New Study Finds C-Section Delivery Not Always Best For Small Babies
Contrary to coventional wisdom, Cesarean sections are no safer than vaginal delivery for infants who are born early or who are small for their age, according to a new study by the Society for Maternal-Fetal Medicine. In fact, C-sections might actually lead to a greater risk of respiratory problems and other complications in these infants, causing doctors to re-think how they look at the procedure.
“You shouldn’t assume there’s no downside to the baby with a C-section,” said Dr. Erika Werner, lead author of the study and assistant professor of gynecology and obstetrics at the Johns Hopkins School of Medicine.
The results of the study are particularly important, as Cesarean deliveries become more and more common, with C-section rates rising 33 percent from 2000 to 2007, with women under the age of 25 experiencing the greatest increase at 57 percent.
The most recent data – from 2009 – show that 45.6 percent of premature babies were delivered by Cesarean section, as compared to 35.1 percent of those born at 37-38 weeks.
Part of the explanation for the especially high rate among preemies likely lies in the assumption that vaginal births is too traumatic – and dangerous - for fragile infants who are underweight and preterm, said Dr. Diane Ashton, deputy director of the March of Dimes.
But according to the study, babies born vaginally were no more likely to have developed subdural hemorrhages, seizures, or sepsis than those delivered by C-section. Instead, the researchers found that babies born by C-section were 30 percent more likely to develop respiratory distress syndrome, which may have long term fallout for the babies.
“The breathing problems can turn into asthma later in life,” Dr. Nancy Snyderman, NBC’s chief medical editor explained. “In the last few weeks of pregnancy, that’s when the lungs and the brain are developing. So developmental problems, cerebral palsy, learning disability – all those things become compounded if a baby is taken out prematurely.”
While C-section deliveries may be necessary in certain situations, like if the baby is in distress or the heart rate is dropping, vaginal delivery is preferable in cases where there is no imminent danger to the baby or the mom.
Dr. James Ducey, director of maternal-fetal medicine at Staten Island University Hospital, agrees.
"You shouldn't have a C-section unless there is a good reason," he says. "Being small, in and of itself, is not a reason to do a C-section. It is more risky for mom and there is no benefit for baby, so why should we do it?"
“When you start to look at 37 maybe 38 weeks, there’s an increased belief now that the longer a baby stays in the womb, up to 40 weeks, the better the outcome is for the baby,” Dr. Snyderman adds.
Synderman is quick to caution against the mistaken belief that Cesarean sections are an easier, less painful alternative to vaginal birth.
”They say ‘I don’t want the pain, please let me just do a C-section. You have to remember the ultimate outcome should be a healthy baby.”
Now that's something everyone can agree on.
[image via istockphoto]