Elective Repeat C-Sections: Damned If You Do, Dammned If You Don’t

All week we’ve been hearing that babies born via elective, repeat c-sections before 39 weeks face roughly double the health risks such as respiratory distress. Okay, fine. But if you’re like me, and have been around the parenting corner a few times, especially the last decade, then you’re probably remembering all the bad press about VBAC deliveries (vaginal births after Cesarean birth).

Remember studies like this one, I might add, from not too long ago?

National Study Finds Second Cesarean Section Safer Than Normal Delivery

ScienceDaily (Jan. 3, 2005) — WINSTON-SALEM, N.C. – For a pregnant woman who already has had one cesarean delivery, an attempt at vaginal delivery is more dangerous for the baby than a second cesarean section, according to a research study at 19 academic health centers, including Wake Forest University Baptist Medical Center.

Granted, the risk to the baby and the mother was very small in this study, but nonetheless many women with visions of ruptured uterus’s opted for elective, repeat c-sections. How many doctors flat out refused to let women even consider vaginal births? If you’re like me, you know more than a few women who were never given the option.

And now we’re practically chastising women who choose repeat c-sections.

And what I’d really like to know but can’t find out without shelling out money to read the research article is this – just how large a risk are we talking about? I’ve read the risks are roughly double for full-term babies born before 39 weeks. But what is the risk at 39 weeks? A 1 in 100 chance of respiratory problems? A 1 in 1,000 risk? If it doubles from 1 to 2 in 1,000 – is that really a meaningful difference? Remember these researchers studied over 13,000 births. That’s a very large sample. And very very small differences in very large samples can yield statistically significant differences – and thus publishable articles – with questionable meaningful differences.