C-section no riskier than natural birth for mother and baby, according to new study

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  • New evidence shows that planned C-sections are safe for low-risk pregnancies
  • Researchers of the study assessed data on pregnancies over a six-year period
  • Planned C-sections may even involve a lower risk of adverse events, compared to planned vaginal deliveries

Giving birth is a pivotal life event, and for most women, choosing between having a Caesarean (C-section) or natural birth is a daunting decision.

Both birthing options come with risks and potential complications, but while C-sections are a choice for some women, they are generally carried out for medical reasons, including the foetus being in the wrong position, or the mother suffering from preeclampsia.

Now, new research by Ottawa University scientists provides reassurance that planned C-sections pose no bigger threat than vaginal deliveries for either mother or baby. In fact, it found indications that women taking this birth route might even be better off.

The researchers assessed medical records of more than 420 000 low-risk births, counted the number of women requiring admission to intensive care, and death rates in the two groups. Their findings were published in the Canadian Medical Association Journal.

Rise in C-sections

There’s been an upward trend in C-sections, making the procedure increasingly common.

Figures from the 2015/2016 District Health Barometer report indicate that around 26% of babies born in South African public hospitals were born by C-Section, Bhekisisa reported, while a more recent article in Business Insider SA notes that 77% of medical-aid babies in the country are now born via C-section.

Reassuring findings

The study used province-wide data from the Better Outcomes Registry & Network (BORN), Ontario's provincial birth registry.

The authors analysed data on pregnancies over six years (2012 to 2018). A total of 46 533 C-section deliveries took place, of which just over 1 800 were planned at the request of the mother.

"Our finding that CDMR [Caesarean delivery on maternal request] rates have remained stable in Ontario provides reassurance to those concerned about the potential contribution of CDMR to rising Caesarean delivery rates," wrote lead author, Dr Darine El-Chaar, Department of Obstetrics, Gynecology and Newborn Care, The Ottawa Hospital.

Fewer adverse events in CDMR

The researchers also checked how many women suffered tears to the rectum or uterus or required blood transfusions. Among the babies, the team looked for adverse events including trauma, death, and heart rate problems.

A total of 18 336 (4.4%) adverse events were reported among women who opted for vaginal delivery, compared to 37 (2%) in those who had C-sections.“This analysis shows that planned CDMR is safe for low-risk pregnancies and may be associated with a lower risk of adverse delivery outcomes compared with vaginal deliveries,” they said.

A study published in 2019 indicated that there were more complication risks with C-section than natural delivery, Health24 reported. However, the study sample was much smaller than the more recent study, with the data of just over 4 900 women included in the research.

Still, the authors of the newer study cautioned that more research was needed.

“Although our study addresses concerns relating to the immediate implications of planned CDMR, exploration of longer-term risks is needed, including its impact on breastfeeding and the child's risk for infection and respiratory illness,” they said.

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