• Susan Watt, Wendy Sword, Debbie Sheehan, Gary Foster, Lehana Thabane, Paul Krueger, and Christine Kurtz Landy.
• School of Social Work, McMaster University, Hamilton, ON, Canada. wattms@mcmaster.ca
• J Obstet Gynecol Neonatal Nurs. 2012 Nov 1;41(6):728-37.

ObjectiveTo report on the relationship between delivery method (cesarean vs. vaginal) and type (planned vs. unplanned) and breastfeeding initiation in hospital and continuation to 6 weeks postpartum as self-reported by study participants.DesignQuantitative sequential mixed methods design.SettingWomen were recruited from 11 hospital sites in Ontario, Canada.ParticipantsParticipants included 2,560 women age 16 years or older who delivered live, full-term, singleton infants.MethodsData were collected from an in-hospital questionnaire, hospital records, and a 6-week postpartum interview.ResultsNinety-two percent of women reported initiating breastfeeding, and 74% continued to 6 weeks. The method of delivery, when defined as cesarean versus vaginal, was not a determining factor in breastfeeding initiation in hospital or in the early postdischarge period. An unexpected delivery method (i.e., unplanned cesarean or instrument-assisted vaginal deliveries) was associated, at a statistically significant level, with an increased likelihood of initiating breastfeeding and continuation to 6 weeks postdischarge.ConclusionBreastfeeding can be considered a coping strategy that serves to normalize an abnormal experience and allows the individual to once again assume control. These unexpected results warrant further investigation to understand why women make the decision to initiate breastfeeding, why they choose to continue breastfeeding, and how they can be supported to achieve exclusive breastfeeding as recommended for infants in the first 6 months.© 2012 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses.

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