Are Babies Delivered By C-Section Put At Risk?
(BlackDoctor.org) — A new study finds that mothers who deliver vaginally after a cesarean section are less likely to have their babies admitted into the neonatal intensive care unit. However, babies delivered by elective, repeat c-section double the chances of being admitted into the NICU.
These c-section babies are also more likely to have breathing problems requiring supplemental oxygen, the researchers say.
“In addition, the cost of the birth for both mother and infant was more expensive in the elective repeat c-section group compared to the vaginal birth after c-section (VBAC) group,” noted Dr. Beena Kamath, the study’s lead author and a clinical instructor of pediatrics at the University of Colorado School of Medicine, Denver.
The study appears in the June issue of Obstetrics & Gynecology.
Nationwide, the c-section delivery rate keeps rising. According to the study authors, by 2006, 31.1 percent of deliveries in the United States were done this way.
Furthermore, women who have delivered once by c-section have a greater than 90 percent chance of undergoing another, the authors noted. But experts continue to debate whether these women should try labor and vaginal delivery, or automatically undergo another c-section, as there are risks are associated with each method.
To help clarify those risks, Kamath and her colleagues turned to records from the perinatal database at the University of Colorado Denver. Those records ran from late 2005 through mid-2008 and focused on babies born to 343 women who had planned a repeat, elective c-section and another 329 who planned to try vaginal birth after having previously had a baby via c-section.
The researchers looked at the differences between groups in newborn admissions to the neonatal ICU and the need for oxygen for breathing problems, as well as cost differences.
Kamath’s team further divided the women into four groups. Of the 343 repeat c-sections, 104 went into labor before the c-section and 239 did not. Of the 329 women who attempted vaginal delivery, 85 failed (for various reasons) and went on to have a c-section.
Kamath’s team found that 9.3 percent of the c-section babies were admitted to the NICU, but just 4.9 percent of the vaginally delivered babies were. And while 41.5 percent of the c-section babies required oxygen in the delivery room, 23.2 percent of the vaginally delivered babies did. After NICU admission, 5.8 percent of the c-section babies needed the oxygen compared to 2.4 percent of the vaginally delivered babies.
The median hospital stay was three days for babies who were delivered vaginally and four days for the other three groups. Total costs for the c-section group averaged $8,268; for the vaginal group, $6,647.
“The failed VBAC babies required the most resuscitation and had the most expensive total birth experience,” Kamath concluded. But, overall, the VBAC group did better than the c-section group in terms of hospital stay and other measures, she said.
Women who opt for a repeat c-section should first understand these risks and differences before they make their decision, Kamath said.
The study results suggest another important take-home point, according to Dr. Alan Fleischman, senior vice president and medical director for the March of Dimes, based in White Plains, N.Y. “The decision to have your first c-section is very important,” he said. “There should be a clear medical indication [because] your first may dictate subsequent [delivery methods].”
Women also need to know that vaginal delivery is possible for many women who have already undergone a c-section, Fleischman said. Some hospitals do not allow vaginal delivery after a prior c-section, however, so he suggested that any woman who is planning on one find out early on what her hospital’s policy is.
In the same issue of the journal, other researchers found that the chance of a pregnant woman having a hypertensive disorder — such as high blood pressure that first occurs during the pregnancy — has risen greatly in recent years, from about 67 per every 1,000 deliveries in 1998 to more than 81 per 1,000 deliveries in 2006.
This increase, in turn, is boosting the number of hospitalizations associated with health problems in the mother-to-be, such as kidney failure or breathing problems, according to researchers at the U.S. Centers for Disease Control and Prevention.
Protect Your Baby From SIDS
Infant death is hard to understand and it can bring anger, pain, sadness, and confusion. Causes of infant deaths vary, but could include sudden infant death syndrome (SIDS), birth defects, pre-term/low birthweight, problems with the pregnancy, accidents, or respiratory distress syndrome. African American infant deaths are more than twice the rate of non-Hispanic white infant deaths. There are things you can do to improve your chances of having a healthy baby.
- Visit your doctor or nurse as soon as you find out you’re pregnant. See your doctor or nurse during your pregnancy for prenatal care.
- Talk to your doctor or nurse about taking a vitamin with folic acid and iron.
- Talk to your doctor or nurse about how much weight you should gain.
- Drink lots of fluids and eat foods high in protein and fiber such as whole wheat breads, whole-grain cereals, fruits (apples, pears, strawberries), nuts, seeds, and beans. Avoid high-fat and fried foods.
- Talk to your doctor or nurse to make sure you’ve had all the vaccines (shots) you need.
- Talk to your doctor or nurse about what exercises will help you.
- Don’t touch cat litter or undercooked meat.
- Avoid hot tubs, saunas, and steam rooms.
- Tell your doctor or nurse about any medicines you take, both prescription and over-the-counter.
- Don’t use drugs, smoke, or drink alcohol.
- Avoid insecticides and products that have lead, mercury, or solvents (such as paint thinner).
Of great concern to African Americans is sudden infant death syndrome (SIDS). African American mothers have higher rates of SIDS, compared to non-Hispanic white mothers. SIDS is the sudden and unexplained death of a baby under one year of age. Even though there is no way to know which babies might die of SIDS, there are some things you can do to make your baby safer.
- Always place your baby on her or his back to sleep, even for naps.
- Place your baby on a firm mattress that fits snugly inside the crib.
- Remove soft, fluffy, and loose bedding (pillows, quilts) and stuffed toys from your baby’s sleep area.
- Make sure everyone who cares for your baby knows to place your baby on her or his back to sleep on a firm mattress.
Make sure your baby’s face and head are never covered during sleep. Keep blankets away from your baby’s mouth and nose. The best way to do this is to dress the baby in sleep clothing so you will not have to use any other covering over the baby. If you do use a blanket, make sure that the baby’s feet are at the bottom of the crib, the blanket is no higher than the baby’s chest, and the blanket is tucked in around the bottom of the crib mattress.
- Don’t let anyone smoke around your baby.
Don’t let your baby get too warm during sleep. Keep your baby warm during sleep, but not too warm. Your baby’s room should be at a temperature that is comfortable for an adult. Too many layers of clothing or blankets can overheat your baby.