The fact that these mothers are concerned about the affect their births will have on their breastfeeding experiences seems to indicate that they are motivated to breastfeed, and will likely do well regardless of the course they choose.  That said, I was faced with exactly the same choice with my daughter.  At 37 weeks my midwife (actually a substitute for my original midwife) suspected that my baby was breech, and confirmed she was frank breech using ultrasound.  They pretty much wanted me to schedule a date for surgery as soon as they found out.  I too was concerned about possible negative effects on breastfeeding, such as the baby being born too early with "wet lungs" and being separated.  As well as having to face the VBAC battle in the future.  Over the course of the next few weeks we attempted two external versions and multiple sessions of chiropractic care (Webster technique) and acupuncture; with no luck.  Our final arrangement was to schedule a third external version about four days past my due date in the hospital with an epidural in place.  The idea being that one, the epidural would relax the uterine muscles more and two, if it didn't work then we would go into surgery.  Luckily (I guess) I went into labor on my due date.  First time moms often have the sense that labor is an "emergency", and that it happens very quickly.  If they live in a city of a decent size and within easy driving to their hospital they should have plenty of time to get there once labor begins.  As to whether they chose a vaginal birth or a c-section I think it is very important that they understand they DO have a choice.  Something that didn't really cross my mind at the time.  Oh, and I got to the hospital at maybe 9:30 at night and had the c-section done within an hour.  Staffing did not seem to be a problem.  I do think we experienced some initial problems breastfeeding due to the c-section; though we're now past the two year mark and still going strong.  I had tremendous pain for some time, possibly due to incorrect latch masked by the painkillers.  And to this day have vasospasms (though no longer with any pain).  Most hospitals in the US also will not allow rooming-in after a c-section if the woman is alone; at least till you can get up and walk.  Something else I didn't know.  The best little "primer" on c-sections I've heard was from a podcast, http://www.pregtastic.com/elective-cesarean-c-sections/.  It features Dr. Thomas Moore, Chair of Reproductive Medicine at University of California at San Diego and would be a good intro to the choices these women face.

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