Elective Caesarean births put babies at three times the risk of dying

Sep 7 2006

Researchers in the U.S. say that babies born by Caesarean section rather than normal birth, are three times more likely to die.

As an increasing number of today's mothers choose to have their babies this way, when there is no medical need for it.

The large study is the first to compare death rates when women chose the procedure in advance in consultation with their obstetricians.

The cases chosen were those of women with no known medical reason for the procedure, or with no special complications during labour.

Marian MacDorman, of the Centres for Disease Control and Prevention in Atlanta, Georgia, who led the study, says neonatal deaths are rare for low-risk women, around one death per 1,000 live births, and even after they adjusted for socioeconomic and medical risk factors, the difference persisted.

Almost a quarter of British babies are born this way and U.S. Caesarean rates increased by 41 per cent between 1996 and 2004, while the rate among low-risk women nearly doubled.

Baby deaths following Caesareans were known to be higher than after normal vaginal births, but the reason was always thought to be that many operations were done as emergencies, when problems arose during labour.

MacDorman says the findings should be of concern for clinicians and policymakers who are observing the rapid growth in the number of primary Caesareans to mothers without a medical indication.

MacDorman, says they are not trying to alarm anyone but advise women considering an elective Caesarean to consult with their doctor.

The team studied more than 5.7 million live births and nearly 12,000 infant deaths in the United States from 1998 to 2001.

They counted neonatal deaths among babies (occurring within 28 days of birth) and found that the neonatal death rate for Caesarean birth among low-risk women was 1.77 deaths per 1,000 live births while the rate among vaginal births was 0.62.

The rates of Caesarean operations have been increasing rapidly in the U.S., where they now account for 29 per cent of births.

Experts suggest that the natural vaginal birth process as well as squeezing fluid out of the lungs, releases hormones that promote healthy lung function.

The authors hope the results will promote greater discussion within the obstetrical community about the pros and cons of offering Caesarean sections for convenience.

A French study has co-incidentally suggested that Caesarean delivery more than triples a woman's risk of dying in childbirth compared with a vaginal birth.

Researchers led by Catherine Deneux-Tharaux, of the Tenon Maternity Hospital, Paris, found that the risk of death, from blood clots, infection or complications from anaesthesia, was 3.6 times higher for women who had Caesareans.