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C-section vs. natural delivery: is it a true need or a cultural issue?

The increase in cesarean sections is on the verge of a global epidemic. Though WHO recommends an optimal C-section rate of 10-15%, the United States’ C-section rate is more than 30%. In many Latin American countries, the procedure is skyrocketing, reaching more than 50% in some. While C-sections are lifesaving in some cases, they are increasing beyond recommended rates with harmful consequences for children’s health. Cesarean delivered children tend to be susceptible to infections, obesity, asthma and allergies. This occurs in part because many mothers are unable to successfully breastfeed them after a C-section. However, recent research shows that this may be culturally mediated. In some parts of the world, mothers are able to breastfeed successfully after C-section deliveries, and this practice may reduce their negative child health effects. Amanda Veile, an assistant professor of anthropology at Purdue University, and her team report that indigenous mothers in farming communities in Yucatán, Mexico, breastfeed for about 1.5 months longer following cesarean deliveries than they do following vaginal deliveries.

Veile believes this is possible because the mothers live in an exceptionally supportive breastfeeding environment. Her research features 10 research articles written by anthropologists, biologists and healthcare practitioners, which are available open access through spring 2019. In Veile’s study, she and her team compared breastfeeding durations and childhood infection rates based on how the child was born to Yucatec Maya farmers. Following 88 children from birth until age 5, the results show that those children born via C-sections were breastfed for about 2.7 years, whereas vaginally delivered children were breastfed for just over 2.5 years. There was no difference in infection rates between the two groups of children. Yucatec Maya women do experience post-cesarean challenges in the hospital environment, such as prolonged separation from their infants, latching issues and delayed milk let-down reflex. Still mothers overcome these challenges through determination, consumption of special foods, and the use of herbs and compresses. They also receive emotional support and breastfeeding advice from their family and friends.

Dr. Veile explained the issues found in this rural community: “Moms living in this Mexican community don’t have to hide in a bathroom to feed their child when they are in public. Here, it is a cultural norm to breastfeed anytime, anywhere, and to sustain breastfeeding for longer than two years. And we think that prolonged breastfeeding offers protective benefits that reduces some of the health problems we often see in children delivered by C-section. Besides, this is a powerful message supporting breastfeeding. We need to continue studying this issue, but it seems that these mothers, perhaps subconsciously, increased their breastfeeding efforts post-cesarean. Now that C-sections are becoming more universal, it is important to understand more about the consequences for children’s health in a variety of settings. This includes very rural communities worldwide that are transitioning to increased health care access, while simultaneously experiencing poor community sanitation and the double burden of malnutrition”.

  • Edited by Dr. Gianfrancesco Cormaci, PhD, specialist in Clinical Biochemistry.

Scientific references

Veile A et al. Amer J Hum Biol. 2019 Feb; e23228.

Veile A, Kramer KL. Amer J Hum Biol. 2017; 29(2).

Mueller NT et al. Int J Obes. 2017; 41(4):497-501.

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Dott. Gianfrancesco Cormaci
Dott. Gianfrancesco Cormaci
Laurea in Medicina e Chirurgia nel 1998; specialista in Biochimica Clinica dal 2002; dottorato in Neurobiologia nel 2006; Ex-ricercatore, ha trascorso 5 anni negli USA (2004-2008) alle dipendenze dell' NIH/NIDA e poi della Johns Hopkins University. Guardia medica presso la casa di Cura Sant'Agata a Catania. Medico penitenziario presso CC.SR. Cavadonna (SR) Si occupa di Medicina Preventiva personalizzata e intolleranze alimentari. Detentore di un brevetto per la fabbricazione di sfarinati gluten-free a partire da regolare farina di grano. Responsabile della sezione R&D della CoFood s.r.l. per la ricerca e sviluppo di nuovi prodotti alimentari, inclusi quelli a fini medici speciali.

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