To be worried that C section causes autism

[37weeks001]

Name change as I don’t want to out.

I am currently 33 weeks pregnant with second baby. My DD was born by emergency C section at 40 weeks weighing 5lbs but healthy. I have been diagnosed with IUGR as this baby is on 5th percentile. He is very active and moves around constantly so not worried about how the pregnancy is progressing and my instinct tells me he is physically ok.

However, throughout this pregnancy I have been so anxious that I could have a child with autism (history of males in family with autism), I also have anti natal depression.

I have am having regular scans because of IUGR. A consultant has today has told me that they want to schedule a c section at 37 weeks due to babies size. However last week another consultant told me that a c section before 39 weeks increases chances of autism/ADHD and learning difficulties.

The conflicting information has left me so confused. A part of me wants the c section at 37 weeks as I am getting a little fed up with the constant hospital appointments and becoming increasingly anxious with what I may be told and the other part of me thinks I should weight 39 weeks to lower risks?

WWYD?

@Emeraldshamrock it's now generally considered early term. Although as I mentioned in my post I would follow advice for c section at 37 weeks if in same position because the risks of continuing sound like they far outweigh the possible hypothesised risk of an earlier delivery

@Cheeseboardandmincepies I don't think it's at all ridiculous to consider what you have been told by a consultant and do your own research as OP has (and you haven't)

Wouldn't the best thing here be for the two consultants to talk to each other and work out what's the least risky approach overall, rather than landing this information in the lap of their patient leaving her worried about what's best to do? Can you contact the hospital and ask the consultants to have a conversation? It shouldn't be all on you. They are supposed to weigh these issues up.

This is absolutely bs and really very offensive and I say that as both an autistic person and the parent of a child with both ASD and ADHD.
Both of these conditions are hereditary (asd my side and ADHD his dads side) they are neurological conditions where parts of the brain don't develop normally, this happens way before 37 weeks as the brain has finished developing by 37 weeks. Also babies are not considered premature unless they are born before 36 weeks.
The dr who told you that is no better than Andrew Wakefield and also should be struck off.
The study is proof of correlation not causation they may aswell of said a tiger is a cat therfor all cats are tigers.

The fact that there is a strong history of ASD on your dh side is reason that you may have an autistic child which by the way is not the end of the world.

I also think that hard as it is it's unhelpful to project as a parent with a child with ASD or similar and dismiss all research as nonsense designed to make mothers feel guilty because it isn't

I say that as a mother of a child with a problem sometimes connected with a neural tube defect. I took folic acid before conception and throughout pregnancy but that doesn't mean I can't believe that there isn't a link between folate deficiency and that kind of defect. Of course that link is well established and completely different to the discussion on environmental factors which may have a correlative rather than causative effect on ASD (likely in conjunction with genetic predisposition), but it would be helpful to discussion if we could talk about it objectively rather than defensively or with anecdote

@Threeinthebedandlittleonesaid

I think it's really frustrating when an OP posts a concern such as this, raised by a medical professional, and shows a balanced understanding of the risks and many posters (having not researched themselves) utterly dismiss the OP's question out of hand with disbelief a professional would say this, or question whether they'd "just been on google". Peer reviewed articles are often easily accessed these days via google itself incidentally.

Although it's likely that a large component of later developing ASD is genetic, there's a growing body of evidence that environmental factors in utero and early life may sway the balance in some cases of whether a predisposition will lead to ASD. Some of the factors that are linked (and yes I agree that this may be correlation rather than causation, I suspect a mix of both) are shorter gestation and c section delivery. There are theories around the mode of action ie microbiota differences with c section deliveries, babies not having quite finished developing earlier in gestation. Equally there are correlative reasons where the risk is increased by a condition that necessitates early or c section delivery.

And of course most babies won't go on to develop ASD, it's just a possible increased. A consultant will need to balance the risk of the pregnancy continuing with early delivery. They are right to explain to the OP why they don't just go ahead and schedule a delivery anyhow as soon as the baby is viable.

If you're talking about me, I am a professional and have studied autism at MSc level. A consultant would not say that having a C section in itself causes autism because there is just no evidence of this.

OP has probably misunderstood what the consultant meant - it's more likely the consultant was saying that there is a higher incidence of autism in babies which are delivered early. As other posters have said, it is not the method of delivery but whatever is behind the need for the early C section.

The reason c sections have a higher rate of SEN is obvious, these babies are the ones that become distressed during labour and thus end up c sections.

This.

Babies in distress during labour may have already had compromised oxygen levels.

Remember The best birth is a safe birth. Good luck with it.

@Cabinfever10

This is absolutely bs and really very offensive and I say that as both an autistic person and the parent of a child with both ASD and ADHD. Both of these conditions are hereditary (asd my side and ADHD his dads side) they are neurological conditions where parts of the brain don't develop normally, this happens way before 37 weeks as the brain has finished developing by 37 weeks. Also babies are not considered premature unless they are born before 36 weeks. The dr who told you that is no better than Andrew Wakefield and also should be struck off. The study is proof of correlation not causation they may aswell of said a tiger is a cat therfor all cats are tigers.

