Elective C-section vs. Labor C-section

Day: 36+1

I’ve been reading the blogs on mitbbs for a while, it’s pretty helpful but sometimes I get frustrated seeing people making their decision based on very little or no research. One of the biggest thing that gets me is the casual scheduled (or elective) C-section. I thought the following paragraph summarizes this particular topic very well.

From Chaper 4 – Your C-Section Baby, “The Essential C-Section Guide” by Maureen Connolly and Dana Sullivan

“If you know in advance that you are going to delivery by Cesarean – and neither you nor your baby is experiencing any difficulties – you may want to discuss with your physician the pros and cons of waiting for labor to begin naturally rather than scheduling the surgery on an arbitrary day.

Why bother, you ask? After all, isn’t one of the benefits of a scheduled Cesarean delivery skipping the labor pains? Well, a number of studies suggest that if the baby initiates labor and then experiences some pre-Cesarean contractions, he may benefit from the natural hormones discussed above. One study in particular found that full-term babies who experience labor before a Cesarean delivery were 20 percent less likely to experience respiratory difficulties than the babies who’d been delivered via elective Cesarean prior to the onset of labor. It should be noted that waiting for labor to begin does put a woman at higher risk of infection following a c-section. Also, if you have a full stomach, and then require general anesthesia, you risk serious breathing problems associated with aspirating stomach contents. For this reason your OB may be reluctant to honor our request. Another option is to request that your Cesarean not be done until the thirty-ninth week. A British study that examined nine years of birth records – some 33,000 babies – compared the rates of respiratory illness among babies who were delivered by elective Cesarean during Week 37 and those who delivered during Week 39. The babies born during Week 39 were less likely to experience respiratory problems.”

The hormone mentioned is catecholamines,

“at the onset of labor, the hormones send blood away from ‘nonessential’ organs, such as the skin, in order to keep the essential ones, e.g. the brain and heart, well supplied with blood and oxygen.

Catecholamines also help absorb amniotic fluid from the lungs, and they stimulate the production of surfactant in the lungs. Surfactant is a slippery substance that keeps the lungs surfaces from sticking together and prevents them from collapsing once the baby is outside the womb and breathing air. Some physicians speculate that because this cascade of events doesn’t take place in Cesarean-born babies, it is one reason that some have difficulty breathing at first. Plus, even with all the technology we have – from sonograms that measure the baby’s size to amniocentesis that can be used to check lung development – babies occasionally get delivered by Cesarean too soon. When that happens, the baby can face a host of problems associated with incomplete lung development and prematurity. “

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1 Comment

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One response to “Elective C-section vs. Labor C-section

  1. Kim

    Our society is WAY to concerned with convenience. I think many people choose a scheduled c-section simply because they don’t want to be “surprised” by labor. Being a parent is often about being flexible and dealing with unexpected events. We often have to make sacrifices and do things that are difficult in order to give our children what they need. Most parents are happy to make these sacrifices if it means their children can have things even a little bit better. However, many parents these days are more concerned about their own comfort level. They are not willing to let their children change their lives or interrupt their plans. I think this is intensely selfish.

    Some parents choose this simply because they trust their physician. They think there is no need to research information for themselves because the physician is an expert. However, they don’t realize the physician is motivated and shaped by more than simply their education. Their own comfort/schedule, fear of being sued, and preconceived philosophies weigh on their medical decisions. This is not necessarily wrong, but patients just need to be informed and realize that medical professionals are people who make mistakes just like everyone else.

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