Is a Vaginal Delivery Safer for Preemie Babies?

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Updated March 2, 2017
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A new study published in the journal Obstetrics & Gynecology found that very premature babies have fewer breathing problems when they’re born via vaginal delivery compared to those born via C-section.

The research, which studied more than 20,000 newborns, found that regardless of why a C-section birth was preformed (whether because of pregnancy-related complications or maternal medical problems), vaginally delivery tended to be saver for premature babies. Werner’s team of researchers collected data from birth certificate and hospital discharge records for 20,231 babies born early (between 24 and 34 weeks) in New York between 1995 and 2003. They found that just over two-thirds of the babies were born vaginally.

After the data had been collected, researchers factored in mother’s age, race and underlying medical conditions. From there, they concluded that babies delivered via C-section were more likely to be born in respiratory distress: over 39% of C-section preemies had breathing problems, while just 26% of vaginally delivered preemies exhibited breathing problems. Researchers calculated that between seven and eight preemie deliveries would have to be switched from C-sections to vaginal births to avoid one case of newborn respiratory distress.

Dr. Erika Werner, who led the study at Johns Hopkins School of Medicine in Baltimore, said, “My suspicion is that the labor process, the contractions, that natural squeezing probably does something to clear out the lungs so that when babies are born they have a better breathing status,” adding, “If a vaginal delivery is safe, it’s something that should be attempted.”

According to data collected by the U.S. Centers for Disease Control and Prevention, C-section births accounted for almost 1 in 3 births in 2011, which is up from 1 in 5 births in 1996.  Now, researchers worry that because the rate of C-sections continues on an upward trend for all pregnancies, there are more possible complications for mothers and babies.

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Though Werner is the first to recognize that there are certain circumstances where a C-section delivery is required (such as maternal bleeding or the baby’s heart rate drops), she did acknowledge that there hasn’t been much data collected on whether C-section or vaginal delivery is the safer method for other premature babies.

Because Werner and her team looked back on old records, they were not able to control for all the differences between women who had C-sections and vaginal deliveries, which she calls a “huge limitation” of the study. She said, "I was struck by the fact that there does not seem to be an increased risk of some things with C-section. "

Yet, one thing Werner feels the study did shed light on is the need for further research. Citing the limitations of her own work, she said, “I don’t know if you can make a definitive statement that it is higher risk to have a C-section based on this study.”

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Please note: The Bump and the materials and information it contains are not intended to, and do not constitute, medical or other health advice or diagnosis and should not be used as such. You should always consult with a qualified physician or health professional about your specific circumstances.

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