Abstract:
This prospective non-experimental study was conducted to explore the impact of unplanned cesarean section delivery on breastfeeding self-efficacy and breastfeeding outcomes for first time mothers when the Centers for Disease Control and Prevention (CDC) recommendations to support breastfeeding were implemented. First time mothers experiencing an unplanned cesarean section were compared to first time mothers delivering vaginally on breastfeeding self-efficacy scores and breastfeeding outcomes at 10 days and 8 weeks postpartum. A sample of 250 mothers was recruited for the study at 24 to 48 hours postpartum. Follow-up surveys of breastfeeding self-efficacy and breastfeeding outcomes were mailed to the mothers' homes for completion and to return to the researcher at 10 days and 8 weeks postpartum. Although the initial data were rich in descriptive characteristics of the mothers, attrition at 10 days and 8 weeks was high, resulting in a return rate of less than 50%. At 10 days postpartum, 134 surveys were returned, and at 8 weeks, 111 surveys were returned, yielding only 93 complete sets of data. The data were evaluated with multiple regression, ANOVA, ANCOVA, and chi-square analysis to compare the two groups, cesarean birth mothers and vaginal birth mothers, on breastfeeding self-efficacy and breastfeeding outcomes. Results indicated little significant difference in breastfeeding self-efficacy and breastfeeding outcomes between the groups. Although there were several significant correlations between the recommended practices of the CDC in the Maternal Practices and Infant Nutritional Care variables (mPINC), Breastfeeding Self-Efficacy (BFSE) scores, and breastfeeding outcomes, the overall models only indicated time to the first feeding and the number of supplemental feedings impacted the mothers' breastfeeding self-efficacy. Future breastfeeding studies should be conducted using an intervention to increase breastfeeding self-efficacy, and thus positive breastfeeding outcomes.
