c-sections, early c-sections

It’s Better to Wait on Elective C-Sections, Study Says

January 09, 2009 05:01 PM
by Cara McDonough
Many Caesarean sections are scheduled at 37 weeks for reasons of convenience, but new data shows waiting a couple weeks could be much better for the baby.

Planning a Safer C-Section

A pregnancy is considered full-term after 37 weeks, but that doesn’t mean a baby is totally ready for the outside world at that age, a new large-scale study shows.

Looking at 24,000 full-term babies, researchers found that those born at 37 weeks to mothers who had elective repeat C-sections were two times as likely as babies born at 39 weeks to have complications, including breathing problems and bloodstream infections, reports The Washington Post.

The American College of Obstetricians and Gynecologists recommends that elective repeat C-sections occur no earlier than 39 weeks to ensure that the baby is fully developed and ready for delivery. But some doctors and patients decide to schedule the C-section a little earlier for a variety of reasons, including being tired of pregnancy, eager to see their baby, or because of scheduling conflicts with their doctor.

Babies born vaginally at 37 weeks may not have the same complications, said John Thorp, professor of obstetrics and gynecology at the University of North Carolina, Chapel Hill, and coauthor of the study. “We would not worry about a 37 1/2-week baby born vaginally with the onset of labor,” he said to USA Today. In that case, “there is some signal from a baby to his mother that says, ‘I’m ready …’”

Background: Rise in number of C-sections

The study comes at a time when some doctors are concerned about the number of C-sections being performed. A federal report released this week indicated that C-sections in the United States are at an all-time high, with more than a third of babies delivered by C-section. The reasons for the increase aren’t entirely clear, although reasons may include the fact that women are having children later in life when complications are more common, that doctors are intervening in problem pregnancies in order to protect mother and baby, and that women who have undergone C-sections are much more likely to have a repeat procedure.

The trend is not limited to the United States. Data from the World Health Organization (WHO) released in July found that C-sections accounted for 39.1 percent of births in Mexico, 40.5 percent of births in China and 44 percent of births in Brazil. But with WHO only recommending that C-sections be performed as necessary in 15 percent of births, there is concern about the high numbers. Some believe doctors aren’t prepared for irregularities in vaginal births and switch to C-sections whenever something unusual happens. Some women are reportedly asking for the procedure themselves, due to the fear of pain associated with vaginal childbirth. The trend is common in Brazil, for instance, where the procedure has become ingrained in the culture.

Another study conducted last year, however, found that many women value the opportunity to have a natural childbirth, and many are more willing than their doctors to face risks in order to have one. The Australian study surveyed pregnant women, obstetricians and midwives about situations that would prompt them to choose a Caesarean section over a vaginal delivery. In nearly all of the cases, the pregnant women were more willing to deal with complications in order to have natural birth than their doctors or midwives.

Reference: C-sections and pregnancy


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