Death twice as likely by caesarean

[Trish]

BABIES born by elective caesarean are almost 2? times more likely to die within their first month than babies born vaginally, researchers have found, adding weight to the argument that caesareans should only be carried out in emergencies.
The study, which involved more than 8 million births in the US over four years, is the first of its kind to focus on full-term babies born to women with no medical reason for choosing a caesarean over a vaginal delivery, an increasingly common phenomenon in Australia.
One in three babies is now born by caesarean section, up from about one in five 10 years ago, but those born before the onset of labour are often unresponsive and unable to breathe without help.
They are frequently admitted to neonatal intensive care units because their lungs cannot eliminate secretions and they lack catecholamines, a vital chemical secreted during labour that keeps them alert and eager to feed.
"We are designed to give birth vaginally. When will people wake up and realise this?" the secretary of the NSW Midwives Association, Hannah Dahlen, said yesterday. "When a baby is born vaginally, fluid is squeezed out of the lungs as it is pushed through the birth canal. The baby can then inhale with clean lungs, aerating its blood supply and kick-starting its circulation. A baby born by caesarean quite often comes out gurgling because its lungs are full of fluid, requires suction and is non-responsive because it lacks the hormonal surge delivered during labour."
But babies born vaginally with high levels of catecholamines were usually alert and quick to seek out their mother's breast. "They've got that 'wow, I'm alive and I'm ready to go' response."
The study, published in the international journal Birth, only included women who had not had a previous caesarean; were giving birth to a single baby which was head down in the cervix; were between 37 and 41 weeks gestation and had none of the 16 common risk factors, such as diabetes or hypertension, associated with birth complications, in a bid to ensure that only low-risk births were evaluated.
It found the mortality rate for babies born vaginally was less than one in 1000 births while the rate for elective caesareans was 1.73 per 1000. A professor in obstetrics and gynaecology at the Australian National University medical school, David Ellwood, said the risk was still very small. "We have enough evidence now to know that caesareans should only be done when there is a medical indication, but when you look at the overall risk here, it is not that high."
The clinical director of women's and children's health at the Sydney South West Area Health Service, Andrew Child, said the study should be treated with caution. "It's been done by statisticians, not obstetricians or midwives," he said.
Carolyn Constantian, 43, of Chatswood, delivered her twins, Amelie and Remy, by caesarean two weeks ago, but said she would have chosen a natural birth if she had been given an option. "I had to have a caesarean 2? years ago when my daughter was born breech, but I tried everything to turn her around so I could give birth naturally. I just didn't feel comfortable about having a caesarean then. Nor did I this time, but you have to do what's right for your child."

From SMH.

[Trillian]

They had this story on the news last week. One of the Dr's they spoke to about it actually had the gall to say that a c/s was better for babies as they haven't been through the 'trauma of birth' - no bloody wonder the c/s rate is as high as it is when we have quacks lying about it.

[BellyBelly]

These studies are always saying the same thing but there are no changes, nothing is being done... what can you do but try and inform women? Even that has to be done sooooo carefully.

[Trish]

You are so right Kelly. If you go about it the wrong way women and Dr's get their back's up. No one wants to say "hey this is wrong" but at the same time no one wants to wear the consequences either.

Trillian, it's no wonder hey. Bag's not going to that nOB.

[Bathsheba]

Thanks for posting Trish. It was very well written... explained it well without getting emotional or alarmist. And Trillian (regarding that OBs comments) : Geeze, maybe we should be saved from the trauma of going to the toilet to do number twos as well?! (yes I've read that BB article... it's a great one! LOL) um, life's abit like that... not always meant to be comfy! Everything for a reason!

[Trish]

Just trying to help spread the word Bath

[sonya1]

Can i ask if everyone is supportive of caesarian if it IS in the best interests of mum and bubs? i follow these stories with interest but sometimes i get the cold shoulder for my choices.

i wholeheartedly disagree with famous women who have c/s for image etc...

my stillborn was a 24hour natural labour and my eldest son was an agonizing 15hr natural labour. i have kyphoscoliosis in which my spine is curved 73dg and twisted forwards as well. AND all this in my lower back. so each contraction rips through me frombehind my ears to the tip of my toes from start to finish, not just the final stage.for this reason i elected to have a c/s with my youngest son. i was lucky enough to have an epidural (though i was so scared of paralysis) and not be knocked out, Cody came out screaming so hard his mucus was expelled and he is a healthy little boy. i believe circumstances such as mine warrant c/s.

are we just against needless promotion of c/s for people who want to 'fit' childbirth into both dr and patients timetables? i hope so?
though i must say, if i am lucky enough to fall pg again, coz i know i can have epidural i will opt for a natural (with drugs) delivery, unless told otherwise

sorry if i have rambled im just curious.

[Rach75]

I understand a natural birth is best but its articles like this that scare the crap out of people who have no choice but to have a c-section

my OB wouldn't let me go naturally as I have a ventricular bijimany (spelling wrong) and he was more soncerned about my heart giving in due to stress of labour than the risks of c-section I wasn't sure at first my heart dr kept saying we can monitor but in the long run Jack is better off with a healthy mum than one who could possibly die or suffer a heart attack during labour...in the end we did try a natural well induced labour but my body did not progress my heart raced, Jacks dropped drastically low, so we were rushed in for a emergency c-section Jack was not breathing but thankfully was ok after 10mins

ok I have rambled too much, but I know I will opt for a elective c-section not becuase its convenient or easier for the OB but because I beleive it will be better for me in the long run

I hope I am coming across right, yes a natural birth is best but there are those of us who have little choice but to have a c-section and as I said articles like this make it hard to live with that fact

ETA sonya we posted at same time thats basically what I was trying to say ........is it all c-sections or those of people who as the saying goes are too posh to push

my Katy was a natural labour as well...

