It may seem like undergoing surgery to have a child wouldn’t have a lot of advantages, but it turns out there may be some benefits to having a cesarean section.
Experts warn, however, that it doesn’t mean you should schedule the operation unless it’s needed.
Dr. Sarah Stock, who researches preterm birth at the University of Edinburgh in Scotland, and her team looked at one randomized controlled trial and 79 cohort studies involving nearly 30 million women.
The studies looked at long-term outcomes of women who had the surgery compared to those who delivered vaginally.
They found that babies delivered via C-section had an increased risk of asthma for up to 12 years and an increased risk of obesity for up to 5 years of age.
Stock’s team can’t say whether the findings are causational. They also didn’t evaluate data so it could be separated into planned vs. emergency C-sections.
Risks and benefits of C-sections
There are a few potential benefits to having a C-section, Dr. Neil S. Seligman, an OB-GYN at the University of Rochester Medical Center in New York.
Most C-sections are scheduled during the 39th week of pregnancy, so doctors know within minutes of delivery if the infant needs surgery for problems such as congenital heart disease.
A planned cesarean section also lowers the risk of birth injuries such as asphyxia (oxygen deprivation), shoulder dystocia, and fractures, Seligman said.
Whether cesarean section operations actually prevent pelvic floor disorders (such as prolapse or incontinence) is still somewhat controversial. In cases where women have had surgery for incontinence prior to pregnancy, having a C-section may be preferred in order to avoid re-injury.
There are risks associated with having a C-section though — especially if the woman has future pregnancies.
Miscarriages and placenta previa (when the placenta covers the cervical opening) are risks associated with having a C-section.
In addition, women who have C-sections are also at an increased risk for placenta accreta (when blood vessels grow deeply into the uterine wall and don’t easily detach during delivery) and placental abruption (when the placenta detaches from the womb).
In the case of placenta accreta, a hysterectomy must be performed after delivery, Seligman noted.
There’s also a rare complication called a cesarean scar pregnancy, a type of ectopic pregnancy that forms on the old cesarean delivery scar.
Scar tissue from a C-section can make subsequent deliveries more difficult because it increases the risk of bowel or bladder injuries, and excessive bleeding.
C-sections on the rise
Caesarean deliveries have gone up across the globe — especially those performed when not medically necessary.
About one in three births in the United States is via C-section. That rate has soared from about 5 percent in 1970 to 20 percent in 1996 to 32 percent in 2015, according to the Centers for Diseases Control and Prevention (CDC).
“There is an exaggerated perception of the safety of cesarean section to [an] extent that is viewed as essentially risk-free. But it’s major abdominal surgery and complications are going to happen” Seligman said. “Thankfully, the risk of most major complications is low, but at a high-volume hospital, complications are a reality that can have a significant impact, among other things, interfering with breastfeeding, bonding with the baby, and can spark postpartum depression.”
“Once you put a hole in the uterus there’s no going back,” he added. “It will always be an issue that needs to be addressed in future pregnancies so it’s essential that the decision to pick up a knife is a well thought out one by both the physician and the patient.”
This past fall, a study came out that found the length of a surgical incision is associated with pain after delivery.
The research, which was presented at the Anesthesiology 2017 annual meeting, found that the optimal length is between 4.5 inches and 6.5 inches.