An exploration of the breastfeeding behaviors of women after cesarean section: A qualitative study

Objectives: To explore the factors affecting breastfeeding behaviors in women after cesarean section. Methods: This is a qualitative study that used a phenomenological approach. This study used individual face-to-face interviews with 19 women who underwent a cesarean section in a Women and Children's Hospital in China between July to September 2019. Information saturation was used to determine sample size. Data were analyzed using a thematic content analysis method. Themes were developed based on the theory of planned behavior. Results: Thirteen (68.42%) had a planned cesarean section, and six (31.58%) cesarean sections were unplanned or emergent. Three major themes emerged: ambivalent attitude about breastfeeding, motivation to comply with the traditional cultural norms, and barriers and challenges. The motivating factors for breastfeeding after cesarean sections included perceived benefits of human milk, support from healthcare professionals, and responsibility for breastfeeding. The challenges for breastfeeding after cesarean sections included physical discomfort, knowledge and skills deficit of breastfeeding, lactation deficiency, and lack of knowledge and coping skills in managing their depressive mood after cesarean sections. There were a couple of neutral factors, such as the influences of family and peers. These factors could influence women either positively as facilitators or negatively as barriers. Conclusions: The findings can offer valuable information for healthcare professionals to help women breastfeed after cesarean sections. To promote women's breastfeeding behaviors after cesarean sections, it is necessary to change women's attitudes, belief systems, and the external environments and help them become more confident. (C) 2020 The authors. Published by Elsevier B.V. on behalf of the Chinese Nursing Association.