Survey research on Mississippi obstetricians' agreement with The Ten Steps compared to their maternity care practices

Background: Low breastfeeding rates in Mississippi as reported by the Centers for Disease Control and Prevention 2010 Breastfeeding Report were 15.2% and 6.5% for exclusive breastfeeding at 3 and 6 months, respectively. Physician advice regarding health behaviors has been shown to be associated with adoption of behaviors. Methods: This 2006 survey research investigated Mississippi obstetricians about their agreement to each of The Ten Steps and their maternity care practices related to breastfeeding education and support. Results: One hundred nineteen obstetricians (59.2%) completed the 42-item survey instrument developed by the researchers. In both health district nine (p=0.002) and seven (p=0.002), chi square tests indicated physician agreement with Step Three (inform women of benefits and management of breastfeeding) did not match the practice of encouragement to choose breastfeeding. Physician agreement with Step Six (give newborns no food or drink other than breastmilk) did not match the distribution of formula coupons to prenatal patients in health district five (p=0.035). Step Ten, an important construct to encourage collaboration between healthcare professionals to establish optimal breastfeeding support, was tested by awareness of WIC or La Leche League activities. Chi square tests indicated that: awareness of the WIC breastfeeding counseling program was not reflected by referrals to WIC in health district seven (p=0.008); awareness of La Leche League was not reflected by awareness of breastfeeding classes conducted by La Leche League in health district four (p=0.018). Conclusion: These findings could serve as a baseline for future investigation into maternity care practices in Mississippi.