers to identify statistical associations, such as higher formula use in private hospitals (OR = 1.67), while capturing personal barriers like conflicting clinical care.

The findings are constrained by the observation that fewer than 50% of the 961 participants reported skin-to-skin contact (SSC) during breastfeeding initiation. This indicates that the results primarily reflect experiences where this standard practice was not consistently implemented after surgical birth.

The study's authors propose that clinical staffing and care protocols should be modified to ensure mothers have full access to partner support. This recommendation aims to address the specific physical needs, such as reduced mobility and pain, that hinder breastfeeding after a caesarean birth.

Related Concept Videos