Danny Hirsch asked about C/S versus spontaneous vaginal birth (SVD) and the
impact of C/S on breastfeeding. Here's a brief overview:
The mechanical / physical barriers are automatically higher with any C/S
birth. Even true emergency C/S births result in more maternal pain, more
fear, more drugs for the baby to metabolize (including antibiotics which
increase risk of thrush), and less mobility for her - all of which affect
breastfeeding. Post birth, she has to deal with her own non-trivial pain
including gastric problems, bladder catheter, IV, and even respiratory
support in some moms. Trying to position a newborn at breast is always a bit
of a challenge. A painful abdominal incision makes it all the harder and
limits some positions she can use, unless she uses even more pillows - which
can be awkward, especially for heavy women or those with short arms and/or
large breasts. More women die from C/S births than vaginal births. Even a
4th degree episiotomy is less painful that major abdominal surgery. It takes
~6 weeks for the woman's body to heal from a SVD - with a C/S, she has all
that healing to do, PLUS repairing the enormous tissue damage from the C/S
itself.
And there's the potent, poisonous psychological messages - "You couldn't DO
birth, dearie - we had to cut the baby out of your incompetent body. Just
what makes you think your body will now work for breastfeeding?" (or its
variant, "You were a threat to your baby's life, so we had to rescue the
baby from your lethal clutches.") If mother was unconscious for the birth,
she has to deal with the "missing pieces" phenomenon.  Psychological factors
play a very strong role in a woman's decision to initiate breastfeeding, and
an even more potent role in her confidence to continue trusting herself to
provide enough milk for her baby.

BIRTH journal recently published an article about an increase post-traumatic
stress syndrome occurring in women who had traumatic C/S births. Creedy DK,
Shochet IA, Horsfall J. Childbirth and the development of acute trauma
symptoms: incidence and contributing factors. Birth 2000; 72(2):104-111.

Linda J. Smith, BSE, FACCE, IBCLC
Bright Future Lactation Resource Centre www.bflrc.com
6540 Cedarview Ct., Dayton, OH 45459-1214 USA
(937) 438-9458 email [log in to unmask]

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