Early C-Section Affects Babies

By Margarita Nahapetyan

According to the latest large new study published on Wednesday in The New England Journal of Medicine elective (non-emergency) Caesarian sections can cause a variety of health problems and be very dangerous for newborns if performed early.

Dr. Alan Tita of the University of Alabama at Birmingham led the study. The main goal of the study was to examine the danger and complications for babies born before the recommended 39 weeks. "There are definitely risks associated with delivering early," Dr. Tita says.

In the recent years the rate of Caesarean births has achieved the highest level, more than a third babies born in the United States are delivered by C-section. There are lots of reasons why women started increasingly choosing surgical removal of a baby over a natural vaginal labor: being tired of pregnancy, multiple births, older mothers, being sure that the doctor is available and many others.

Scientifically a normal human gestation is considered to be 39 to 40 weeks, which is about nine months. Doctors have different opinion in this calculation, considering a baby to be "full term" already at 37 weeks.

The study of 13,258 deliveries, done at 19 medical centers and involving women who had previously had at least one pregnancy, showed that the earlier Caesarean deliveries had a high rate of complications for babies. The researchers found 36 percent of the C-sections took place at 37 or 38 weeks which is a double risk of serious danger for newborns, such as breathing problems, neonatal death, newborn sepsis, low blood sugar, hypoglycemia. Mainly, this extra time between 37 and 39 weeks allows for full development of newborn's lungs.

Even deliveries that were just one, two or three days before 39 weeks carried more than 20 percent increased risk of complications, indicates the study.

"It looks like a day or two makes a difference," said John Thorp, a professor of obstetrics and gynecology at the University of North Carolina-Chapel Hill, who participated in the study. The nature of labor is a baby's way of signaling it is ready to live outside the womb, Thorp said. In elective c-sections, there is no signal from the baby to the mother that he is ready to be born and this study shows that even one or two days earlier can have bad health risks for the baby. When doctors decide on C-sections, "we're saying we're smarter than that signal," he said. "There are some babies who aren't ready yet to make that transition and we force them to do so."

Most of women want to have elective cesarean sections without fully recognizing the possible consequences that might follow. Most of them think that because their baby is considered full term then everything should be fine. Some of them while being pregnant do not like the way that they look. They have their homes re-decorated and cannot wait to meet their new creatures so they ask their doctors to perform C-sections at an earlier period of time. Doctors usually do not say no to their patients because the babies are considered full term at thirty seven weeks.

"After a closer look at these women it became clear that those delivering earlier were white, married women with private insurance and had prenatal care", says obstetric gynecologist Michael Greene of Harvard Medical School and Massachusetts General Hospital in Boston, who didn't participate in the study. "Women who decided to deliver early have their own private doctors to perform the cesarean, which requires planning and scheduling", he says. "They probably scheduled their deliveries on the early side to avoid any risk of going into labor at a time when their doctors might not be available to care for them."

Dr. Greene says as well that it is now important to convince "patients (and their doctors) that having 'their doctor' perform the delivery is less important than avoiding the complications associated with early-term birth."

At the same time, he mentioned that the study only examined live births and did not consider the risk of a stillbirth while waiting to reach 39 weeks against the risk of complications resulting from an earlier Caesarean. That risk has been estimated up to 1 in 1,000, he said.

Women just need to understand that pregnancy is always hard and exhausting but getting as far as you can in your pregnancy is what is best for kids. We want our children to have the best and right start in their lives that they possibly can. Doctors should only perform early cesarean sections if there is a valid medical reason, when there is a real risk for mother's or baby's health. Women must wait until they are at least thirty nine weeks pregnant to have an elective cesarean section if they want it that much. And as to medical authorities, they need to think not only of the patients' requests and wishes but also what is best for the unborn child.

Being pregnant and having a child is a miracle, a wonderful event, but women should not rush it just because they cannot wait to meet with their babies or because they are tired of the pregnancy. Everything should happen in its own natural time.