Caesarean Benefits Evident in Long Term Outcomes Study, though not widely reported

Dr. Amy Tuteur’s summary of a new study (Long-term risks and benefits associated with cesarean delivery for mother, baby, and subsequent pregnancies: Systematic review and meta-analysis) succinctly explains why its findings – despite media headlines to the contrary – only leave prophylactic maternal request caesareans even further justified.

Remember, this study compares vaginal birth outcomes with ALL caesarean birth outcomes (both elective and emergency).

• Therefore a sizeable portion of the caesarean outcomes are actually associated with PLANNED vaginal birth plans.
• And even with the study’s mixed data, caesarean birth of any kind considerably reduces the risk of urinary incontinence and pelvic organ prolapse.
• The risk of placental complications is higher with (all) caesareans, but in terms of actual numbers of women affected, still significantly smaller than those with vaginal birth pelvic floor damage.
• And if the data was adjusted to compare intention to treat (i.e. outcomes for vaginal birth and caesarean birth plans), we’d have even more evidence of maternal request caesarean health benefits when compared with PVD.

Until then, there will remain those who may only see the caesarean ‘bad’ and vaginal birth ‘good’ in studies like this, and who may plan to use it as a means of trying to counsel women against their caesarean choice.

I do find it concerning how such mixed caesarean data can leave some medical professionals so certain that it should still inform discussions on elective caesarean birth, which is evidently safer than an emergency at the end of a vaginal birth plan.

Fortunately, more women are getting wise to the flaws in caesarean studies and how they are being communicated, and with increasing social media, there can be no more hiding or downplaying of pelvic floor outcomes either.

• Written by author and journalist Pauline Hull