• Rebecca Genuis

New study about C-sections


The process of surgically delivering a child from their mother’s womb has been reported in historical texts dating back to several hundred years B.C.. Initially seen as a way to try and save the child after a mother had, or was about to die, it was then repeatedly re-invented and refined to result in what today is widely known as a Cesarean section, or C-section. In many ways the success of the C-section highlights some of the greatest advances we have seen in medicine to date. The procedure, in its original form, had a 100% mortality rate, until the first recorded case of a woman surviving a C-section in 16th century Switzerland.


The origins of it’s name are really a mystery. While many sources suggest it was named after Gaius Julius Cesar was born in this manner, history does not support this claim. But the word Cesar, means “to cut” so either way, the term is fitting.


C-sections have been a true medical advancement, saving the lives of countless women and their children. The operation was developed to be used as a highly selective, life preserving measure, not as a procedure done without exploring all other options.




In Canada, we have seen sky rocketing rates of C-sections. In just 15 years, from 1995 to 2010, we saw rates rise from 17% of all births to nearly 30% of all births (28% in Alberta and 29% in Ontario). With almost one third of Canadian children being born by surgical intervention, it’s important we consider the impact of C-sections on our children’s health.


A good starting point may be a 2014 article from the American Academy of Pediatrics. It found that rising rates of C-section are associated with increased risks of numerous chronic immune disorders, including asthma, systemic connective tissue disorders, juvenile arthritis, inflammatory bowel disease, immune deficiencies, and leukemia. Many of these can be life-altering diagnoses for a child and their family, so it’s a caution worth paying careful attention to. It’s also been well established that the germ environment of children born through C-section is notably different from infants born vaginally, which may have an impact on the future health of children.


As for women who undergo C-sections, a 2017 article published in a leading medical journal found that women who had delivered a baby and later required a hysterectomy were 50% more likely to have had a C-section than a vaginal delivery. And these women were also 16% more likely to experience complications after their operation, 30% more likely to require additional operations and if they had 2 or more C-sections previously, they were 96% more likely to need a blood transfusion during their hysterectomy operation.


I think this information is important, because it is more and more common for me to hear language from patients around desiring a C-section for the sole reason of avoiding the pain of labour or the risk of complications they’ve heard can come with vaginal deliveries later on in life. For women who have a medical indication for a C-section, I totally believe you can still have an incredible experience of giving birth to your child. As a medical community, I think it is our role to make sure that we are doing our job to help alleviate fears in our patients and encourage them towards a vaginal delivery when it is a safe option.


References

Lindquist, S. A., Shah, N., Overgaard, C., Torp-Pedersen, C., Glavind, K., Larsen, T., . . . Knudsen, A. (2017). Association of Previous Cesarean Delivery With Surgical Complications After a Hysterectomy Later in Life. JAMA Surgery, 152(12), 1148. doi:10.1001/jamasurg.2017.2825


Sevelsted, A., Stokholm, J., Bonnelykke, K., & Bisgaard, H. (2014). Cesarean Section and Chronic Immune Disorders. Pediatrics, 135(1). doi:10.1542/peds.2014-0596

©2018 by Dr. Rebecca Genuis