C-Sections Pose Respiratory Risks for Some Small Preemies

[Renew Deal]

Very small babies delivered prematurely by Caesarean section because they were not growing properly in the womb developed more respiratory problems than those who had induced vaginal deliveries, a new study found. The study adds to growing concern over the high rate of Caesarean section deliveries in the United States, which reached 32 percent, or nearly one in three deliveries, in 2007.

On Wednesday, the federal secretary of health and human services, Kathleen Sebelius, announced a public health campaign to educate families that it is best for both the mother and the baby to let a problem-free pregnancy go for as long as possible, and to let labor start naturally. The campaign is a partnership that expands on a March of Dimes public awareness drive emphasizing that “healthy babies are worth the wait.”

The latest study looked at babies who were extremely small for their gestational age and not growing properly in utero, so waiting was not a medical option. But the findings raise new questions about the risks of Caesarean section.

For the study, researchers analyzed nine years of data from births in New York City, identifying 2,560 babies who were small for their gestational age and delivered between 25 and 34 weeks of pregnancy. Forty-six percent were delivered vaginally, and 54 percent by Caesarean section.
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http://well.blogs.nytimes.com/2012/02/09/c-sections-pose-respiratory-risks-for-some-small-preemies

[TheWraith]

1. Aren't premature births in general at high risk for respiratory problems? nt

[Renew Deal]

2. Yes, and I thought the same thing

But the first sentence makes it pretty clear that they are talking about vaginal births vs. c-sections.

[TheWraith]

4. Yeah, but what I'm thinking is, how much of a difference is there?

The article says 30 percent more likely to have respiratory distress, but have they carried this beyond the initial stage to see if there's a significant difference in respiratory ailments later in life?

[uberblonde]

3. This isn't news.

The stimulating effect of labor on the lungs is conducive to their proper functioning.

[Tumbulu]

5. Yes, I thought that this was a well known fact (nt)

[CanSocDem]

6. Another consideration...

...that my friend discovered before his own child was born was that the majority of C-sections (in our local facility) were done on Fridays suggesting that the convience factor was part of the decision. Apparently doctors too, needed their weekends off.

Of course, since the medical industry treats pregnancy as a 9 month disease, C-sections and induced labour are all part of the process.

My ex-girlfriend trained as a mid-wife only to find that the greatest impediment to practising was the power of the doctors associations.

.

[Tumbulu]

7. and I have a young friend who is doing her residency

as an OB/GYN and she says the doctors are almost forced to offer/suggest/recommend c-sections by the insurance companies.

I had my own baby with the tremendous help of brilliant midwives at a birthing center of a great hospital. The midwives run the center, but the doctors and surgeons of the hospital are on call. It is a very good way to have the best of both worlds. I had a complication after giving birth and I was extremely grateful a surgeon was there and that I was in a hospital after all.

Childbearing and childbirth are seriously difficult things for all female mammals and perhaps the most difficult for humans. It used to be that 1/100 women died giving birth. As it is now the death rate of 24/100,000 live births is still absolutely nothing to trivialize.

I appreciate midwives and the medical community tremendously and hope that in more places they can work together as successfully as they do where I gave birth.

[gkhouston]

8. Why would the insurance companies recommend C-sections?

More meds, probably more time in the hospital, and the procedure itself would be more costly... or are they thinking that by scheduling a C-section, you don't have to pay for the hours of labor?

[Tumbulu]

9. If the mom or baby die, then the doctor/hospital is sued

c-sections are not always scheduled- they are medically necessary for many reasons. But the doctors in residence are encouraged not to let things progress too long in any risky direction and err on the side of caution by recommending c-sections for numerous situations that in the past they would have allowed more time for.

[gkhouston]

10. I thought you meant health insurance companies, but apparently you meant malpractice insurance.

And the number of "medically necessary" C-sections is low compared to the number that are done. When I had my kid, I used a large practice of physicians and midwives. Their overall C-section rate was 15% and the lead physician's C-section rate was 5%--he still did breech deliveries. That's way less than most practices.

[Tumbulu]

11. yes, where I had my baby the rate was (still is) 8%

but what is the US average now....33% or something?

The insurance companies that offer malpractice insurance have had a very big effect on the number of c-sections according to this young OB/GYN resident that I know.

[gkhouston]

12. I think it's closer to 50% if you're "high risk". And "high risk" seems to be an ever-broadening

definition. I was 40 when I had the munchkin, so I did my homework and looked for a practice with a low rate. I didn't have an issue with getting a C-section if I really needed one; I just didn't want someone deciding that I would need a C-section when I was 3 months' pregnant simply because of my age.

[SheilaT]

13. I am under the impression

that even babies born at term but who arrive by C-Section are at slightly higher risk for respiratory issues. I have no clue where I got that idea. But I do think that being born vaginally somehow squeezes the chest and does some kind of good.

And if others who read this can point to why I'm simply full of nonsense, then I'll apologize for my ignorance ahead of time.