Ok, I just read about this study, and haven’t really “ruminated” on it, which I normally do, so I’m just shooting from the hip with this. Basically, researchers went back and reviewed birth records of children born in one locality in Minnesota from 1976-1982, to see if they were born vaginally or by C-section, and if by C-section, then with the mom under regional or general anesthesia. Then, they looked at the children to see if they had any learning disabilities during school…
I’d like to read the entire article, and not just the abstract. I wonder if they controlled for enough stuff in this study. I was born in another state during the time period of this study, and my mom was knocked out during a routine vaginal birth; I assume I was dragged out by the head with forceps. Obviously, I have no learning disability — or if I do, imagine just how brilliant I would have been, if I hadn’t been born that way! ;-P But just because a woman gave birth vaginally does not mean she did not have general anesthesia nor regional anesthesia. Was this controlled for? It appears that all vaginal births were lumped into one group, regardless of whether or not a woman had drugs either for pain (such as an epidural, pudendal block, IV or IM or SQ narcotics or other drugs), or to speed up her labor (pitocin); it also is not noted in the abstract whether there were any forceps or vacuum (if applicable at the time) births; nor was the neonates’ condition noted (such as Apgars, NICU admittance, etc.).
Some women may have gotten general anesthesia, and were “under” a lot longer with their babies inside of them, during a vaginal birth than during a C-section — a typical C-section takes an hour, but the actual time from giving drugs to getting the baby out is in the neighborhood of 5-15 minutes — quicker if an emergency, slower if not. I recently read a nurse’s first experience with attending a C-section with general anesthesia, and she said the doctors worked in double-quick time, because they wanted the baby out as quickly as possible, so it wouldn’t have negative effects from the drugs given to the mother. I don’t know how long women were usually knocked out for either vaginal or C-section births, but this would seem to be a relevant factor. After all, sometimes a little of something might not be bad, but a lot of it could be. Drugs definitely fall into this category.
I find it interesting that “drugs don’t harm the baby” yet somehow babies whose mothers were given regional anesthesia for C-sections had fewer LDs than mothers given general anesthesia for the same operation. It would seem, then, that general anesthesia was more harmful to babies than regional anesthesia. Were there *any* mothers not given *any* drugs? These should have been the control, not just “vaginal birth” which can come with a plethora of drugs and other interventions.
I first read about the study on “Mommy Myth Busters,” and they look at this from another angle, and include more information, including that “The team is investigating whether use of an epidural on a mother during natural labor has similar effects on the incidence of learning disabilities in children as a C-section with an epidural.” So, this research doesn’t look at women who give birth vaginally or by C-section with an epidural. If I remember correctly, the drugs and procedures used 30 years ago were quite different from what is the current norm today, with much of the then-standard practices going the way of pubic shaves and 3-H enemas (high, hot, and a helluva lot).
So, I think this research may be important, but it is probably going to be pretty well mangled by the press, leading women to think that their babies may even be better off to have a C-section with an epidural than to have them vaginally without drugs. When that wasn’t what was even looked at in the study. We’re looking back through time at what was perhaps standard operating procedure three decades ago, which is quite a bit different from current norms.
Allow me to say that this myth may not be quite as “busted” as one might think from reading the popular press. I remain skeptical. Perhaps time will tell…
Filed under: C-section, studies & stuff Tagged: | anesthesia, baby, birth, C-section, cesarean section, childbirth, epidural, general anesthesia, L&D, learning disabilities, natural birth, pregnancy, pregnant, regional anesthesia, vaginal birth