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Vaginal Delivery Recommended Over Maternal-Request Cesarean

Vaginal Delivery Recommended Over Maternal-Request Cesarean

March 21, 2013

Washington, DC — The nation’s largest ob-gyn organization recommends that pregnant women plan for vaginal birth unless there is a medical reason for a cesarean. In new guidelines issued today, The American College of Obstetricians and Gynecologists (The College) says maternal-request cesareans are especially not recommended for women planning to have several children, nor should they be performed before 39 completed weeks of pregnancy.

In the Committee Opinion, The College addresses the controversial issue of “maternal-request cesareans.” Cesarean deliveries done at the request of the mother without a medical indication represent an estimated 2.5% of all US births. Some women request cesareans because they fear childbirth pain, while others believe a cesarean will prevent urinary incontinence or preserve sexual functioning.

Cesareans involve risks and require longer hospital stays than uncomplicated vaginal births. Women face the risk of bladder and bowel injuries during cesarean surgery, as well as serious complications in future pregnancies. Placental problems, uterine rupture, and emergency hysterectomy are all risks that increase with each subsequent cesarean. Compared with vaginal births, planned cesareans have a lower risk of excessive bleeding during birth and the need for blood transfusions.

Benefits of vaginal births for women include shorter hospital stays, lower infection rates, and quicker recovery. Babies born vaginally have a lower risk of respiratory problems.

The rates of postpartum pelvic pain, sexual dysfunction, pelvic organ prolapse, and depression in women are similar between vaginal and cesarean births. The College says additional research is needed on both the short-term and long-term outcomes of maternal-request cesareans on women and babies.

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