The fact that there is a strong history of ASD on your dh side is reason that you may have an autistic child which by the way is not the end of the world.

This.. I find it offensive too. There’s more risk of other complications with a early birth then there is ASD, it’s not something that’s caused by a traumatic birth (or very rarely anyway), it’s mostly genetic and decided way before birth. Having a child with ASD is not the end of the world, the spectrum is huge.

Basically OP I think the overall message is that it's not causative.

The C-Section doesn't CAUSE the autism. The autism, if it's going to be there, is most likely there whatever you do. Early birth might COULD play a part - but that has to be weighed up with other factors - the baby may need to be delivered early in order to be safe.

What's pretty certain is that the process of having a C-section IN ITSELF doesn't cause autism.

If you would like to see the evidence of earlier delivery and SEN it is in this report- saving Babies Lives Version 2, released in 2019. Freely available. Method of delivery highly unlikely to be the ‘cause’ of autism or SEN. it is the situation around when and why the CS was done as well as what happened in the pregnancy and months leading up to delivery.

@wildraisins the OP's consultant did not say this about c sections in general (though most of us have been led down this tangent because of the tenuous link) but specifically delivery before 39 weeks. I'm not sure about ASD specifically but certainly read an article just the other week about neurological outcomes and early vs full term delivery. Again though any possible risk is far outweighed by risks of not delivering for IUGR if consultant deems necessary.

Thanks to those who have given help and advice so far. It's a sensitive topic and as the OP is worried about what to do, we've moved this thread out of AIBU and into the General health section.

The spectrum is huge and whilst it's not the end of the world having a child with autism for some parents like myself it's hugely challenging ,my child is non verbal and will need life long care and there are many other people like him with autism who have similar needs .

Baby has restricted growth - this presumably means that not sufficient blood supply (& that means not enough oxygen?) is getting through - the longer the baby is there the more they need - if the baby is not delivered early their health & future quality of life is at severe risk - & not wishing to scare you op but their life maybe at risk. Whatever issue they may have is already present & the reason there may be an apparent (!) correlation there is is far more likely to be caused before the c section - delaying it increases the chance of a worse outcome.
You were justifiably frightened when the consultant spoke to you so may not have picked everything that he said or meant.
Op under your circumstance I would have my baby at 37 weeks as suggested

@x2boys

Autism is a massive spectrum though and whilst it won't stop some people going to university , for many people with autism they will also have severe learning disabilities ,there is an awful lot of ignorance on here about autism ,.It's a spectrum some people are massively impacted by it others see it as a difference.

It’s not a spectrum as in there is a ‘worse’ and better end. That is not what it means when it refers to spectrum. This is why the term ‘high functioning’ is being phased out.

A consultant had really said that? I would love his name and quiz him on that as to where he got those stats from.

Nobody knows where autism really comes from, yes can have a genetic predisposition and don't you think that would be a lot more like to cause it in your case than a c section?

I think @x2boys makes a good point and would note that a lot of the research into link with environmental factors and autism also looks at the severity of symptoms; in some cases we may find with further research these can be ameliorated by another factor

Given the amount of family members with ASD on both mine and DH's family I'd say my sons ASD is genetic.

I truly believe ASD is there at the point of conception when both parents carry the gene and it's luck of the draw if your child is affected or not.We have 1 child out of 4 with it;same as my mum,aunt and grandmother.

To say that c-sections can cause it is abit absurd tbh.

It’s not a spectrum as in there is a ‘worse’ and better end. That is not what it means when it refers to spectrum. This is why the term ‘high functioning’ is being phased out
They now use levels the differentiate where on the spectrum a person is.
Level 1,2,3.

Actually nobody really knows what causes Autism though do they and I don't think there is one cause ,my son has an understanding chromosome deletion which the geneticists beleive is a contributing factor in his autism and learning disabilities,I was once on a bizarre thread on an autism discussion group ,( American centric) and people were arguing that not having baby boys circumsized could be a factor,I did point out that in the UK ,circumsistion is done far less .

I haven’t done my own research? I have autism myself as done my son. A c section doesn’t make you magically have autism, that’s an absurd claim. It’s genetics, it’s already done and dusted once baby is born regardless of a c section.

@Threeinthebedandlittleonesaid

What is "later developing autism", and how is it found?

Would like to reiterate that the question at hand was predominantly surrounding early term delivery and not mode of delivery in general which is a separate question.

I think most posters are completely underestimating the complexity of "genetics". There are a huge huge number of genes involved in development directly and indirectly and the function of each has an impact on the next. That's even without epigenetics, which affects the way each gene is expressed.

Some genetic differences might mean that in a very indirect way a fetus is more vulnerable to environmental influences that can then have a knock on effect on processes and lead to differences in brain development. This might explain the very small but statistically significant increases in ASD cases in the cases of certain in utero exposures.

Some genetic or epigenetic differences have a more direct impact, as in Rett syndrome.

Nothing "magically" causes ASD but it's likely a very complex interplay with different factors, largely genetic.

I think a lot of very interesting work has been done on neurodevelopment and it's a shame to see it completely rubbished in this way without engaged discussion.

OP, I would suggest asking the consultant for further information, ask to see the research to back their claim.

Correlation is not causation