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  • Chicago Birthworks Collective

How Your Birth Impacts Breastfeeding

A doula’s support through labor and delivery will provide a positive start to your breastfeeding journey.

If you plan to breastfeed, you’re probably preparing during pregnancy to set yourself up for success. You’re likely reading up on breastfeeding, gathering items like a breastfeeding pillow and nipple cream or maybe you’re even taking a class.

But what about hiring a doula? A 2013 study found that mothers who had doula support were more likely to start breastfeeding. Working with a doula is an essential part of the breastfeeding process. Here’s why:

No matter how you give birth, you can breastfeed.

We want to trust our medical providers and that they will choose what’s best for us, but that’s not always the case. It’s important that you understand the impact that birth interventions can have on your birthing process and breastfeeding...

Induction of labor, continuous fetal monitoring and assisted delivery through forceps, vacuum and C-section can affect your breastfeeding. In a normal, low-risk pregnancy where the baby is well-positioned and there isn’t a medical reason to intervene, these medications and devices are not necessary.

Engaging a doula can help you avoid some of these birth interventions. Also, take some time to research recommendations from the American College of Obstetricians and Gynecologists and the American College of Nurse-Midwives. These are the guidelines your provider should be following.

For lactation to be successful, all the psychological, social and physiological aspects must work together. The mind is an integral part of breastfeeding — your mental health and your support system will affect the process. No matter what type of birth you have, a doula will consider your mental state and be a part of your support system during pregnancy, labor, delivery and postpartum, giving you the best possible start to breastfeeding.

Inducing labor can impact the hormones needed for lactation.

During induction, the cervix is artificially softened and dilated with medication, physical devices like a Foley bulb or artificial oxytocin known as Pitocin. Your body needs oxytocin, prolactin and other hormones to kickstart the creation of colostrum after the placenta is delivered. That natural hormonal process is disrupted during an induction, so your body doesn’t always realize that it’s time to create more oxytocin to begin lactation. A doula can support you with a natural start to labor that upholds your body’s natural hormonal process.

Even talking about a set deadline for induction with your provider can weigh on your mind as you prepare to give birth and breastfeed. Have a discussion with your provider about any risk factors and what you can do mentally and physically to manage them. A doula can also help manage and monitor risk factors, ultimately preventing the need for induction and other birth interventions.

Continuous fetal monitoring typically isn’t necessary.

Weigh the risks and benefits of continuous monitoring. Many women may think, “what’s the harm in listening to the baby?” Well, when you’re continuously monitoring contractions and tracking the baby’s response, there is a risk that the results of monitoring may lead to medical interventions that can impact breastfeeding.

When your uterus contracts, your baby’s heart rate will naturally accelerate and decelerate. Your body needs to undergo hormonal and chemical changes to get the baby out, and sometimes that can change the baby’s heart rate. In a hospital setting, a provider may jump to interventions too quickly based on monitoring alone, without assessing other factors — for example, different positioning can allow the baby to tolerate contractions better.

Know that you can request intermittent fetal monitoring. A midwife will listen with a doppler intermittently to see whether the baby’s heart rate responds appropriately to contractions. She will also consider all the different factors that may affect the baby’s heart rate, such as your nutrition, hydration, movement and positioning. A doula can help guide this process and support you to make sure you’re eating, drinking, in the best position and feeling comfortable mentally and physically.

Assisted labor and delivery can impact breastfeeding.

Assisted labor (using devices like forceps or vacuum) when it’s not necessary or without trying different positioning can affect breastfeeding. When you have assistance with delivery, you often build up a lot of adrenaline. You and your baby may feel that stress — after all, you’ve both just been through a lot. These physical and mental feelings can make initial breastfeeding harder.

During labor or pushing, a doula can help you reposition to most effectively move the baby down the birth canal and prevent interventions. Without unnecessary assistance, you’ll also feel more comfortable, empowered and have a greater sense of privacy with fewer health providers involved.

In a hospital setting, your doctor or nurse may push breastfeeding immediately after delivery. But delivery can sometimes feel shocking or surprising, and you may need time to calm down and be in a good mental space before focusing on initiating breastfeeding.

Even if your “golden hour” doesn’t happen as soon as your baby is placed on your chest, your doula can give you the comfort and privacy to start breastfeeding when you’re ready. She will survey the room and bring a sense of quiet and calm. Your doula can help your oxytocin kick in by reassuring you with her support and knowledge.

You need to feel safe and have your physical needs met.

As a mother, you must feel safe, whole and alert to allow your body to make the necessary hormonal changes for successful breastfeeding. You need to have your physical needs met, and a doula can ensure that you are fully supported through labor and delivery.

Leaving your home to give birth in a hospital can impact how safe you feel. When you are away from your comfort items and sense of community, it can be harder to feel comfortable, both physically and mentally. A doula will help you move and position yourself, as well as offer comfort and encourage rest.

Your doula will support your physical needs for food, hydration and movement. A hospital often restricts you from eating during labor to prevent vomiting and aspiration in the case of an emergency C-section. But withholding food is unnecessary because you can receive anti-nausea IV medication during a C-section, and food can actually help prevent vomiting. More importantly, not eating can have a negative effect on your ability to labor.

The hospital may also require intravenous fluids. Instead, request a hep-lock be inserted in case an IV is needed and focus on drinking water to stay hydrated. Without an IV, you’ll be able to move freely.

Your doula will encourage you to be your own advocate — speak up, ask questions and make requests. If mothers were given better information about risks and benefits, they might make different decisions. A doula can help guide you to work within a hospital’s system of rules.

Surround yourself with people who know about breastfeeding.

Having a doula by your side means you have someone well-versed in breastfeeding in the immediate postpartum period, right after birth and for those first feedings. She can check the latch, encourage frequent (not timed) feedings and show you how to do hand expression. A postpartum doula will know what’s normal and when you might need to supplement or seek more help. Her breastfeeding support at this point is crucial for your success.

Your doula understands the connection between birth and breastfeeding. She knows there are physical, social and mental factors involved. To keep you from doubt and stress, a doula will give you encouragement and information, share stories and experiences and help you through this incredible time of transition.

If you’d like to learn more about working with a doula, connect with Chicago Birthworks Collective about our doula packages that offer pregnancy, birth and lactation support.

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