Caesarean benefits and risks FOR BABY

[iaMHannah91]

I'd like to start by saying that there are enough threads which talk about all of the risks of caesarean birth for the mother. From my research, all of these risks are acceptable to me, so I don't want to go down that windy path!

Other than to say, in my comparison list, the only benefit of VB over an ELCS (for the mother) that I could think of was "quicker recovery". Are there other benefits which I'm overlooking???

However, what I'd like to ask about are the possible benefits and risks to the baby? I'd like that to be the priority in forming my decision, but there isn't too much talk on the matter!

So far, I've only been able to identify the removal of several VB risks as the benefit of a CS, but wondered if anyone knew of any others?

I have a referal for the birth choices clinic in a couple of weeks and would like to see if there are any other risks/benefits that I might want to add to my list before this appointment.

** It may also be useful to know that my current plan is for a maternal request ELCS on the basis of the removal of risks to the baby such as distress during the birth (getting stuck, lack of oxygen, difficulty passing through the birth canal), together with the risks to my mental health (I have severe anxiety) that would result from a traumatic birth experience. Amongst other things!

The squeezing of the baby through the birth canal is what prompts them to take their first breath I believe.

Breathing. My C-section boy ended up with breathing trouble from section. He was 40+5 so he was t below term. Paediatrician says “don’t worry a lot of section babies are like that”. And he spent a week in neonatal with it. I had a big bleed and needed a transfusion after and with a section you need to stay in hospital which I hate.

Overall sections are safer for babies (I was told this by three consultant obstetricians) as as you said, the risks of a VB are removed (of which there are actually quite a few).

However, sections are more dangerous for the mother.

You don't have to justify anything to request one though- just say you want one based on maternal request and you'll get it.

Yep, this is correct. All things considered, c-sections are much safer for babies than VB (that's why, when things are going wrong, they perform a c-section, it's never the other way around!).
But obviously much longer recovery and more complicated for mothers. Plus - it is more expensive for the hospital as a lot more staff are involved.

I think if you want an elective section you should have one. No need to make a list of reasons why you want one or a list of why vaginal birth is risky. If you want one then have one. No excuses, reasons or guilt required.

If you have anxiety the benefit to your baby is you having the birth experience that works for you and not one that is terrifying and out of control, and therefore starting your baby's life outside the womb in the best possible mental place.

I'm not sure about the longer recovery thing tbh. Clearly true if you compare to uncomplicated VB but perhaps not if you compare across all VB. I personally think there is a bias as problems after a VB are more embarrassing and less often reported.

As pp have mentioned, potential breathing difficulties for ELCS babies (and potential nicks to the baby if they cut too far). My trust refused to do it before 39 week when thought I was high risk.

Also, risk for mum is more than just ‘slower recovery’, for my first emergency c section, I had sepsis and major haemorrhage. My second was an elective but much more difficult because of the adhesions that had formed after the first and they had to use forceps to get baby out. I suffered massive internal bleeding after the second and nearly died. I know my example is a bit extreme but don’t trivialise a major abdominal surgery. Obviously vaginal birth also carries its risk and risk to baby (basically birth is just such a risky business!!!)

However I have to say, mentally I did much better after my elective c section despite much more serious complications. Whereas I didn’t cope too well with the exhaustion of induced labour for days, the pain, the scariness of it all when we had to do an emergency c section at the end.

Wishing you all the best with your pregnancy and birth. You don’t need reasons to present to your team other than knowing you’re making the right choice to you and your baby. If they refuse you, you need to request that they refer you to somewhere who will let you have an ELCS.

The only problem ds had was he didn't get rid of the mucus on his chest as he would have done if he had been born via VB, I had one night in hospital when he mega puked & it was all mucus, other than that he was fine.

There was some research that showed that planned c-sections are £400 cheaper than vaginal birth for the NHS once negligence claims are taken into account. Cost should never come into it in any event.

www.itv.com/news/2019-04-18/caesareans-cheaper-than-natural-deliveries-once-negligence-claims-taken-into-account

No, not true. Caesarean babies take their first breath as soon as they are born, just like vaginally born babies.

A good unassisted vaginal birth is better for the baby but the odds of that happening as a first time mother (particularly if induced) weren’t worth taking my chances on with NHS midwifery shortages.

My NCT group ended up almost all EMCS anyway. Two got sepsis and another had further surgery for retained placenta. Only one of the 10 had a good, vaginal birth.

Babies born via CS are more likely to have trouble transitioning to normal breathing. This is because they haven’t had the ‘stress’ of labour hormones which stimulate surfactant production in the lungs and also the mechanical squeezing in the birth canal to remove mucus from the airways. Many babies have no issue at all, some may require monitoring at mum’s bedside and some may require help with their breathing and a stay on the neonatal unit. There’s no way of predicting which babies this will affect.

There is some evidence that babies born via CS are at increased risk of allergies/asthma.

There is a small risk of an accidental cut to the baby. I’ve seen this happen and require plastic surgeon involvement, but it’s very rare given the amount of CS that happen.

There is a more significant risk to future pregnancies and babies that I think are worth consideration. Future pregnancies are more likely to end up in stillbirth and carry the risk of uterine rupture. It’s a decision that doesn’t just impact this pregnancy.

No, not true. Caesarean babies take their first breath as soon as they are born, just like vaginally born babies.

But the squeezing forces the mucus from their lungs.

