Impact of Antenatal Depression, Anxiety and Mode of Birth on Breastfeeding Outcomes

BACKGROUND: Breastfeeding rates and duration have been linked to a variety of factors, including mode of birth and maternal psychopathology. Although the research on mode of birth has focused primarily on caesarean sections and produced conflicting results, the research on psychopathology has primarily been undertaken in postnatal women. Furthermore, no study has explored whether mode of birth may moderate the relationship between maternal psychopathology and breastfeeding rates and duration. AIMS: To evaluate the impact of mode of birth (caesarean section, spontaneous vaginal birth, instrumental birth) and antenatal maternal psychopathology (depression and anxiety symptoms) on breastfeeding in a sample of new mothers. DESIGN: A longitudinal study design was employed to collect data during pregnancy, at 10 weeks post-partum, and at 10-months post-partum. METHODS: Participants were 488 women booked in to give birth at a Private Hospital in North Sydney, Australia. Participants completed self-report questionnaires relating to maternal depression, anxiety, and breastfeeding during pregnancy and at 10-weeks and 9-months post-partum. Details about mode of birth and breastfeeding during the immediate postnatal stay were extracted from hospital records. RESULTS: Older maternal age and primiparity were associated with lower breastfeeding rates and duration at hospital discharge, 10-weeks and 9-months post-partum. No associations were observed between mode of delivery or antenatal depression/anxiety symptoms and breastfeeding. CONCLUSION: For Australian women who give birth in the private system, risk factors for poorer breastfeeding outcomes include older age and primiparity. Women who present with these characteristics may benefit from targeted breastfeeding support.