During the final weeks of pregnancy, your body is preparing for the birth of your baby. Hormones carefully coordinate the birthing process—from your earliest contractions and gradual cervical dilation to your baby's first latch after delivery. However, when medical interventions are introduced, they can alter this natural progression. While some interventions are essential for safety, using them without medical need can increase complications, affect birth outcomes, and influence breastfeeding success.

The American College of Obstetricians and Gynecologists (ACOG) notes that many common obstetric practices provide limited or uncertain benefit for low-risk women, and recommends that all interventions follow the best available evidence to support optimal outcomes for both mother and baby.

What Is a Birth Intervention?

An intervention is any medical procedure used for labor induction or augmentation, to manage labor pain, or assist with delivery. While such birth interventions can be life-saving, unnecessary procedures can lead to a cascade of additional procedures, sometimes interfering with skin-to-skin contact, the first latch, and early breastfeeding outcomes.

First Stage of Labor: How Interventions Affect Breastfeeding

This is when contractions intensify and cervical dilation occurs. It’s also when many birth interventions are first introduced.

Common Interventions

  • Induction of Labor: Using medications or procedures to start contractions.
  • Augmentation of Labor: Using medications or artificial rupture of membranes to speed up the progress of labor and delivery.
  • Continuous Electronic Fetal Monitoring (EFM): Used to monitor the baby’s fetal heart rate and the strength and frequency of mother's contractions.
  • Restriction of Oral or Food Intake: Limiting food or drink during labor, often intended to reduce aspiration risk, but generally unnecessary for most low-risk women.

Possible Benefits and Risks

  • Induction and Augmentation: Using oxytocin or breaking the amniotic sac can trigger stronger contractions, sometimes speeding up labor, but also potentially increasing the need for epidural analgesia or cesarean delivery. Studies link artificial oxytocin exposure to reduced newborn suckling reflexes, which may require more breastfeeding support in the early days.

  • Continuous EFM: While the use of continuous EFM is standard for high risk pregnancies, for most low-risk women, intermittent monitoring is equally safe and allows for upright positions and movement—both of which help with the progress of labor and mother's comfort.

  • Oral Intake: For women at low risk, the World Health Organization supports oral fluid and food intake during active labor to maintain energy and reduce fatigue.

Possible Effects on Breastfeeding

Birth interventions can sometimes affect early feedings by delaying skin-to-skin contact, altering the baby’s natural sucking reflex, or reducing maternal energy and alertness. Awareness of these effects allows care providers to offer targeted support, helping establish successful breastfeeding.

Second Stage of Labor: Birth and Immediate Breastfeeding

The second stage of labor, often called the pushing stage, begins when the cervix is fully dilated and ends with the birth of the baby as it moves through the birth canal.

Pain Relief and Anesthesia Options

Epidural anesthesia can provide effective pain relief, allowing you to remain awake and comfortable during delivery. However, epidurals can sometimes slow pushing efforts, leading to longer labor, necessitating oxytocin augmentation, or assisted vaginal delivery (forceps or vacuum).

Possible Benefits and Risks

While pain management can offer possible benefits—including reduced maternal stress and increased comfort—it also carries an increased risk of interventions such as instrumental delivery or cesarean delivery, both of which can influence early breastfeeding, including a delay in milk "coming in."

Possible Effects on Breastfeeding

Babies born after maternal epidural use may show reduced alertness and weaker sucking behavior initially. Maternal numbness or fatigue can delay early skin-to-skin contact, which is crucial for stimulating oxytocin and milk flow.

Cesarean Birth and Breastfeeding

A cesarean section (C-section), whether planned or unplanned, is a major surgery. The use of epidural or other regional anesthesia, intravenous fluids (IV), and antibiotics is standard.

Possible Effects on Breastfeeding

  • Mothers may experience delayed skin-to-skin contact and later initiation of breastfeeding.
  • IV fluids can increase breast swelling, making latching more difficult.
  • Babies may experience fluid retention at birth, leading to more excessive weight loss, which can prompt unnecessary supplementation.

Despite these challenges, breastfeeding after cesarean surgery is absolutely possible. With the right support—such as early skin-to-skin contact and guidance from a lactation consultant—many mothers are able to successfully establish breastfeeding, overcome initial challenges, and build a strong bond with their baby.

Why Support Matters

Evidence supports that upright positions, mobility, and continuous labor support (from a doula, nurse, or partner) lead to:

  • Shorter second stage of labor
  • Fewer unnecessary interventions
  • Improved birth outcomes
  • Higher rates of exclusive breastfeeding

Working With Your Healthcare Provider

It’s important to discuss your preferences early in pregnancy. Talk with your provider about hospital policies regarding food and fluid intake, intermittent fetal monitoring, and mobility during labor. Ask about available pain relief options and their potential side effects, and how your care team supports immediate skin-to-skin contact and rooming-in after birth. Being informed and having these conversations ahead of time can help ensure your labor and delivery experience aligns with your goals and supports a successful start to breastfeeding.

For most pregnant women, spontaneous labor and vaginal birth lead to the best breastfeeding outcomes. Still, every birth story is different. If birth interventions become necessary, remember that with the right information, preparation, and postpartum support, you can still enjoy a positive and empowering start to your parenting journey—no matter how your birth unfolds.

Disclaimer: Our classes and accompanying materials are intended for general education purposes and should not replace medical advice. For personalized recommendations, please consult your healthcare provider and/or lactation consultant.