Will a caesarean be safer for you and your baby?

Is a C-section safer than a natural birth? North & South investigates.

The number of caesareans being performed ‘on demand’ in New Zealand is at a record high – often for no other reason than the mother-to-be wanted one. But does technology always make childbirth safer? And are there long-term effects on the baby we don’t yet fully understand?

{Photo credit (above): Adrian Malloch} Midwife Helen Bunster assesses a newborn baby girl at Auckland Hospital

In an investigative cover story in its latest issue, North & South looks at the evidence on the risks – and the benefits – of giving birth by push or by cut.

Fear of childbirth is one of the most common reasons why women chose a planned caesarean, says obstetrician Michelle Wise, a consultant at Auckland Hospital, where a third of babies are born in a surgical theatre. “Fear of pain, fear of the outcome for the baby. Women have a lessening faith in their own bodies that they’re able to birth normally.”

[Photo Credit: Adrian Malloch]

Consultant obstetrician Michelle Wise says whether all pregnant women should be offered a caesarean is “a complex issue for society to debate”.

And older mothers do have a higher risk of complications. Professor Peter Dietz, a urogynaecologist and expert in pelvic floor damage in childbirth, believes elective caesareans should be routinely offered to first-time mums aged 35-plus, or who are carrying a large baby likely to weigh more than 4kg.

He puts the chances of a woman having her first baby at the age of 20 by a normal delivery without major trauma at about 70-80 per cent; by the age of 40, that drops to 20 to 30 per cent. “And no one gets told this. You may well not go into labour spontaneously and the likelihood of being overdue is much higher than at age 18. And every day overdue, there is a cumulative risk of stillbirth. That risk is minimised by an elective caesarean.”

The latest issue of North & South hits stands September 12.

What researchers don’t know is the possible long-term impact on the baby. Numerous international studies have linked being born by caesarean to an increased risk of chronic health problems, including obesity, asthma, type 1 diabetes, coeliac disease, allergies and even childhood myeloid leukaemia. Neonatal specialist Professor Neena Modi, at Imperial College London, told North & South the odds of a c-section baby developing some of these conditions go up by 20 per cent.

“A medically indicated caesarean section can be lifesaving for both mother and baby,” she says. “But normal labour is a very complex process that’s been honed by billions of years of evolution and yet we’ve introduced a new treatment, which is an elective caesarean where there is no medical indication but maternal choice, without thinking what the consequences might be.”

Read the full story, including a comprehensive analysis of international studies on the risks and benefits of a planned caesarean, in North & South on sale Monday, September 12.

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