High C-Section Rates Not Linked to Newborns' Health Outcomes

Amanda Chan, MyHealthNewsDaily Staff Writer

Date: 15 April 2011 Time: 10:45 AM ET

High rates of induced labor and Caesarean sections (C-sections) among low-risk women don't seem to make a difference in the health outcomes of newborns, according to a new study.

There did not seem to be a difference in the newborns' health, whether the hospital had a high or a low C-section or induced labor rate, said study researcher Dr. Christopher Glantz, professor of maternal fetal medicine at the University of Rochester Medical Center. The conclusion was based on five years of data on newborns' health at 10 community hospitals.

The finding suggests that more may not be better, Glantz said. Unless induced labor or C-section is medically necessary, doctors should tell their patients that natural labor is also a safe option for delivering a baby, he said.

"If you could get by doing fewer interventions, why wouldn't you want to do that?" Glantz told MyHealthNewsDaily.

Currently, 32 percent of all deliveries are done by C-section and about one out of every five American births is induced, according to the Centers for Disease Control and Prevention. (A C-section is the surgical removal of the baby from the mother's abdomen; induced labor is when doctors induce cervical widening or "breaking" of the water with medication or other methods.)

The study was published in the April issue of the Journal of Maternal-Fetal and Neonatal Medicine.

Assessing any differences

Glantz and his colleagues reviewed data from 2004 to 2008 from 10 community hospitals without neonatal intensive care units (NICUs). Glantz purposely chose hospitals without NICUs because they tend to care for low-risk women; women with high-risk pregnancies who may need medical intervention are more likely to deliver at hospitals with NICUs.

The study included data from an analysis of 28,800 women who had natural or induced labor, followed by a re-analysis of 29,700 women (many of whom were in the first analyzed group) with no history of C-section.

Glantz assessed the health of these women's newborns by looking at whether they were transferred to a hospital with an NICU (meaning complications arose that required more specialized care of the infant), whether the infants needed immediate breathing assistance and whether the infants received low Apgar scores (a 5-minute assessment of the infant's overall health).

Researchers found that the method of delivery was not associated with whether a baby was transferred to a NICU, received breathing assistance or received a low Apgar score, the study said.

Effects of C-sections and induced labor

While the study also shows that there doesn't seem to be a danger to the infant in having induced labor or a C-section, even if it's not medically necessary, there are additional maternal risks and costs that come with these procedures compared with natural childbirth , Glantz said.

For induced labor, there's a higher chance a mother will wind up with a C-section she doesn't actually need, he said. And with C-sections, there are higher risks of bleeding and infection for the mother than with natural labor, according to another study conducted by Glantz, published in February in the Journal of Reproductive Medicine.

Women who undergo a C-section also tend to have longer hospital stays after delivery than those who undergo natural labor, which means added health care costs, Glantz said.

But that's not to say natural labor is for everyone. Induced labor or a C-section can be safer for a woman if labor isn't progressing, the baby is in an abnormal position, the baby is too big to be delivered vaginally or if there's a problem with the placenta or umbilical cord, according to the Mayo Clinic.

C-sections also tend to be more convenient "quick, one hour, and the baby is out," Glantz said. The idea is appealing to people who are schedule-minded, or people who are afraid of a long labor process, he said.

But "Caesarean is a major surgery," Glantz said. "Why subject a mother to risks of a Caesarean if you're not improving the outcome? I think if you're going to do a major surgery, you'd hope to have some benefit accrue from it."

Pass it on: There does not seem to be a relationship between high or low rates of induced labor or C-section and the health outcomes of the newborn.

Follow MyHealthNewsDaily staff writer Amanda Chan on Twitter @AmandaLChan.