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May 13, 2021

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Women who plan to have a cesarean delivery are not more likely to suffer poor results

A study shows that planned cesarean deliveries do not pose a greater threat than vaginal births to the mother or child.

NHS doctors tend to only perform the main procedure if it is considered the safest option as it carries many risks.

But Canadian researchers have now challenged the claims, finding it might be best for mothers and their babies.

University of Ottawa scientists searched records of 422,000 births, including 2,000 where expectant mothers chose to have a C-section.

They counted the number of those admitted to intensive care and compared the death rates between the two groups.

The results showed that women who chose to have a caesarean section faced no greater risks, and suggested that mothers and their babies might be in a better position.

About 700,000 babies are born in the UK every year, a quarter of them from cesarean delivery. The measure accounts for a similar percentage of baby boomers in the United States.

Women who have had a cesarean delivery and their babies are not more likely to suffer poor results compared to those who choose vaginal delivery (stock)

What is CDMR?

Some expectant mothers require a cesarean delivery before birth.

Doctors call this a cesarean delivery at the mother’s request, or CDMR.

The benefits of a vaginal delivery are well established, including no need to recover from surgery, reduced risk of scarring and an improvement in the baby’s microbiome.

But some women still request the procedure due to concerns about childbirth, perceptions will be better care, or concerns about urination or sexual issues.

The NHS says a C-section can be done for non-medical reasons once the risks have been explained by a doctor or midwife.

They wrote online: “After discussing all the risks and listening to all the support on offer, you still feel that vaginal delivery is not an acceptable option, you should be offered a planned caesarean section.”

“If your doctor is unwilling to undergo the operation, he must refer you to a doctor who will do so.”

There are around 700,000 births in the UK each year, of which more than 100,000 are Caesarean deliveries. The United States has 3.75 million annually, including 1.25 million C-sections.

It is not clear how many cesarean deliveries were at the mothers’ request.

NHS guidelines argue that the common procedure is “extremely safe” but does come with standard surgery risks, such as blood clots and infections.

Caesarean deliveries are usually performed for medical reasons including babies in the wrong position, or the mother suffering from preeclampsia.

For this reason, it is difficult to compare different birth methods because women are already at a higher risk.

Dozens of women, often called “push-tight”, are choosing to undergo the surgery for non-medical reasons.

Experts say expectant mothers may choose a cesarean delivery due to perceptions that they will receive better care, improving outcomes for themselves and their babies.

This is despite the fact that the benefits of vaginal delivery are well known, including the lack of need to recover from surgery and the improvement of the baby’s microbiome.

The researchers led by Dr. Yan Fang Ju, who is also part of the Ottawa Hospital Research Group, examined official birth records in Ontario, Canada, for a period of seven years through 2018.

The team determined the number of vaginal births and “cesarean delivery at the mother’s request” (CDMR).

Among the pregnant women, they examined the number of women experiencing rectal or uterine tears, unexpected surgical procedures or required blood transfusions.

Among their children, they screened for adverse events such as shock, death, and heart rate problems.

There were 18,336 (4.4 percent) adverse events among pregnant women who chose to give birth vaginally, compared to 37 (2 percent) in women who had a cesarean delivery.

For children born vaginally, there were 17,899 (4.3 percent) adverse events, while in Group C there were 34 (1.9 percent).

The results indicated that the women who underwent a C-section were 50 percent less likely to experience poor outcomes.

But academics caution that more research is needed because this figure is based on a very small sample size.

They also found that those who chose vaginal delivery tended to be older and richer, in contrast to the profiling of women who chose CDMR.

The scientists said: “This analysis shows that planned CDMR is safe for low-risk pregnancies and may be associated with a lower risk of negative birth outcomes compared with vaginal births.”

“Although our study addresses concerns about the direct effects of planned CDMR, exploring long-term risks is essential, including its effect on breastfeeding and the child’s risk of infection and respiratory disease.”

They added: “ Women may prefer CDMR for many reasons, including rest scheduling, concern about labor pains, perceptions that the quality of obstetric care is better for women with cesarean sections, and concerns about possible incontinence and sexual dysfunctions after a vaginal delivery. “.

The study is published in the Canadian Medical Association Journal.

What are the medical causes of conditioning department?

There are many reasons why a doctor might recommend a cesarean delivery instead of a vaginal delivery.

If you have had complications in a previous pregnancy or delivery, or in an existing pregnancy, then a so-called planned or elective caesarean section, or planned repeated caesarean section, may be advised.

If you are planning to give birth vaginally, but complications during labor or delivery mean that it is recommended to give birth by caesarean section, you will undergo what is called an emergency or unplanned cesarean delivery.

Here are some of the reasons why doctors may choose a planned or emergency cesarean delivery instead of a vaginal delivery:

  • You have already had at least one caesarean section;
  • Your child is in a bottom-down or a seat position;
  • If your child is in a sideways (occasional) position, or continues to change position (unsteady lie);
  • You have had a low placenta previa (placenta praevia);
  • You have a medical condition, such as heart disease or diabetes.
  • You lost a baby in the past, either before or during labor;
  • You are pregnant with twins or more;
  • Your baby is not growing as it should be in your womb;
  • You suffer from preeclampsia or severe preeclampsia, which makes delaying labor dangerous.
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