Disempowered, passive and isolated: how teenage mothers’ 1 postnatal inpatient experiences in the UK impact on the 2 initiation and continuation of breastfeeding

Teenage mothers in the UK and other developed, English-speaking nations are among those least likely to breastfeed. Evidence suggests 7more young mothers intend to breastfeed than actually start, indicating that their post-birth experiences militate against initiating breastfeeding. We aimed to explore how the inpatient experiences of a group of young women who gave birth as teenagers influenced their feeding decisions and experiences, and ascertain their ideals for breastfeeding support. Six focus groups or interviews were conducted with 15 women aged 16-20 who had intended to breastfeed or breastfed. Women were recruited from teenage parent groups in Oxfordshire, UK. Ethical approval was obtained from the relevant authorities. Data was analysed inductively using a thematic approach. Three overriding themes of ‘postbirth experience on Labour Ward: disempowered and passive’; ‘the postnatal ward: alien, alone and exposed’; and ‘being there: a need for relational support’ were identified. Sub-themes on Labour Ward were ‘feelings at birth: ’so tired and so dazed’; ‘deliver, stitch, dress’ and ‘initiating feeding’. Participants described care that followed set routines, discouraging their initiating breastfeeding by compounding feelings of dependance and encouraging a passive role as midwives took control, often deciding when and how babies should be fed. Sub-themes on the postnatal ward were ‘an alien environment’; ‘feeling exposed and judged’ and ‘miscommunications’. The young mothers’ breastfeeding support requirements reflected those known to be desired by older women, but they particularly wanted guidance and esteem support to be provided by a health professional, while looking to their peers for emotional support