[Trish]

Sonya, it is one thing to have a caesarean for a medical reason, whether its psychological or physical. It's another thing to have a c section just because you want to.

Not that I am bashing the girls that choose to do that either. It's all about making an informed decision either way

I hope that you do fall pregnant again, very soon and you get the birth that you dream of

[sonya1]

thanks trish

i only want what is best for our maybe baby. my recovery after a c/s was slow, but i had tubal ligation as well.
im not fussed on the experience for myself, mainly its mums and bubs health i.e like rach's story.... and for my recovery and ability to go home and be a happy and healthy mother for my other children.

these topics are so very interesting, but the stats are very scary for mothers who have 'no option'

[BellyBelly]

If its worth the risk to you then who cares what anyone thinks? The risks need to be said though, so everyone can make an informed decision and clearly, something is going on which is resulting in more c/s - we have a long way down to be at an acceptable level - what else will bring the rate down but knowing the risks? It's like induction - if you know the risks and it's worth it (i.e. urgent situations, psychological) then that's all that matters. But someone has to be allowed to mention it or the c/s will continue to skyrocket as will the stats, and dead mothers and babies. The US has the highest rate of this in the developed world - so its not the 'poor' and 'unhygenic' countries that are skewing stats here!

C/S and induction should be seen and treated as the major surgery it is to keep things in perspective. How do you tell a father whose wife has gone in for a c/s where they have been told there are very little risks when his wife arrests on the table or haemorrages? Or like a client of mine, went into surgery to stop the bleeding after an induction and ended up waking up being told she had no uterus? Small risks... big consequences. My client didn't have surgery complication - but no matter what we NEED to know realities which are not always as rare as we think. Yes it's scary and that sucks. But what's more scary is never knowing in the first place and it coming as a completely unexpected surprise. Lots of law suits I would imagine.

[Trillian]

Sonya, i am not against them when there is a real medical reason to have one(including psychological ones). Regardless of the reason for having it, you just can't stick your head in the sand about the very real risks involved - it is all about informed consent. If you have no other choice but to give birth this way, you still don't need to be scared of the risks, after all many women have them everyday and have no negative outcomes, but you do need to be aware of them is all.

[Tanya]

I think all women should be aware of all the risks involved in such procedures, whether you elect it or not, you need to be made aware. So often c-section is seen as a safe option but it is a major operation and should not be taken lightly.

One of my partners friend's GF has elected to have a c-section because, "I am not pushing anything out of there!"... This really grates me!! Why can this surgery that carries so many risks be funded and yet another birthing choice such as home birth not?

[*Belle*]

Im sorry but I am sick of having these articles around to "scar" people, I need to have a c-section for medical reasons, and dont need these scare tactics of saying my baby may die this makes me very angry and upsets me and I dont need this for my anxiety. Had to say my 2cents next time I wont open the thread. Just wanted to mention that these articles to scare those who medically still need to have a c-section.

[SamanthaP]

It's not even about the discourse of risk anymore. The risks of c-section are in the media every other week at the moment. I think everybody appreciates the risk, you'd have to have your head in the sand not to. The majority of women are not choosing to have c-sections - they are being told they have to have them. The accountability for this lies firmly at the feet of the doctors who are actually not acting exclusively in the best interests of the women, they are protecting their own. So long as women continue to choose inappropriate care givers for their situation (and doctors contine to take advantage of this lucrative industry), then the c-section rate will continue to rise.

[MantaRay]

I am not sure that it is about scare tactics at all. Sure, people get scared when they hear about the risks, that's only normal. But the purpose of informing isn't to scare, it is to inform. I know of someone who chose to have a c-sect as they had trouble conceiving and wanted to take the "Safe" option to reduce the risks. These people are not helped if no-one points out the risks are actually higher with a c-sect.

And Samantha, you are right, the doctors often ARE telling women to do it. All the more reason for us to be informed so that we can assess the information given to us by medical professionals, question it, analyse it, maybe get a second opinion and then decide. We need to be empowered. And to do that we need information.

[Tanya]

Belle, no-one is trying to scare you out of having your baby... threads like this are simply to inform. Everyone who is involved in the birth of a child should be made aware of all the risks involved in all aspects needed to birth their baby. If you are having a c-section for medical reasons or otherwise you shouldn't go into it blindly, these risks are real.

*snap* MR

[myboysmumma]

It is true that the risks are higher (a less than 1 in 1000 choice for vaginal birth, a 1.7 in 1000 chance for caesars). Although there is a double chnace, the chance still thankfully is under 2%.

As long as we keep a balanced view that not all women go into a caesar blind of the risks, and that some people choose them for their own complicated reasons, I agree it is a good thing to know about these risks and make an informed decision.

Any study is interesting pro or against when it comes to birth and parenting.