Elective C-sections and the Risk to the Baby

Many women have a C-section for no medical reason, which is considered an “elective” C-section. Some of these include the “too posh to push” women; those who are afraid of labor and birth; those who want to schedule a “no-muss, no-fuss” C-section rather than go through the unpredictable and sometimes messy labor (which, by the way, I gotta question why these women even get pregnant in the first place — are not babies by their very natures unpredictable and sometimes messy? Perhaps the unpredictability and mess associated with labor somehow helps these women come to grips with the reality of life with a new baby, but I digress…); women who are not allowed to have a VBAC, women whose first birth was a C-section so go with what they know rather than attempt a vaginal birth, etc.

My husband’s cousin was sort of in this last group — her first baby was born preterm by C-section due to some health issue (I think pre-eclampsia, but can’t remember for sure right now), and her doctor told her she could have a VBAC IF she got all her work done and IF she could find something suitable to wear. No, wait a second, that was Cinderella’s wicked stepmother. No, her OB required that she go into labor naturally after she reached term but before the date of her already-scheduled C-section, which was at 38 weeks. Oh, yeah, just conjure up labor sometime in that week, and you’re good to go; if not, we’ll slice you open! Is it any wonder so many Cinderellas out there end up in rags instead of going to the ball?

But, a recent study (hopefully I’ll be able to find the article somewhere, but until then, I’ll make do with this) has looked at elective C-sections — that is, surgery for no medical reason — and found that babies who are born by C-section prior to 39 weeks have a much higher risk of complications, including respiratory distress, low blood sugar, infection or need for a respirator or intensive care. It also found that a full 36% of these elective C-sections were performed prior to 39 full weeks of gestation, which is the minimum age or cut-off point recommended by ACOG.

While “term” is considered to begin at 37 weeks, ostensibly, babies who are born after that time by C-section should not have any more problems than those born vaginally. However, in speaking of the difference between babies born at 37 weeks after the spontaneous onset of labor and those born at the same time with no labor but by elective C-section, one of the authors of this study says,

“We would not worry about a 37 1/2-week baby born vaginally with the onset of labor,” Thorp says. In that case, “there is some signal from a baby to his mother that says, ‘I’m ready …’ “

Hmm, maybe a baby should still be considered “premature” until the onset of labor. After all, while the exact mechanism may be unknown, it is accepted that, normally, the baby sends a “readiness” signal to his mother signifying to her body that he is ready to be born — he is mature enough to leave the womb and survive on the outside without the need of respirators and all the other gadgets I’m so glad exist to save the lives of premies.

Those born at 37 weeks were twice as likely

and those born at 38 weeks 50% more likely

to have a problem than those at 39 [weeks].

Wow, so nature knows best, huh? Who’d’a thunk it?

h/t to Dr. Jen for bringing the article to my attention

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3 Responses

  1. [...] new study came out this week with information on elective c-sections (thanks to Kathy at Woman to Woman Childbirth Education – can you tell I LOVE her blog!) She also [...]

  2. How can I locate a graph showing increase in elective c-sections births for period approx. 1975 to present?

    • I have *no* idea! For one thing, it would be complicated to differentiate between the various classifications of “elective” C-sections. There are some people who have been forced into C-sections (because their doctors refused to attend a VBAC, for example) or coerced into them, and they were then labeled “elective” — although the women would have chosen a vaginal birth, if possible. Many women believe their C-sections to have been necessary or at least medically indicated because the doctor suggested or encouraged it, when they were actually “elective.” And many doctors would be loathe to admit that many of the C-sections they perform are not actually necessary.

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