Impact of birth trauma on breast-feeding: a tale of two pathways.

BACKGROUND Up to 34% of new mothers have reported experiencing a traumatic childbirth. Documented risk factors for delayed or failed lactogenesis include stressful labor and delivery, unscheduled cesarean births, and psychosocial stress and pain related to childbirth. OBJECTIVE To explore the impact of birth trauma on mothers' breast-feeding experiences. METHODS Phenomenology was the qualitative research design used to investigate mothers' breast-feeding experiences after birth trauma. Fifty-two women were recruited over the Internet through the assistance of Trauma and Birth Stress, a charitable trust located in New Zealand. Each mother sent her breast-feeding story to the researchers via the Internet. Colaizzi's (1978) method was used to analyze the data. RESULTS Eight themes emerged about whether mothers' breast-feeding attempts were promoted or impeded. These themes included (a) proving oneself as a mother: sheer determination to succeed, (b) making up for an awful arrival: atonement to the baby, (c) helping to heal mentally: time-out from the pain in one's head, (d) just one more thing to be violated: mothers' breasts, (e) enduring the physical pain: seeming at times an insurmountable ordeal, (f) dangerous mix: birth trauma and insufficient milk supply, (g) intruding flashbacks: stealing anticipated joy, and (h) disturbing detachment: an empty affair. CONCLUSIONS The impact of birth trauma on mothers' breast-feeding experiences can lead women down two strikingly different paths. One path can propel women into persevering in breast-feeding, whereas the other path can lead to distressing impediments that curtailed women's breast-feeding attempts.