I have been interested in all the various posts surrounding breastfeeding
and cesarean. We all see such different segments of the population. The
newborns that come to my practice  tend to be referrals from the homebirth
midwives; a select group that is very different than when I was working in
the urgent care and VERY different from my residency training ( I wasn't
exposed to homebirth  in residency.) And of course it would be very
different than what I saw in the NICU. I tend to see babies of mothers of
four or more, post dates, extended breastfeeding is a given, and natural
family planning. Minimal intervention is standard. The few midwife's
patients who did end up with a cesarean or who had a previous cesarean also
come to me and express much grief.  I think a rotation for residents and
students with a population like mine would be enlightening.

I do appreciate all the different points of view shared

Regarding this statement previously posted on lactnet:

>>>Don't have any studies to quote but how can we forget the huge maternal
>>>and
fetal mortality before the advent of c-sections and modern medicine>>>

I have found this study that supports that a woman is twice more likely to
die during a cesarean. Bewley S. Maternal mortality and mode of delivery.
Lancet 1999; 354: 776


Ina May Gaskins in her book Guide to Childbirth ( a must read for anyone
interested in this tread) also discusses the earliest mortality data
accumulated by midwives and physicians (some of it from preserved jpersonal
journals a couple hundred years old). It seems that midwifery model has
always had a safer record then the medical model of birth.  Before any
recorded data I can only assume vaginal birth (and breastfeeding!) works
because we as humans have done a great job population the earth.  The CDC
released US Birth Data for 2003 and the total Cesarean Rate was  27.6% (up
6% from 2002). Looking at it from the other way... I have a hard time
believing that 27% of woman were dying in childbirth before we doctors
mastered the cesarean and we still managed to populate the world. Many
cesareans are planned at the time of positive  HCG (no kidding) or coerced
with fear near the end of pregnancy with suspect diagnoses like low fluid or
SGA following a failed induction to add up to 27%.


Denise Punger MD FAAFP IBCLC, private practice, mother of three boys who
breastfeeds 6 plus  years and tandem, and had a successful undiagnosed
double footling breech birth at a planned homebirth has proved to me to take
a second look at what I have been previously taught.

Fort Pierce, Florida
http://denisepunger.tripod.com

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