ICPA Family Wellness First - 025
Dangers with Elective C-Sections
A recent study titled: Infant and Neonatal Mortality for Primary Cesarean and Vaginal Births to Women with "No Indicated Risk," found that the risk of death to newborns delivered by voluntary Caesarean section is much higher than previously believed.
In this study of almost six million infants, researchers found the neonatal mortality rate for Caesarean delivery among low-risk women is 1.77 deaths per 1,000 live births, while the rate for vaginal delivery is 0.62 deaths per 1,000.
Their findings were published in this month’s issue of Birth: Issues in Perinatal Care. http://www.blackwell-synergy.com/doi/abs/10.1111/j.1523-536X.2006.00102.x
The study included 5,762,037 live births and 11,897 infant deaths in the United States from 1998 through 2001, a statistically significant sample even though neonatal death is a rare event. There were 311,927 Caesarean deliveries among low-risk women in the analysis.
“Neonatal deaths are rare for low-risk women — on the order of about one death per 1,000 live births — but even after we adjusted for socioeconomic and medical risk factors, the difference persisted,” said Marian F. MacDorman, a statistician with the CDC and the lead author of the study. “This is nothing to get people really alarmed, but it is of concern given that we’re seeing a rapid increase in Caesarean births to women with no risks,” Dr. MacDorman said.
The researchers noted that vaginal birth is beneficial to the baby. During this process, hormones are released promoting healthy lung function. The physical compression of the baby moving through the vaginal canal also helps remove fluid from the lungs and helps infants in breathing. Other risks of c-section mentioned by the researchers, like cuts to the baby during the operation or delayed onset of breast-feeding, were also considered as reasons for the increased death rate.
Although there was no mention of the importance of cranial molding that happens in a vaginal delivery and not in a c-section, we do know that vaginal births allow for this process necessary for central nerve system function.
Dr. Michael H. Malloy, a co-author of the article and a professor of pediatrics at the University of Texas Medical Branch at Galveston, said “Despite attempts to control for a number of factors that might have accounted for a greater risk in mortality associated with C-sections, we continued to observe enough risk to prompt concern.” He remarked that doctors might want to consider these findings in advising their patients giving them the option of informed choice.
I think some women have been seriously misled into believing that c-sections are better and safer than normal, natural deliveries. What is not emphasized when they are being given the option for elective c-sections is that a c-section is a majory abdominal surgery! Just because the c-section rate is increasing, it does not make it safer for either the mother or baby.
In a previous FWF E-Newsletter: http://www.icpa4kids.org/wellness/0019.htm We discussed a study that sited the many risks of c-section to both the mother and baby. http://www.medscape.com/viewarticle/512946_4
Also, our web site has many studies listed on the dangers of c-sections: http://www.icpa4kids.org/research/pregnancy/csections.htm and the importance of natural birthing: http://www.icpa4kids.org/research/pregnancy/natural.htm
One interesting study on our site discusses whether OBs should even be seeing women with normal pregnancies, let alone offering elective c-section to low risk mothers! http://bmj.bmjjournals.com/cgi/content/full/312/7030/554
Our advice remains -- for all of your family decisions -- make sure you are informed before you choose what seems to be safe and accepted practices.