Tuesday, October 13, 2009

Rethinking Preterm in Regards to Repeat Cesarean

According to the March of Dimes, preterm is any baby that is born before 37 weeks. They say about 12.8% of all births in the United States are preterm and this rate is steadily rising. But a recent study came out that highlighted the risk of increased complications like respiratory distress and lung/digestive prematurity for babies born before 39 weeks via cesarean section.

In the past the trend has gone towards earlier, repeat cesarean, rather than waiting until closer to term (39 weeks). As this study shows, this has lead to an increase in complications for the baby. And since many of the determinations of gestational age were based on ultrasound and/or a "guess" at conception date, there is a chance that this time frame was off. So perhaps many families went in to a cesarean thinking they had a healthy, term baby only to end up in the NICU.

How can this be helped? With increased research into the incidence of complications regarding cesarean before 37 weeks and a clear VBAC policy that respects women. Many of the women who have repeat cesareans are not given the option of VBAC. And if the hospital is not set up for emergencies that would necessitate cesarean in cases of VBAC, what are the odds that they will have a top-of-the-line NICU to accommodate the newborn in case of complications.

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