No link found between caesareans and stillbirth
Publication Date:04/06/2008
Having your first baby by caesarean section does not increase the risk of stillbirth in the following pregnancy, according to a new study.
The results contradict recent research, which seemed to show a link between the two.
What do we know already?
Caesarean section, where the baby is taken out of the womb through a cut in the mother's abdomen, used to be done only for problems that stopped the mother from giving birth through the vagina. But because the operation has become safer, it's now used more often. About 1 in 5 women in the UK have their baby this way.
In the UK, having a baby, whether vaginally or by caesarean, is usually a very safe event and the death of a mother or baby is rare. But having a caesarean section carries certain risks. For example, one study showed it increased the risk of breathing problems in the baby. And recent research has linked having a caesarean with the risk of a baby being stillborn in a later pregnancy.
What does the new study say?
The new study found that women who had a first baby by caesarean were no more likely to have a subsequent stillbirth than women who had a first delivery through the vagina. The risk of a stillbirth was very low: 2.1 in 1,000 for women who had a caesarean and 1.6 in 1,000 for those who had a vaginal delivery. This difference in numbers between the two groups is so small that it is likely to be down to chance.
The researchers used information from a database tracking pregnancies and births in 81 hospitals in Alberta, Canada.
Where does the study come from?
The study was done by researchers from the University of Calgary. It was published in the medical journal BJOG: An International Journal of Obstetrics and Gynaecology, which is owned by the Royal College of Obstetricians and Gynaecologists.
How reliable are the findings?
The study was generally well done. The figures are likely to be reliable, because they come from hospital records. Also, when they worked out the results, the researchers took into account several factors that could make a woman more likely to have a stillbirth, and this makes the findings more reliable. Other things which can affect the risk of a stillbirth include diabetes, older age, obesity, smoking during pregnancy, and high blood pressure. The researchers also did not include babies who had died during birth or as a result of known causes, such as infections.
However, the researchers looked only at 265 stillbirths. A larger number would have made the study's findings stronger.
What does this mean for me?
If you've had a caesarean, or if you're pregnant and considering whether to have a caesarean or a vaginal birth, this study has useful information for you. It suggests that there is no risk of a future stillbirth because of the operation. However, the study does not tell us anything about other possible risks of having a caesarean.
What should I do now?
If you are pregnant, there are lots of things to consider when deciding how to have your baby. If you're considering having a caesarean section, or your doctor has recommended one, make sure you understand the reasons why. Talk to your doctor or midwife about the risks and benefits of this operation for you and your baby. It's your decision, so make sure you have all the information you need to make the choice that's right for you. And bear in mind that childbirth in the UK is very safe, with the vast majority of babies born healthy.
From:
Wood SL, Chen S, Ross S, et al. The risk of unexplained antepartum stillbirth in second pregnancies following caesarean section in the first pregnancy. BJOG. 2008; 115: 726-731.
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© BMJ Publishing Group Limited ("BMJ Group") 2007. All rights reserved
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