C-Sections May Be Bad for the Baby
There's a certain appeal to scheduling a new baby's arrival, but it might not be so good for the baby. Moms who undergo a C-section without any medical reason have a higher risk of losing their infant than those who give birth vaginally, according to new data from the National Center for Health Statistics. The death rate for babies born by cesarean (1.77 per 1,000 births) is nearly three times the rate for vaginal deliveries (0.62 deaths per 1,000 births). Since the death rate in either case is under 1 percent, "our study shouldn't alarm women," says lead author Marian MacDorman, a statistician with NCHS. But doctors and women may want to factor the data into their decisions about delivery.
The study, published in the September issue of the journal Birth, relied on birth certificates issued for the approximately 16 million babies born in the U.S. from 1998 through 2001, and linked them with infant death records. Birth certificates indicate whether an infant was delivered vaginally or by cesarean, and whether there was a medical need such as a previous C-section, a breech position, infant distress, or health conditions in the mother such as diabetes or hypertension. The study did not address the death rate among babies born to women who needed C-sections, but the authors emphasized that "timely cesareans in response to medical conditions have proved to be life-saving interventions for countless mothers and babies."
What might explain the increased death rate among C-section babies? MacDorman speculates that the benefits of vaginal delivery might play more of a role than any risks of the surgery itself. Labor triggers the release of hormones that help a baby's lungs start the breathing process, she explains. And the compression of the infant during the trip down the birth canal helps to remove fetal lung fluid.
This study speaks to a growing trend among pregnant women to opt for a surgical birth. In 2003 (the latest year for which statistics are available), nearly 7 percent of pregnant women who had no medical reason to consider surgery--and 11 percent of first-time mothers--were given cesareans compared with 3 percent of women in 1991. The overall percentage of women having C-sections is up dramatically in recent years, from 21 percent in 1996 to 29 percent in 2004.