Caesarean Doulas: Implications for Breastfeeding at 24th Annual International Breastfeeding Conference & Nutrition and Nurture in Infancy and Childhood: Bio-Cultural Perspectives

Upcoming 24th Annual International Breastfeeding Conference & Nutrition and Nurture in Infancy and Childhood: Bio-Cultural Perspectives presenter Emily Clark MA, CLC, CD (DONA), CPD says attendees won’t be surprised by her message: Women who birth their babies by surgery require just as much emotional and physical support as women who birth vaginally. Clark makes clear her presentation–Caesarean Doulas: Implications for Breastfeeding— is not a presentation about doulas being “magical.” The idea is that when women are empowered during the birth process, we are empowered in our postpartum experience.

“C-section birth can be empowering…when it’s treated as a birth experience and not a medical event,” Clark explains. She calls for the use of medical safety nets during these major surgeries without diminishing the pieces of the birth experience allow mothers empowerment, like breastfeeding for example.

Exploring and growing research

Current research clearly supports doula services. Doulas are a low cost intervention to some of the biggest problems, especially in minority and low-income groups. In her presentation, Clark will explore the reasons why the research shows the benefits of doula support, like how doulas can help facilitate early, continuous skin-to-skin contact.

“I really want to offer attendees solid pieces of information to bring back to their clients, clinics and hospitals,” she says.

Still, Clark acknowledges “huge gaps in maternal infant health research.” She’s eager to see more research surrounding doulas’ and labor support’s effect on breastfeeding outcomes. Clark celebrates the work of  Katy Kozhimannil, PhD, MPA  and Amy Gilliland,  Ph,D., BDT(DONA)  who have spearheaded birth empowerment research.

“I am hungry to get numbers out in the world,” Clark says.

Dissecting health outcomes

Switzerland’s c-section rate is similar to that of the United State’s, hovering around 32 percent;  yet Switzerland’s maternal infant mortality rate remains much lower.

Clark explains that Switzerland’s c-section rate is “probably a product of choice;” that is the highest c-section rates are at private clinics with elective surgeries accounting for 60 to 70 percent, she reports.

“In the U.S., I think there are a lot more layers, and it’s a bit more complicated,” Clark goes on.

First, there’s a culture of fear of litigation in the U.S. Additionally, most low risk births are attended by high risk specialists. There’s a connection between high intervention births and high maternal infant mortality rates. Often low income populations are subject to these high intervention births coupled with little or no access to perinatal support.

“This simply doesn’t happen in Switzerland,” Clark says.

In Switzerland, uncomplicated, vaginal births are attended by midwives; evidence shows mothers in the care of midwives experience better health outcomes. What’s more, the country’s universal health insurance covers all women with extensive perinatal care including six weeks worth of prearranged postpartum, home care from midwives and lactation specialists.

“It’s a tremendously supportive environment,” Clark says.

Reaching at-risk populations

Reflecting on her work as a private practice professional, Clark recognizes that she reaches women who have the means to hire her. Mindful of striking health disparities, she connected with Nurture Project International to reach underserved populations, specifically mothers and children in the refugee camps of Thessaloniki, Greece this summer.

“What struck me most was the incredible resilience of this population,” says Clark.

In a situation where families have lost everything and their futures unpredictable, Clark still witnessed women giving life.

“These women have had to rely heavily on others…When they can provide nutrition for their children… that is incredibly empowering,” she observes. “[It] gives them some joy and some power in this really awful situation.”

Clark emphasizes that the risks of infant formula in crises magnify. Infant feeding choice amounts to life and death.

“There are people everywhere who feel really cut off from support and don’t have access to [vital] kinds of services,” she says. She encourages health advocates to “look in their own backyard” for migrant and refugee populations in need of health services.

Connecting and collaborating

Looking ahead to the International Breastfeeding and MAINN Conference, Clark says she’s excited to connect personally with like-minded individuals with whom she’s only had email conversations with or seen their names on papers.

“And obviously I’m really excited about a lot of the [presenters’] topics,” she adds. “It’s exciting to see what we can do together.”

Join Clark and others at the upcoming conference. Click here for more information.

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