BABIES born by elective caesarean are almost 2½ times more likely to die within their first month than babies born vaginally, researchers have found, adding weight to the argument that caesareans should only be carried out in emergencies.
The study, which involved more than 8 million births in the US over four years, is the first of its kind to focus on full-term babies born to women with no medical reason for choosing a caesarean over a vaginal delivery, an increasingly common phenomenon in Australia.
One in three babies are born by Caesarean in Australia: most of these caesareans are elective. The most common reason for performing an elective caesarean is for a previous caesarean. This is despite evidence that suggests that a vaginal birth after a caesarean (VBAC) is safer for women and babies.
... babies ... born before the onset of labour are often unresponsive and unable to breathe without help.
They are frequently admitted to neonatal intensive care units because their lungs cannot eliminate secretions and they lack catecholamines, a vital chemical secreted during labour that keeps them alert and eager to feed.
"We are designed to give birth vaginally. When will people wake up and realise this?" the secretary of the NSW Midwives Association, Hannah Dahlen, said yesterday. "When a baby is born vaginally, fluid is squeezed out of the lungs as it is pushed through the birth canal. The baby can then inhale with clean lungs ... A baby born by caesarean quite often comes out gurgling because its lungs are full of fluid, requires suction and is non-responsive because it lacks the hormonal surge delivered during labour."
... babies born vaginally with high levels of catecholamines were usually alert and quick to seek out their mother's breast ...
The study ... only included women who had not had a previous caesarean; were giving birth to a single baby which was head down in the cervix; were between 37 and 41 weeks gestation and had none of the 16 common risk factors, such as diabetes or hypertension, associated with birth complications, in a bid to ensure that only low-risk births were evaluated.
It found the mortality rate for babies born vaginally was less than one in 1000 births while the rate for elective caesareans was 1.73 per 1000 ...