Benefits of Caesarean Birth

The modern 'bikini line' caesarean section has developed as a relatively safe surgical operation for the mother and baby. It will never be possible to properly compare the safety of caesarean birth with vaginal birth in a randomised controlled trial, but the Term Breach Trail (Hannah et al. 2000) which involved more than 2,000 women and aimed to compare vaginal and caesarean birth for breach babies indicated that serious rates of health complications for the mother were the same for each group.

Caesarean section was developed as a rescue operation and provides an opportunity for the baby to be born when a vaginal birth is not possible. It also provides a more favourable alternative for the baby, to a vaginal birth which is likely to involve significant intervention. In-labour caesarean birth has greater benefits for the baby when compared with non-labour caesarean birth.

The benefits of a planned caesarean birth for the mother include:

• improved pelvic floor health: no injury to the vagina and reduced risk of urinary stress incontinence compared with vaginal birth (NICE 2012);

• very small cosmetic impact with the modern caesarean which all happens below the bikini line (Odent 2004);

• the actual birth being less painful because of the anaesthetic (NICE 2012);

• less risk of severe early bleeding after the birth (NICE 2012).

The benefits of a planned caesarean birth for the baby include:

• provides an opportunity for the baby to be born when vaginal birth is not possible - a rescue operation;

• reduced risk of physical and psychological injury to the baby compared with a 'difficult' vaginal birth involving an artificial oxytocin drip, epidural anaesthesia, vacuum and forceps assisted deliveries (Hankins et al. 2006, Li et al. 2010).

The benefits of an in-labour caesarean birth compared with a non-labour caesarean birth for the baby include:

• the baby is less likelily to be born prematurly by mistake;

• fewer breathing problems;

• fewer breastfeeding problems (Dahlen et al. 2013, Odent 2013).

References

• Dahlen, H.G., Kennedy, H.P., Anderson, C.S., Bell, A.F., Clark, A., Foureur, M., Ohm, J.E., Shearman, A.M., Taylor, J.Y., Wright, M.L., and Downeh, S. (2013). The EPIIC hypothesis: Intrapartum effects on the neonatal epigenome and consequent health outcomes. Med Hypotheses. 2013 May; 80(5): 656–662. Available online at http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3612361/
• Hankins, G.D., Clark, S.M., Munn, M.B. (2006) Caesarean section on request at 39 weeks: impact on shoulder dystocia, fetal trauma, neonatal encephalopathy, and intrauterine fetal demise. Semin Perinatal. 2006 Oct;30(5):276-87.

• Hannah M.E., Hannah, W.I., Hewson, S.A., et al. (2000) Planned caesarean section versus planned vaginal birth for breech presentation at term: a randomised multicentre trial. Lancet 2000; 256: 1375-83.

• Li, H-T., Ye, R., Achenbach, T., Ren, A., Pei, L., Zheng, X., Lui, J-M. (2010) Caesarean delivery on maternal request and childhood psychopathology: a retrospective cohort study in China. BJOG 2010; DOI: 10.1111/j.1471-0528.2010.02762.x.
• NICE (2012) Caesarean Section. NICE Clinical Guideline 132. Available online at http://www.nice.org.uk/nicemedia/live/13620/57163/57163.pdf
• Odent, M (2004). The Caesarean. Free Association Books: London.
• Odent, M (2013) Childbirth and the Future of Homosapiens. Pinter and Martin Ltd.: London