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February 21, 2013 by KAREN FOSTER
C-Sections No Safer Than Vaginal Deliveries Even For Complicated Pregnancies


According to new research from a multi-site trial led by University of Toronto researchers, even complicated deliveries such as twins are just as safe via planned vaginal births as they are by planned cesarean section.

An increasing number of women, including many first-time mothers, are requesting a C-section, even when it's not medically necessary. The latest maternity figures show that 25 percent of mothers had the surgery--an alarming trend which has many drawbacks for both mother and child.

Older mothers are more inclined to have an elective C section - with 18 percent over the age of 35 opting not to give birth naturally.

One in 10 mothers aged 25 to 34 had the elective surgery with just five percent of those under 25 giving birth by caesarean, according to the hospital data from the Health and Social Care Information Centre (HSCIC).

“Our findings show that planned vaginal birth is the correct method for delivering twins in a pregnancy that is otherwise uncomplicated, and when the first baby is facing head down,” says Professor Jon Barrett from the Department of Obstetrics and Gynecology. “We found that there is no reason for doctors or women to be planning to deliver twins by cesarean section, as the babies’ outcomes remain the same regardless of how they are delivered.”

The findings of the study, which involved 106 centres in 25 countries, were presented this week at the Society for Maternal-Fetal Medicine Annual Meeting in San Francisco. Nearly a decade in the making, it is the only large scale, randomized controlled trial that has been undertaken to determine the optimal method of delivering twins.

The study randomized 2,804 women with twin pregnancies, in which the first baby faced head down, for either a planned cesarean section or planned vaginal delivery. Women were enrolled between 2003 and 2011, and randomization was centrally controlled at the Centre for Mother, Infant and Child Research at Sunnybrook Health Sciences Centre, part of the University Health Network. Mothers and infants were followed to 28 days after birth.

As the number of multiple births in Canada and around the world has risen, so too has the trend of delivering twins by planned cesarean section. Barrett says he hopes the results of this study will help women and their physicians choose the method of delivery that is right for them.

“People are often not sure what the right delivery method is and sometimes default to cesarean section because they perceive it to be safer. However, we now know that is not the case,” says Barrett, who is also Chief of Maternal-Fetal Medicine at Sunnybrook Health Sciences Centre and Director of the Women & Babies Research Program at Sunnybrook Research Institute.

C-Sections Unhealthy For Mother and Baby

A Danish study examining 34,000 deliveries suggests babies born by C-section were up to four times more likely to have respiratory problems than those born naturally.

Newborns delivered by caesarean may miss out on critical bacterial molecules that help their gut grow healthily--something that seems to be effectively accomplished through vaginal births.

A recent study also showed that caesarean born babies are also at double the risk of becoming obese children as those delivered naturally.

Infants who are delivered by C-section may have an increased risk of developing food allergies, according to a new report published in the August issue of the Journal of Allergy and Clinical Immunology.

Women who have their first child by caesarean are also more likely to have placenta-related problems in their second pregnancy, research suggests.
A Caesarean section increases the risk by 50-fold that a woman's uterus will rupture during a subsequent vaginal delivery, research suggests.

Women who give birth by caesarean section take longer on average to become pregnant again, according to the results of a large British study

Women having a non-emergency caesarean birth have double the risk of illness or even death compared to a vaginal birth, according to a study from Latin America.

Additionally, the study found that those women who were randomized to planned cesarean sections delivered their babies earlier, something Barrett says should be avoided.

Dr. Barrett said he and his colleagues hope the findings of the Twin Birth Study will help decrease the rate of unnecessary cesarean sections. “I think these results will serve as a heads up to physicians to keep vaginal delivery skills in practice, so we don’t lose them,” he says.

Karen Foster is a holistic nutritionist, avid blogger, with five kids and an active lifestyle that keeps her in pursuit of the healthiest path towards a life of balance.

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