Data Suggests Premature and Early Births Are Increasingly Common
The number of women giving birth early has spiked over the past two decades, inviting health risks for the newborns. A normal pregnancy is 40 weeks. Between 1990 and 2006, births at 36 weeks increased by 30 percent, while births at 37 and 38 weeks rose by more than 40 percent. In fact, the length of the average pregnancy has decreased by about seven days since 1992, according to the nonprofit California Watch, which analyzed data from the U.S. Centers for Disease Control and Prevention. That's worrisome, researchers say, because a shortened pregnancy could affect lung and brain development, vision, and weight, and could cause babies to sleep longer than normal, have trouble learning to breast-feed, and suffer from dehydration or jaundice. "The vast majority of early-term babies do fine, but it's like playing Russian roulette," Bryan Oshiro, vice chairman of obstetrics and gynecology at Loma Linda University, told The San Francisco Chronicle. The trend could be fueled by women who schedule early births for convenience, rather than a medical reason.
The C-section rate may be too high, but there are ways to avoid the surgery, U.S. News's Megan Johnson reported in September.
It's no secret that the C-section rate is rising. Between 1996 and 2007, the rate jumped from 21 percent to 32 percent of all births. What is surprising, however, is that the C-section rate is that high for first-time mothers, according to a study published in the American Journal of Obstetrics & Gynecology. One in every three new moms has a cesarean, researchers reported. Concerned about the surgery's costs and its health risks, such as excessive bleeding and infection, public health experts are now trying to bring those rates down.
The C-section rate should be more like 20 percent, as it was in the '90s, says Robert Barbieri, chief of obstetrics and gynecology at Brigham and Women's Hospital in Boston. Much higher than that, he says, suggests that the surgeries are being performed without medical need.
"Most obstetricians would like babies to be born vaginally," says Sebastian Faro, vice-chair of the obstetrics, gynecology, and reproductive sciences department at the University of Texas Health Science Center at Houston, but parents don't necessarily agree. "Have I ever done an elective C-section at the patient's request? The answer is yes," says Faro, who has also refused such requests. He talks to patients about the risks of the surgery and tries to persuade them to attempt a natural birth.
Many C-sections are necessary, to minimize the danger from complications such as placenta previa (when the placenta blocks the opening of the cervix) or a baby in breech position. Surgery may also be warranted if labor fails to progress, which can put the fetus in distress. But C-sections are major operations, says Faro. Aside from the additional risk, women who have them also face a lengthier hospital stay while they recover.
So what can pregnant women do to prevent an unnecessary C-section? Wait as long as possible until natural labor begins, says Barbieri—at least until 39 weeks of pregnancy. In the study mentioned above, the government researchers found that women who were induced had nearly twice the rate of C-sections as those who went into labor on their own. Inducing is more likely to lead to C-section in first-time moms, he says.
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