Cesarean section, induced labor not always best choice, studies say

LOS ANGELES — Cesarean sections are often performed when a baby is going to be born early. Likewise, sometimes labor is induced when a woman’s water breaks too early in the pregnancy. However, two new studies suggest that these common practices may, in fact, not benefit babies.

Both papers, presented Thursday at the annual meeting of the Society for Maternal-Fetal Medicine, challenge conventional wisdom. The first looked at 2,560 babies delivered preterm because they were small for gestational age. The study found that those delivered by C-section before 34 weeks of pregnancy had 30 percent higher odds of developing respiratory distress compared with similar babies delivered vaginally.

“Although in many instances, a C-section is medically necessary for the health of the baby or the mother, this research shows that in some cases the surgery may not be beneficial for some infants,” said Dr. Diane Ashton, deputy medical director of the March of Dimes. Ashton was not involved in the study.

The second study examined induction of labor after the rupture of membranes (meaning the bag of water breaks). When this occurs, labor is often induced to prompt immediate delivery and lower the risk of infection in the baby. However, 536 women with ruptured membranes were assigned to undergo either induction of labor or close monitoring. Close monitoring extended pregnancy on average by 3.5 days.

The study showed that the risk of infection in the newborn was similar — and quite low — in both groups as were rates of respiratory distress in the baby.

“Due to these findings, we suggested expectant management as opposed to induced labor when possible,” the authors said.

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