Thursday, May 21, 2009

US News: Risk to Baby Rises With Repeat C-Sections

THURSDAY, May 21 (HealthDay News) -- Babies delivered by elective, repeat cesarean section delivery are nearly twice as likely to be admitted to the neonatal intensive care unit (NICU) than those born vaginally after the mother has previously had a c-section, a new study finds.

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.

Read the rest of the article here.


  1. where does this leave me?
    I did not want to have to have a c-sec the first time....the 2nd was nessary because of the bandels ring, and Holdyn's drop in his heart rate. I don't regret having another c-sec, but this kind of info worries me.

  2. So this should be some sort of argument for allowing VBAC, right? And maybe ten years from now VBAC policies will change based on studies like these. Although I'm sure lots of people will do their very best to discredit the study. (I sure miss having university access to journals.)

  3. Yep, this happened to my baby. My second pregnancy ended in a repeat c-section (not by choice, they just took advantage of my vulnerability at the end of pregnancy when I went 8 days over due and told me I had to abandon my VBAC plans and have a repeat since I was overdue). My baby was in the NICU for 5 days. It was such a traumatic experience. I try to tell as many people as I can though to spread the word about c-sections not being safe for mom or baby!!

    Here's the long story on my blog:

    PS I am going to try for a VBAC again someday. I will never again go to the table for some dumb reason like being overdue.

  4. I wonder how much of the increased risk was from the elective part (meaning scheduled, hence no labor and the baby possibly not being ready to be born) and how much from the lack of vaginal birth itself, which helps prime the baby's lungs, especially as the baby goes through the birth canal?

    This isn't really new information at all, but I think it's the first time researchers have quantified the risks with previous cesarean sections specifically. Anyway, I think it just emphasizes the need for caution and prudence when recommending cesareans, whether primaries or repeats (since the primary CS almost always results in ERCS in our country). ERCS is often sold as risk-free while VBAC is portrayed as the only choice that carries risk. That, of course, is not true at all.

  5. I don't think a bandels ring ever goes away. It is the way the uterus is. Not overly common. But I have never heard of a woman having a c-section, having a bandels ring and then having a successful vbac.

    Here is my anecdotal evidence. I used to do the repeat elective C-sections during day at my hospital. That was my job description. So I have seen a lot of repeat electives. And those babies come out not knowing what hit them. I have seen some pretty floppy babies. I have discussed this issue with the the Chief of Neonatology and she agreed with my findings.

    I believe why not just try a vbac? My hospital does them. I mean, you never know how it would have gone if you don't give it a try.

  6. I'd love to know if they had stats on trial of's who at least experienced a good amount of labor before sectioned...but since it's a study scheduled repeats C-secs...I suppose not. I really think it helps clear the lungs.

  7. Angoraknitter: I would like to know that too. I have wondered why a woman is not allowed to wait for labor to begin before a "scheduled" c-section. Could she not be instructed to go to the hospital at the onset of labor rather than just picking a day near the due date?

    When I consented to a c-section I had been laboring for about 36 hrs, and that took a lot of worry away for me regarding my baby's lungs. I knew she was ready to be born, she just needed some help. My husband says she came out kicking and she had no problem breathing on her own.

  8. Olivia,

    I would suspect that the main reason is so that they can schedule the C-section when it is most convenient for them. What if you went into labor at 10:00 at night, and they had to come out at midnight for a C-section, that they could have done when they were wide awake? Not saying that's preferable, but that's probably the main thought process.


  9. Thanks, I bookmarked this study. There was also a recent BMJ study that found children born by cesarean section have a higher risk of asthma than those born by vaginal delivery.

    Like you said, I don't think it's exactly new information, especially that babies require more aggressive respiratory support and suctioning after a c-section than a vaginal birth. But it's good to see it quantified and in a traditional journal and the mainstream news.

  10. Sorry, upon further investigation, I have found out that Bandel's ring does not necessarily appear with subsequent pregnancies.


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