Determinants of caesarean delivery and its relationship with breastfeeding initiation in South Africa: Evidence from the 2016 Demographic and Health Survey

Abstract

Caesarean section (CS) is a crucial method of child delivery recommended when natural birth poses risk to mother’s fatal well-being and child health. However, the increase in the number of CS deliveries raises concerns about their potential effect on the initiation, duration, and exclusivity of breastfeeding in South Africa. This study aims to explore the association of CS with the initiation of breastfeeding and to investigate how marital status, wealth index and education influence the likelihood of undergoing this type of delivery among South African women. Using data from Demographic and Health Survey 2016 and General Household Survey 2018, the research examined variables such as marital status to investigate the patterns of childbirth delivery methods and breastfeeding behaviour among South African women. The findings reveal there is no significant association between Caesarean births and low breastfeeding. Marital status and education are the key factors towards institutional delivery. While there’s no clear link between marital status and mode of child delivery, women from wealthy backgrounds were less likely to give birth through CS. The findings of the study clearly indicated that high CS rate in Mpumalanga was not based on patient preference and influence from maternal socioeconomic status but based on the need for CS. South African hospitals adhere to global health standards, the decision on mode of child delivery is determined by the doctor. This indicate CS birth can only be allowed when medically recommended. The South African midwifery practice should continue to align with global health standards and promote natural birth resulting in faster recovery, less complicated maternal recovery and improved breastfeeding success.