Effect Of Cesarean Section On Postpartum Lactation

Objectives To compare the differences of cesarean section and natural childbirth on the impact of postpartum lactation, and to determine the effect of cesarean section on postpartum lactation.Methods With informed consent, 1 148 hospitalized women for delivery were selected as the participants. The following data were collected by face-to-face survey: socio-demographic characteristics; maternal mental health during pregnancy, including anxiety symptoms (assessed by self-rating anxiety scale), depressive symptoms (using epidemiological survey assessed with the Depression Scale); pregnancy complications; delivery records, including childbirth complications, delivery mode, neonatal gestational age, birth weight, Apgar score and postpartum breastfeeding and interval between breast engorgement and delivery. Demographic characteristics, parity and maternal lactation were described. Prevalance of immediate postpartum breastfeeding, starting time and frequencies of breastfeeding, time of breast engorgement, self-assessed breast milk were compared between cesarean section and vaginal delivery group.Results Starting frequencies of breastfeeding of primipara(92.4%, 935/1 012) was higher than multipara(86.0%, 117/136), the difference was statistically significant(χ~2=6.332, P=0.012); there's no significant difference(χ~2=0.908, P=0.341) of breast engorgement between primipara(69.5%, 703/1012) and multipara(69.4%, 89/136) group; Starting frequencies of breastfeeding of cesarean section group(91.7%, 575/627) and vaginal delivery group(91.6%, 477/521) was no significant difference in the incidence(χ~2=0.009, P=0.926), starting time of breastfeeding of cesarean section groups(36.98±23.9h) were later than vaginal delivery group(28.60±22.3h), the difference was significant(t=5.880, P=0.000). Frequencies of breast engorgement of caesarean section group(75.4%, 473/627) was higher than vaginal delivery group(61.2%, 319/521), the difference was statistically significant (χ2=26.858, P=0.000), starting time of breast engorgement of Caesarean section groups(57.31±21.9h) were later than vaginal delivery group(52.12±18.9h), the difference was statistically significant(t =3.548, P= 0.000); Cochran's and Mantel-Haenszel statistics showed that: after eliminating confounding effects, there's no significant difference of strarting frequencies of breast engorgement between cesarean section group and vaginal delivery group (χ2MH=0.004, P=0.962), and comparing vaginal delivery group, strarting frequencies of galactoplerosis of Caesarean section group were 1.936 times (χ2MH=25.710, P=0.000). Average frequencies of breastfeeding were higher in newborns with normal delivery than those with cesarean section. More self-assessed volumn of breast milk was reported in women with normal delivery 1 day after delivery than those with cesarean section.Conclusions Cesarean section delivery of maternal milk in the open place to start and breast fullness of time than natural delivery delay indicator of maternal.