Elective Caesareans put mums and babes at risk of death

Oct 31 2007

According to a new British study women who opt for non-emergency Caesareans double their risk of dying or developing severe complications following the procedure.

The study by researchers at the University of Oxford has also found that in some cases Caesareans increased the risk of death to newborn babies by as much as 70 per cent.

The study supports mounting evidence that compared to vaginal births, Caesareans are risky procedures.

Dr. Jose Villar, an obstetrician who led the study, says an intervention that is not clinically needed, increases problems for mothers and babies and that needs to be confronted.

Doctors will usually recommend a Caesarean if vaginal delivery could cause medical complications, for the mother and/or the baby, but they have become increasingly common for what would be considered normal births by what is often dubbed the 'too posh to push brigade'.

The data for the study was taken from a global World Health Organisation survey on almost 100,000 births in eight randomly selected countries in Latin America and 120 hospitals; it makes the study one of the largest to examine the risks of Caesareans.

Of that number of deliveries about a third were Caesarean, which equates with figures from Europe and the United States.

Dr. Villar says the number of non-emergency Caesareans was close to the 15 percent rate seen in developed countries.

The research revealed that complications from Caesareans doubled the risk of dying or severe complications, such as hysterectomies, blood transfusions, or admission to intensive care regardless of age, medical history, or where the baby was born.

The researchers found the procedure raised the chances of a newborn being taken to intensive care and the risk of death was 70 percent higher for babies born head first from both elective and non-elective Caesareans.

Villar also says the study showed the procedure helped save the lives of breech babies and reduced the overall risks in cases where the mother or baby was in danger.

Dr. Villar, a former director of maternal health at the World Health Organisation, says there was no benefit from the current liberal use of Caesareans, either for mothers or babies, and they could even do harm.

Caesareans led to longer hospital stays for mothers and babies, increased the risk of re-admission and increased the risk to subsequent pregnancies.

Dr. Villar says doctors are under pressure to play it safe with Caesareans, and that is a policy which might need rethinking.

The study is published by the British Medical Journal.