Saturday, December 13, 2008

How A C-Section Affects Breastfeeding

Did you know that a woman who has a c-section is only half as likely to breastfeed her baby as a woman who has had a vaginal birth?

I was invited to speak to a group of new mothers about breastfeeding in public this last week. I met several great women and am grateful for the opportunity to be working with new moms. Nearly half of these women had had c-sections and only one of them (of the women that had a c-section) was breastfeeding.

First of all, the c-section rates in North Texas were well represented in this group -- about 50%. At a local Arlington hospital, holding steady at a 60% c-section rate, 2 out of 3 of the women that had delivered there had c-sections. The one that did have a vaginal birth said she almost had a c-section.

I was called Friday night to go visit a woman from Russia who is having trouble breastfeeding. She had a c-section. I had plans with my husband, so I have not seen her yet. I hope that by the time I see her she has not resorted to bottle feeding.

So why is this? To begin with, so many c-sections are performed at 38 weeks. If the woman would have been "allowed" to start labor on her own, she might have been pregnant for several more weeks, allowing her baby more time to be ready to suck. It would also ensure that her body gets the message that it is time to make milk for this new baby.

Labor serves a purpose. We pretend, in this country, that it doesn't. We do everything we can to just skip it all together, whether it's through a c-section or an epidural. Rarely do women actually experience labor. Labor is a bridge between pregnancy and being this baby's mother. It is so important! In fact, I always tell my students not to hope for a short labor, but rather a longer one that allows for them to enjoy the journey and process the event. You appreciate the baby so much more when you have worked hard through labor to get the baby here. You trust yourself to parent your baby and your breasts to provide nourishment. A woman who has had a c-section has just learned to not trust her body -- that, even though it is likely not true, even subconsciously, her body doesn't work right. Doctors are very much to blame for this occurance -- "failure to progress" being the number one reason for a c-section sums it up. They have just told this woman that her body has "failed."

There are hormones that occur when labor begins on its own. When a woman is induced with pitocin, these hormones do not occur naturally. Naturally occurring oxytocin crosses a blood-brain barrier that gives the laboring woman endorphins to help her cope with labor. When a woman is induced with pitocin, the uterus is forced to contract harder, longer, and closer together than it would with regular contractions. The baby knows the difference, as seen in so many fetal distress c-sections that occur because of the pitocin. A woman who is induced is twice as likely to have a c-section than a woman who starts labor on her own. Her body simply wasn't ready to give birth.

One of the purposes of labor is to send a message to the breasts that the baby will be here soon and it will be time to feed the baby colostrum. Obviously, in a woman that never experiences a single contraction and has her baby surgically removed from her body, her breasts didn't get that message. They will over the course of several days, but she may have given up breastfeeding by then. She will need lots of encouragement and support by other women who are knowledgeable about breastfeeding, and frankly, most women don't have this support system.

Some babies are not ready to nurse when born too early. The baby could easily have needed another month in the womb. This can contribute to a woman giving up on breastfeeding. A baby must work to breastfeed -- which is so good for them for so many reasons -- and with a bottle, they don't have to work nearly as hard. If they receive a bottle early on, they may not want to work later.

When a mother gives birth without medication, the oxytocin (love hormone) is the highest it will ever be in her life right after giving birth. This is the time that she falls in love with her baby. Mother and baby must be kept together to breastfeed and bond during this time. How sad to miss that opportunity, whether by drugs that inhibited the natural process, a c-section, or stupid nurses that thought the baby needed to be weighed and bathed immediately after birth. Fight for this critical time with your baby!

Many babies receive a bottle early on after being delivered via c-section. The mother is often not feeling well -- go figure -- and someone else takes care of the baby besides the mother, which means feeding the baby a bottle.

Ultimately, women need more information on breastfeeding. And why a c-section is so much more far-reaching than just a (bad) way of getting your baby out of your body. My number one piece of advice in avoiding a c-section? Do not get induced and do not have drugs in labor. I teach an entire class on avoiding a c-section, but none of it matters if you have drugs in your system. There are so many things you can do, but not if you can't move and have subjected your body to drugs that inhibited labor from progressing the way it needs to.

Ladies, trust your bodies to birth your babies and breastfeed them when they arrive. You were made to do this. And if you have trouble, there are so many women who want to help you succeed. If the first one doesn't help, find someone else. All lactation consultants are not created equal. Some are better than others. A La Leche League leader will be able to help you. Seek her out.

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