Early C-sections cause concern

Early C-sections cause concern
 

If you've scheduled a C-section to coincide with your mother-in-law's visit or you wanted to have your baby on your doctor's schedule, you're not alone. Expectant moms and their physicians often time the operation for convenience's sake.

But most experts now agree that the C-section rate — accounting for about one in three live births today, up from about one in 20 in 1970 — is probably too high and many of the planned surgeries are done too early for the baby's well-being. The risks for a pregnant women are generally minimal but increase with each birth.

"We know that [when a woman gives birth] before 39 weeks, the chances of her baby ending up in the neonatal intensive care unit, of having breathing problems or having other metabolic problems are greater," says Dr. Bryan T. Oshiro, a California-based Maternal-Fetal medicine specialist who has been involved in efforts to reduce early elective C-sections. He says that's a message the medical community, by in large, has failed to convey to patients.

A study published in January on repeat C-sections — which are often performed because vaginal birth is considered riskier after a woman's had a C-section — found that 36 percent of the elective surgeries were performed before 39 weeks gestation. The New England Journal of Medicine study focused on babies born at 37 or 38 weeks, which are more likely to suffer health and developmental problems, some which persist into adulthood.

Kids who were born before 39 weeks gestation, on average, don't do as well in school as those born after that, says Dr. Alan Fleischman, medical director of the March of Dimes, which focuses on preventing birth defects, premature birth and infant mortality. Medical organizations are taking note, revising guidelines on timing elective C-sections.

Agencies urge moms to breast-feed

Breast-feeding rates in the U.S. are at their highest levels in at least 20 years, but experts say more needs to be done.

The Centers for Disease Control and Prevention and the Office of Women’s Health, part of the Department of Health and Human Services, are gearing up to promote breast-feeding as a means to improve public health.

Although three-fourths of new moms breast-feed at least briefly, just 14 percent of babies born in 2006 were breast-fed exclusively through six months, based on the latest CDC data. Research shows breast-feeding lowers the risk of illness for baby and certain cancers for Mom.

Brushing for baby

Pregnant women who practice good oral hygiene might be lowering their chance of delivering a preterm, low-weight baby, according to research prompting the American Academy of Pediatric Dentistry to recently release new oral health guidelines for expectant mothers.

“There’s an emerging body of science that says mothers who have bad gum disease, periodontal disease, they’re more likely to give birth prematurely, and there’s all sorts of health complications when you have a premature baby,” says Dr. Michael A. Ignelzi Jr., a pediatric dentist and orthodontist in Greensboro, N.C., who helped write the guidelines and is a spokesman for the academy.

Ignelzi, who’s also highly rated on Angie's List, recommends pregnant women get all cavities treated, brush twice daily, floss once a day, use fluoride rinse daily and limit sweets to mealtime when acid-neutralizing saliva is already flowing.

Protecting babies from H1N1

As the government races to get millions of H1N1 flu shots to Americans this month, pregnant women are a top priority. So are children and parents of infants under 6 months who aren’t equipped to get the vaccine but are susceptible to the flu.

Dr. Carrie Nelson, who sits on the American Academy of Family Physicians’ Commission on Health of the Public and Science, advises getting both seasonal and H1N1 flu shots either at one visit or staggered.

“By immunizing parents, you minimize that risk,” she says.


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