Find out what your practitioner's rates are for labor inductions, epidurals, C-sections, and VBACs (vaginal birth after cesarean), and compare the statistics between birthing centers and hospitals. Then choose the provider and hospital you are most comfortable with that has the lowest rates. Rates for all these procedures have dramatically increased in recent years without a corresponding increase or improvement in birth weight and birth outcomes.
Does this affect breastfeeding? It can. Take the C-section as an example. According to the Centers for Disease Control, as of 2004, the national C-section rate was an unprecedented 29.1 percent. Studies suggest that women who give birth via C-section are less likely to room-in with their babies and are less likely to be breastfeeding several weeks later. If you are in pain after childbirth, chances are it will be more difficult for you to focus on the needs of your baby.
Ask your provider how he or she can help you labor comfortably without using drugs. Find out if you can labor (and even birth) in a tub, if you can eat and drink for energy, and what kind of support you will have. Ask to have sporadic instead of continuous fetal monitoring, as you will be more able to labor comfortably if you have the freedom to move around. Remember that in most cases, the more gently you are treated, the more gently your baby is treated.
Locate a childbirth doula. Doulas offer emotional and physical support to women and provide various combinations of support before, during, and after the birth. Studies show that having a doula at your birth shortens labor, cuts in half the odds of having an unnecessary C-section, and helps women feel more satisfied about their birthing experiences. Having a doula in your birthing room can also help if you are faced with the need for an emergency C-section. She can help you be sure your baby stays as close to you as possible during your recovery and can help you nurse as soon as you are ready.
Find out what your hospital's postpartum policies are. Immediate skin-to-skin contact and being able to have your baby room-in with you increase breastfeeding's success. Drying the baby, assigning Apgar scores, and doing the initial assessment typically should be done while your baby is with you. You can also delay having your baby cleaned, weighed, measured, and bathed until after he or she has had a chance to nurse.
Request, in writing, that your baby be given no supplemental bottles of formula or glucose. Supplemental feedings of formula in the hospital have almost doubled in the past ten years and can derail nursing.
Attend a La Leche League meeting or breastfeeding class before giving birth, especially if you've never been around nursing mothers.
Overall, know your rights as a patient. You have the right to participate in decision-making involving you and your baby, and you have the right to know the benefits, risks, and hazards of drugs and procedures. Remember, as the authors of A Good Birth, A Safe Birth observe, "If you don't know your options, you don't have any."
In the end, remember that birth itself is not the end of your journey as a mother. It is a beginning. If you find yourself with an unplanned C-section, a difficult recovery, or nursing challenges of one type or another, help is available. Express your concerns to your doctor, midwife, nurse, or doula. A good lactation consultant can offer especially invaluable help, (look for the credential of IBCLC—International board certified lactation consultant). In fact, you may want to find one ahead of time; it's one more step you can take as you build the foundation for a successful nursing experience.
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