Booby Traps Series: The c-section rate is at a record high. What does that mean for breastfeeding?

This is the 12th in a series of posts on Booby Traps,™ made possible by the generous support of Motherlove Herbal Company.

According to the CDC, the cesarean birth rate in the U.S. is at an all-time high.  It increased 71% between 1996 and 2007, rising from 21% to a record 32%.  During roughly the same period, the rate of vaginal birth after cesarean (VBAC) declined from 28% to 8.5%.  The World Health Organization recommends a cesarean rate no higher than 10-15%.

Back when the founders of La Leche League were having their babies mothers were sometimes told that breastfeeding after a cesarean was impossible.  Of course we now know that to be wrong, but the truth is that breastfeeding after a cesarean comes with particular challenges which can make it harder for mothers to meet their personal breastfeeding goals.

What are those challenges?  Linda Smith, in The Impact of Birthing Practices on Breastfeeding cites research showing that the following breastfeeding-related outcomes are associated with cesarean birth:

  • Significant delays in initiating the first feeding
  • Increased risk of separation from mother following birth, and increased risk of baby being admitted to the NICU
  • Delayed onset of mature milk supplies (“milk coming in”)
  • For babies:  altered sucking patterns, decreased neurological responses in the first two days, increased risk of respiratory problems in babies born by cesarean without labor, respiratory distress, low blood sugar, higher risk of infection in babies born by cesarean before 39 weeks gestation
  • For mothers:  a longer and more painful recovery, lower oxytocin and prolactin levels in the early postpartum period, increased risk of rehospitalization and infection, higher rates of anxiety and stress, higher risk of exposure to medications of concern
  • In elective cesarean without labor, reduced fetal endorphins and less endorphins (which act as pain killers) in breastmilk

And possibly as a consequence, research has found that mothers who have had cesarean births:

  • Are more likely to have stopped breastfeeding within the first two weeks postpartum
  • Are more likely to not be breastfeeding at 2 months

Cesarean section itself isn’t a Booby Trap,™ and there is no doubt that cesarean births are sometimes necessary to preserve the health of the mother and/or baby.

But birthing practices contributing to our record-high cesarean birth rate – practices like early elective birth and being denied the option of attempting a VBAC – are indeed institutional barriers to our breastfeeding success.

The good news is that with the right support, many mothers can overcome these challenges and meet their breastfeeding goals.  If you’re not sure how to get great support to both decrease your chances of a cesarean birth and to increase your chances of breastfeeding success if you do have one, please see our tips for assembling your A-Team.

I can speak from personal experience, having had one cesarean birth and one vaginal birth (VBAC).  Recovery from my cesarean birth was far more challenging both physically and emotionally, but both of my births were followed by wonderful breastfeeding experiences.

Did you have a cesarean birth?  Did it impact your breastfeeding experience?

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22 Comments | Last revised on 07/12/2011

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