Pregnant women in high-income countries, such as the United States and Australia, give birth via c-section at more than double the rate the World Health Organization recommends.
Outcomes for mothers and babies improve as countries’ rates of c-section tops 10 percent, but once a country’s rate exceeds 15 percent, the risks outweigh the benefits.
There is no doubt that when medically necessary, c-sections save the lives of women and babies.
In certain situations, a medical complication means a c-section is scheduled before a woman’s due date.
This is called a planned or elective c-section.
There may be a number of reasons why an elective c-section is required, and it can be a daunting decision to make.
However, we now know that a c-section birth can cause problems for both mother and baby — problems which are uncommon in spontaneous labours.
When planning an elective c-section, it’s a great idea to look into the benefits of allowing labour begin spontaneously before surgery, as it may be a viable option for you and your baby.
Where possible, allowing labour to begin before surgery can convey positive benefits to your baby, such as the following:
#1: Fewer Respiratory Problems
Babies born via c-section are more likely to develop transient tachypnea, which is also known as ‘wet lung’.
While in utero, babies’ lungs are filled with fluid. In the weeks leading up to the birth, this fluid is slowly expelled. During labour, the squeezing action of the contractions pushes even more of the fluid out, preparing the baby to breathe.
Babies who are born via c-section without labour tend to have fluid in their lungs. They often need help (i.e. with a suction) and sometimes oxygen immediately after birth. In the following days, wet lung can develop. This is characterised by fast, laboured breathing, and may need oxygen treatment, IV fluids for hydration, and possibly antibiotics.
In most cases, babies will spend a few days in the special care nursery, which adds extra stress and can interfere with bonding.
#2: Reduces The Risk Of Premature Birth
Guidelines recommend that unless there is a medical urgency, elective c-sections should not be performed before 39 weeks. This allows for due dates being incorrect, as most estimates are based on ultrasounds and last menstrual period dates, which can be up to two weeks inaccurate either way.
A study shows of almost 13,500 elective repeat c-sections, almost 36% of the babies were less than 39 weeks gestation. These babies are more likely to experience a host of health problems which are less likely to occur in healthy babies born vaginally.
Babies who are born before they were fully developed may have respiratory distress syndrome (difficulty breathing unassisted), difficulty maintaining body temperature, low blood sugar (because breastfeeding is trickier), be prone to infections, and require extended stays in neonatal intensive care units.
Babies are usually able to leave hospital when these issues resolve, but many preterm newborns end up back in the hospital due to jaundice and ongoing feeding issues, which cause weight loss and dehydration.
#3: Breastfeeding Success
It might seem a stretch to think that a c-section can affect breastfeeding success. However, a large meta analysis of research looked at breastfeeding rates after c-section in over 550,000 women, and found early rates of breastfeeding were affected.
Rates of breastfeeding were low after c-section compared to vaginal birth. When the researchers looked further into the data, the women who had surgery after labour had begun had higher rates of breastfeeding than those women who had elective c-sections.
Recovery after the surgery can limit movement, and you may be feeling sore as well. Your baby may be in NICU due to prematurity or breathing difficulties. This can affect nursing, as often babies tire easily and struggle to latch and nurse effectively.
Another study looked at weight loss in exclusively breastfed babies born via c-section. The research found that babies born before labour began had a significantly higher percentage of weight loss than those who were delivered after labour had begun.
Weight loss in newborns often prompts care providers to suggest supplementary feeding in place of or alongside breastfeeding. Supplementation is associated with a shortened duration of breastfeeding and increases the likelihood babies are not feed breast milk exclusively for the first 6 months.
When Is Labour Before C-Section Okay?
You may wish to consider labour before c-section in the following situations:
- Your baby is breech or bottom down
- You are having more than one baby and the first baby isn’t in a head down (vertex position)
- Your baby is in a sideways or transverse position
- You have pre-eclampsia or eclampsia
Most women want to avoid a c-section, and the prospect of requiring one for the safe birth of their baby can bring a sense of disappointment. It’s worth discussing with your care provider about the option of performing a c-section once labour has begun. This will classify your c-section as an ‘emergency’ which defines it having occurred after labour has started.
If you and your baby are both well enough to experience labour for a certain amount of time before your scheduled c-section, it can provide you with a sense of control and satisfaction, as well as offering a host of benefits to your baby.
Talk to your doctor to find out more about your particular situation and if allowing labour to begin is a safe option.