That said. op doesn't need to justify her decision - she has a right to a cs on the nhs.

i had 5 natural births.. all fine. However my 6th I had to have an emergency c section, baby’s heart was getting slow; I was told the c section was the safest for baby, but not for me. I was fine though! They do them day in day out and you are well looked after.

With my elective for twins breathing was an issue with both as they had excess fluid in their lungs. Also my baby girl had a small cut on her right hip from the incision. They recovered after a few days.

One thing to consider is that breastfeeding might be slightly harder to establish after c section compared to uncomplicated vb. It may or may not take slightly longer for milk to come in as no labour to kick things off. It can also be quite uncomfortable to position baby, but manageable of course. Worth doing a bit of research if you want to bf, to know what to expect.
Overall I loved both my cs's despite being desperate to have vaginal births both times. Bf'ing was fine eventually too but I don't think it's ever easy, no matter how baby arrives!
Best of luck.

There are lots of trust worthy websites out there eg AIMS, tommy and NHS.

If breastfeeding is important to you it’s worth researching the impact of c section on breastfeeding and also look a vaginal birth and baby’s microbiom (sp?).

I know you want to concentrate on baby’s health but it’s worth remembering Mum’s and baby’s health are interconnected. If you are not well it’s difficult to be the Mum you want to be. And if your baby isn’t well then I can guarantee you won’t be on top form. I’m trying to remember the word to describe it but in some cultures baby’s under 6 months and Mum are described as being one being.

It should be completely your decision and everyone’s experience is different. I had an EMCS for my first child, ended up very poorly with spesis which it’s self takes months to recover from, I ended up not being able to breast feed, I couldn’t cosleep at the beginning, couldn’t for months hold my baby and get up off from the floor for 6 months, I would have to out her down and then bend down, put the pram in and out of the car for 2 months, drive for 6 weeks, so couldn’t get to breast feeding support and Mum and babies meet up which are vital for maternal mental health. My second was a VBAC, I coslept from the second night, successful with breast feeding, when DH picked us from the hospital he put the bags in the car and left me in the room with baby and 3 year old, of course 3 year old needed a wee and I was able to help her onto the toilet, this won’t have happened after DD1 where I would barely get myself on the toilet. I had a complication with my vbac caused by the emcs which meant after bf DD2 I was whisked to emergency surgery and DH was left holding DD2 for 2 hours worrying about me.

My CS baby had two birth injuries, one from forceps the other a scalpel cut where they rushed. This allegedly was an ELCS.
Bonding issues. Rejecting your baby can be fairly damaging to the baby. Increased risk of PND if you have bonding issues. Respiratory issues. Still ongoing age three.
We had the lot. There aren’t many things I regret in life as much as that CS.

I also nearly died in a bad reaction to the spinal anaesthetic which at best could have caused cerebral palsy in the baby and at worst killed my baby, but apparently this is very unusual. However it did leave me with PTSD which affects the sort of early childhood DC1 has had.

The increased likelihood of allergies mentioned in this thread for babies born by c section might be linked to the fact that they don’t meet the microbes they would in the birth canal; I had a category 1 section I was very grateful for and gave our baby probiotics to help his gut flora still get to a good start. It seems helpful as good microbes seem very linked to general health , reducing anxiety etc .

Such an emotive subject!

I was dead set against a planned section after an EMCS with first. I wanted to push. But the risks of previous scar coming open, and that baby at 35 weeks was measuring 9lbs put me off.

So I went for elective. And I'm glad I did. The anxiety you suffer OP will be more manageable, knowing you're going in on a certain date and can plan around that.

My baby was 9lbs 15oz when born at 39 weeks so, midwives had measured accurately and my baby also came out screaming their head off so no "baby won't breath without help if born via section" worries. Baby was put on me in recovery, shuffled their way up my chest, found boob and started feeding within an hour of being born. Lovely experience!

My second DC was an ELCS as he was a big 10lb boy!! I decided to have a section rather than induction when weighing up the risks, more risks to me but less for him which seemed like a no brainer. Timw will tell if there are any long term implications but from what I can see the only immediate thing is that he’s prone to sneezing more than most babies and more snuffly at night and a bit congested.
My first DC was a natural ventouse birth. I wouldn’t say having a c-section was less risky than a natural birth from a baby perspective….I felt instinctively that an induction might be traumatic but if labour comes on naturally I don’t think the risks are any greater. I personally wouldn’t have had an ELCS if it wasn’t for DC’s size and consultant recommendation.

Thanks everyone for your responses! Its reassuring to hear a lot of things that match up with my thoughts and ideas.

And thank you so much to all of you with encouraging words!

I know that I won't have to fight for the CS, at least not alone, as my midwife is very supportive. But I am a very analytical person, so really needed my comparison lists to reassure myself of my decision.

It felt like an easy decision to make when we were TTC, but once the hormones kicked in and there was an actual baby to consider, I started second guessing myself!

I do appreciate the comments regarding risks to later pregnancies though. But after so much difficulty conceiving this time around, followed by a horrific start to the pregnancy with HG, I'm not sure those risks are high up on my priority list. Certainly not higher than the safety of this little one.

Side note

I know a couple of people have mentioned allergies/asthma and breathing difficulties. However, I found that the studies carried out on these issues did not actually reach a concrete conclusion. For example, in one study, they were able to determine that a slightly larger proportion of babies born by CS were affected by asthma/allergies, but they did not look at the children's predisposition to such issues, to confirm whether the correlation indicated a causal relationship or not.

• apologies! Ex-maths teacher here... ripping up all the stats because the research is not up to scratch haha