Thanks for sharing Kelly,
Do u have the reference for that article
Cheers Ganesha
From: owner-ozmidwifery@acegraphics.com.au [mailto:owner-ozmidwifery@acegraphics.com.au] On Behalf Of Kelly @ BellyBelly
Sent: Wednesday, 18 October 2006
1:29 PM
To: ozmidwifery@acegraphics.com.au
Subject: [ozmidwifery] Risks of
Elective Caesarean Sept 06
In case you haven’t seen it yet, read below. I also
hear there is another study just come out or about too, about maternal
mortality rates which had found that mothers were 4 times more likely to die if
they had a c/section, compared with a normal birth. It broke down cause of
death by %:
Voluntary
C-Sections Result in More Baby Deaths
LARGE STUDY shows significant evidence
Article published in the New York Times
By NICHOLAS BAKALAR
Published: September 5, 2006
A recent study of nearly six million births has found that the risk of death to
newborns delivered by voluntary Caesarean section is much higher than
previously believed.
Researchers have found that the neonatal mortality rate for Caesarean delivery
among low-risk women is 1.77 deaths per 1,000 live births, while the rate for
vaginal delivery is 0.62 deaths per 1,000. Their findings were published in
this month's issue of Birth: Issues in Perinatal Care.
The percentage of Caesarean births in the United States increased to 29.1
percent in 2004 from 20.7 percent in 1996, according to background information
in the report.
Mortality in Caesarean deliveries has consistently been about 1½ times that of
vaginal delivery, but it had been assumed that the difference was due to the
higher risk profile of mothers who undergo the operation.
This study, according to the authors, is the first to examine the risk of
Caesarean delivery among low-risk mothers who have no known medical reason for
the operation.
Congenital malformations were the leading cause of neonatal death regardless of
the type of delivery. But the risk in first Caesarean deliveries persisted even
when deaths from congenital malformation were excluded from the calculation.
Intrauterine hypoxia — lack of oxygen — can be both a reason for
performing a Caesarean section and a cause of death, but even eliminating those
deaths left a neonatal mortality rate for Caesarean deliveries in the cases
studied at more than twice that for vaginal births.
"Neonatal deaths are rare for low-risk women — on the order of about
one death per 1,000 live births — but even after we adjusted for
socioeconomic and medical risk factors, the difference persisted," said
Marian F. MacDorman, a statistician with the Centers for Disease Control and
Prevention and the lead author of the study.
"This is nothing to get people really alarmed, but it is of concern given
that we're seeing a rapid increase in Caesarean births to women with no
risks," Dr. MacDorman said.
Part of the reason for the increased mortality may be that labor, unpleasant as
it sometimes is for the mother, is beneficial to the baby in releasing hormones
that promote healthy lung function. The physical compression of the baby during
labor is also useful in removing fluid from the lungs and helping the baby
prepare to breathe air.
The researchers suggest that other risks of Caesarean delivery, like possible
cuts to the baby during the operation or delayed establishment of
breast-feeding, may also contribute to the increased death rate.
The study included 5,762,037 live births and 11,897 infant deaths in the United States
from 1998 through 2001, a sample large enough to draw statistically significant
conclusions even though neonatal death is a rare event.
There were 311,927 Caesarean deliveries among low-risk women in the analysis.
The authors acknowledge that the study has certain limitations, including
concerns about the accuracy of medical information reported on birth
certificates.
That data is highly reliable for information like method of delivery and birth
weight, but may underreport individual medical risk factors.
It is possible, though unlikely, that the Caesarean birth group was inherently
at higher risk, the authors said.
Dr. Michael H. Malloy, a co-author of the article and a professor of pediatrics
at the University of Texas Medical Branch at Galveston, said that doctors might want to
consider these findings in advising their patients.
"Despite attempts to control for a number of factors that might have
accounted for a greater risk in mortality associated with C-sections, we
continued to observe enough risk to prompt concern," he said.
"When obstetricians review this information, perhaps it will promote
greater discussion within the obstetrical community about the pros and cons of
offering C-sections for convenience and promote more research into
understanding why this increased risk persists."
Best Regards,
Kelly Zantey
Creator, BellyBelly.com.au
Conception, Pregnancy, Birth and Baby
BellyBelly Birth Support
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