Cesarean sections: there is a balance between benefits and risk

The chances that our readers have been pregnant themselves or at least know a woman that has been are pretty high. During a pregnancy, due dates can be a funny thing. At first, they are extremely exciting. A day approximately nine months into the future gets circled on a calendar, and the weeks are checked off.

As the weeks add up, the due date becomes almost a source of frustration. “I’m x days past my due date!” is a common lament. Too far past that date, into a long labor or under certain conditions and a cesarean is often discussed as a delivery method. New guidelines from the American College of Obstetricians and Gynecologists and the Society for Maternal-Fetal Medicine suggest that doctors might be jumping the gun in some cases.

The new guidelines were published in the March issue of Obstetrics & Gynecology. Data showed that the occurrences of cesarean delivery rose 60 percent from 1996 to 2011. Over half of these procedures were conducted in the case of a first-infant birth. A portion of these procedures may have even been unnecessary suggests the new guidelines, reporting that those in low-risk pregnancies should be given more time during the first stage of labor.

SMFM President Vincenzo Berghella MD reminded concerned parties that there is still a risk for birth injury in some cases when doctors wait too long to schedule a cesarean. “Physicians do need to balance risks and benefits,” he noted, “and for some clinical conditions, cesarean is definitely the best mode of delivery.” On the other side of the scale are unnecessary C-sections that “may pose greater risk than vaginal delivery, especially risks related to future pregnancies.”

Delivery specialists, like neonatologists and obstetricians, are trained with the knowledge and skills to make this determination. When a negligent decision is made in California, these and other responsible parties can be held liable in a birth injury claim for damages.

Source: Medscape, “Longer Labor okay to Avoid Cesarean, New Guidelines Say,” Laurie Barclay, Feb. 19, 2014