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Early C-Sections May Cause Complications

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This Sunday, families in New Mexico and nationwide will come together to celebrate Mother’s Day, highlighting once again the important role mothers play in building strong, cohesive families.

But this is also an opportune time to think about expectant and future mothers and to raise awareness about how to increase the likelihood of a safe and healthy pregnancy and delivery.

It’s critically important for mothers, families and physicians to recognize the dangers associated with early, elective deliveries. The potential complications involved with childbirth before 39 weeks are very real, which is why the March of Dimes and UnitedHealthcare consider full term at 39 weeks. The American College of Obstetricians and Gynecologists defines full-term starting at 37 weeks.

Yet evidence shows many people, including a majority of first-time mothers, may be unaware of the risks of early, elective Cesarean-section deliveries.

C-sections are at an all-time high in the United States, with 1.4 million newborns delivered surgically in 2007, according to the latest data available from Centers for Disease Control and Prevention. From 1996 to 2007, the rate of C-sections had risen 53 percent, representing about a third of all U.S. births.

C-sections, especially those that are not required for medical reasons, have been linked to higher rates of surgical complications and rehospitalizations for the mother. Babies born before 37 weeks are also more likely to have breathing problems and developmental delays, according to numerous published studies.

Additionally, a report issued this year by The Leap Frog Group revealed tremendous variation among hospitals when it comes to early, elective C-sections and elective inductions, with some facilities performing those procedures 10 times more frequently.

The practices of 773 hospitals nationwide were examined, including those in New Mexico, and the full report is available at www.leapfroggroup.org/tooearlydeliveries.

What impact could early, elective C-sections have on mothers and newborns? A review of claims data by UnitedHealthcare showed that 48 percent of newborns admitted to the neonatal intensive care unit at select hospitals were from scheduled admissions for delivery — many before 39 weeks of gestation. After sharing these findings, physicians and hospitals in the program altered practice patterns and realized a 46-percent decrease in NICU admissions in the first three months – a decline that has held stable.

Despite this data, a majority of first-time mothers are unaware of the dangers. According to a national survey released last year, more than 90 percent of first-time mothers believe it’s safe to deliver a baby before 37 weeks, while nearly one in four respondents considered a baby to be full-term at 34 to 36 weeks. The UnitedHealthcare survey queried 650 insured, first-time mothers from varied geographic, ethnic and socioeconomic backgrounds.

In addition to raising awareness among expectant mothers, other studies also have shown that efforts to educate physicians can make a positive impact in helping to reduce the rate of elective pre-term deliveries.

UnitedHealthcare offers similar educational resources and programs to mothers, physicians and hospitals, and we should work as a community to consider additional efforts to help stem the rise in these deliveries.

The decision to induce labor early or perform a C-section before a pregnancy is full term should take clinical recommendations into account and reflect the baby’s and mother’s health and medical needs, not convenience.

To be sure, the last few weeks of pregnancy for many mothers can seem endless and often uncomfortable. But expectant parents should take the opportunity to learn just how important the last few remaining weeks are for their baby’s development and health.

For more information about healthy pregnancies go to at www.healthy-pregnancy.com.

 

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