Birth Interventions Related to Lower Rates of Exclusive Breastfeeding and Increased Risk of Postpartum Depression in a Large Sample

Overview: This study examines the impact of birth interventions, such as epidurals, inductions, pain medications, and cesarean sections, on breastfeeding and postpartum depression with a large sample of mothers.

Method: Data for the present analyses were from the Survey of Mothers' Sleep and Fatigue, a 253-item online survey of 6,410 mothers 0–12 months postpartum.

Findings: Mothers were significantly more likely to be breastfeeding if they had unassisted vaginal births, or did not have epidurals or other pain medication during labor. Mothers had higher depressive symptoms if they perceived that their labors were difficult and they experienced high levels of pain. They also had higher depressive symptoms if they had planned or emergency cesareans, but unplanned (nonemergent) cesareans were associated with lower levels. When multivariate analysis was conducted, only epidural, postpartum hemorrhage, and postpartum surgery were significantly related to depressive symptoms.

Conclusions: The type of birth a woman experiences influences breastfeeding and her emotional health. Contrary to previous findings, epidurals are associated with lower breastfeeding rates and higher rates of postpartum depression. Other birth interventions and complications, such as postpartum hemorrhage or surgery, have a negative impact as well.