The World Health Organisation states that the rate for caesarean sections should be no higher than 15 per cent. In Australia, a third of all mothers give birth by caesarean each year.
Caesareans can be a life-saving operation for both mother and baby, and in some situations are the only option to ensure survival. However, the number of caesarean sections performed in Australia is on the rise, and, due to the high rates, it is safe to assume that not all of these are done out of medical necessity.
When people discuss the risks of caesarean section, they are usually talking about the risks to the mother. It is worth noting that there are risks for the baby as well.
There is a 1.9% chance that the baby will be accidentally cut with the surgeon’s knife during the procedure. This risk increases to 6% if the baby presents in any position other than the ideal vertex (head down) position.
Babies born by caesarean section are more likely to spend time in the neonatal intensive care unit than babies born by vaginal delivery.
Babies born by elective caesarean section are more likely to develop transient tachypnea, commonly known as “wet lung”, characterised by fast, laboured breathing during the first few days of life. Whilst in the womb, the baby’s lungs are filled with fluid. During the last few weeks of pregnancy, this fluid starts to clear and, usually, a lot of the fluid is expelled by the uterine contractions of labour. Without these contractions, the fluid stays in the lung and, once born, the baby may need treatment to help clear it.
The last few weeks in the womb are vital for lung maturity. Babies born by caesarean before 39 weeks have an increased risk of a number of breathing problems. Some babies may suffer from respiratory distress syndrome, a condition that means the baby will struggle to breathe until treatment is given.
There is a slightly increased risk of infant mortality. A study comparing the outcomes for full term babies (with no indicated risk) in the head down position, found slightly higher rates of infant mortality for the babies delivered by caesarean section than those delivered vaginally.
Babies born by caesarean generally score lower on the Apgar test performed immediately after birth. This could be due to the effect of the anesthesia given to the mother for the operation, or it may be that the baby was not stimulated in the same way as if it had been a vaginal birth.
Babies born by caesarean section are more likely to suffer from asthma by the age of three than those born by vaginal delivery.
One of the main problems with caesarean births is the risk of preterm delivery. Estimated due dates, based on scans and the woman’s cycle, can be up to two weeks out either way. This can mean that a baby delivered at 38 weeks, may in fact only be 36 weeks old. If delivered early, the baby will be at risk of further health problems.
For women facing serious health problems for themselves of their babies, these risks are probably worth taking. However, some women may be inclined to request a caesarean for other reasons, or they may feel pressured into it by their healthcare provider without fully supporting the decision. This article is aimed at these women, to give them the information the need to make an informed choice about how to deliver their baby.
If you feel that your healthcare provider is encouraging you to have an unnecessary caesarean, you are fully within your rights to request a second opinion.
See also: Caesarean Risks For Mothers