Mumsnet hand grenade: are elective ceasars riskier for babies?

[Gizmo]

I'm just a bit surprised no-one is discussing this news today.

There are some quite interesting discussions today on US Ob/gynae blogs about why this situation is arising: one theory is that elective caesars expose women to a greater risk of having their dates miscalculated and consequently delivering babies that are slightly prem.

Does anyone in the US get advised that an elective CS is riskier for the baby, I wonder? And does this research impose a duty of care on US (or even UK) doctors to mention this as a factor?

oh i don't know....because they were terrified of vaginal birth maybe????

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Like any situation where options are available, women probably choose their mode of birth based on a number of factors. I elected for a CS, knowing that the risks to my health were higher than those for a vag birth, but that the overall mortality etc was still very, very low. What I couldn't have tolerated were the psychological effects of a traumatic vag birth that may have had a long-term impact on my ability to breastfeed, bond with DS or be an effective parent. As it turned out, DS was oblique and any attempt to have him vaginally would have turned into the nightmare scenario I wanted to avoid.

As women, we're lucky that we live in a country where we have health choices. One woman's choice is another woman's nightmare. Comments such as 'I do think that far too many women are having elective c sections these days' are not terribly helpful. It's a personal decision that is nobody else's business.

Just wondering, do they not do an Amniocentesis to check for lung ripeness in the States, before Elective section?
I know they used to...! Quite scary stuff really at that late stage....shudder!

flippin' heck, that sounds a bit rough!

I had DS in Canada, and they seemed a bit casual about when you could have the CS. This time round they won't consider it before 39 weeks to decrease the chances of respiratory distress. Makes more sense.

A baby kicks of labour though, so a baby ready to be born at 38 weeks isn't pre-term, but a baby that would have been born at 41 weeks kicked out at 38 weeks is. Lung maturity play a role in the baby kick starting labour. I was induced at 40 weeks with ds1, elective at 38 weeks with ds2, left to go into labour naturally with ds3- and started at 40 + 4 or something. So obviously i tend to have labours slightly over 40 weeks, and ds2 (who had breathing problems) was not cooked.

There is apparently a substance they can test for (in the amniotic fluid) to see how ready the baby is before inducing an early labour or giving an elective- Odent talks about it in his book- caeasarian.

Highlander it changed here as well- Had ds2 at 38 weeks by the time I got to ds3 they were saying 39 weeks. I asked to have labour anyway, but was pleased to hear there had been the change.

oh 3andnommore- just read your post- I didn't have it but Odent says they should do that.

Dont know but if I hadnt had a section then both me and DD wouldnt be here.

same here LVT. I shudder to to think what might have happened had that option not been available - no wonder childbirth was so outrageously dangerous in times gone by.

I know but its hard to believe that in this day and age mothers and babies still die in childbirth.

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hear, hear norms. I'd like to see the data for 39+ weeks.

I don't thnk anyone has ever suggested to ban sections ! The issue is that in the US (and to a far lesser extent though I do think it is on the increase in the UK) more and more women are requesting sections for non medical reasons... though I would venture to say that someone traumatised from last birth is a medical reason !
Non medical sections are still often done at 38 weeks which for some women mean a baby 4 weeks under "cooked".... Ideally women who can should have a natural start and have the section in labour as Jimjams mentions... it benefits baby (he kickied off labour) and the important transfer of hormones that happens between baby and mother can at least start to happen. This hormone exchange also benefits breastfeeding and bonding. That does not mean you can't bond or BF if you had an elective... please don't start kickiking off on that !!!!

i had problems breastfeeding at the beginning - my milk didn't come thru for two days - even tho my emergency c section was after a long labour and i was 41 weeks. Guess i'll never know why.

Where is the data on 38 weeks? Did I miss it in the article?

FWIW, ds was born by section at 40 weeks after 30 hours of labor and still had problems with his lungs. "Wet" lungs was the term used I believe. I was really surprised as I had always heard that going through labor before a section prevented that. Although since it was an emergency section I hadn't intended it that way IYKWIM.

i remeber ds being very 'chesty' - remember rushing him to the nurse on his second day convinced he was choking - i had to keep his cot slightly elevated at one end - wonder if that has anything to do with 'wet lungs' jabberwocky?

Yep, I'll bet it was the same thing.

I read that this data didn't include women who had 2nd c sections.

I think it's good how people are questioning the methods of the study, but I think the data was gathered pretty fairly. I suppose, for some people, it doesn't matter how much evidence you present it will never be enough because it doesn't suit their opinion.

jabberwocky, I think it's the actual passage of the baby down the birth canal that supposed to force that liquid out of their lungs.

I think it's a slightly different issue from that of whether the lungs themselves are ready to start doing their job.

Ruty, that's normal isn't it? My milk didn't come in until about 48hrs after ds was born (by emergency section). I'd read that 3 days was pretty normal, even after a vaginal birth.

Maybe CM, but i was distraught and didn't get much help. long and traumatic story i'm afraid!

morocco, 38 weeks is full-term. The 40 weeks thing is given as as average to cover the fact that its not known exactly which day the conception occurs.

Mine were born (spontaneous labours, normal deliveries) at 38 weeks and 39 weeks exactly.

Plus, pregnancy is said to be 9 of the individual woman's cycles, which would also cause different cooking times.

Milk coming through after two days is early!