Small premies born by C-Section at greater risk for breathing issues

The United States has one of the highest rates of premature births in the world. We also have one of the highest rates of delivery via C-section regardless of whether the pregnancy ending early or on time. It seems though that if your infant isn’t growing well in utero and premature delivery is advised, talking turkey with your doctor about trying everything possible to have a vaginal birth may serve your baby well in the long run.

For reasons that are still unclear, new data suggest small for gestational age premature infants who are born by C-section because of their slow growth have significantly more respiratory problems and need ventilator support much more often than similarly small infants also born early but via the old fashioned route of a vaginal delivery.

I like to tell parents of C-section babies that they didn’t get “wrung out” through the wringer of a 3 inch diameter cervix and vagina and as a result even full term infants are “juicier” sounding for a day or so. Some even breath very rapidly and have to have some supplemental oxygen to help move that amniotic fluid out of the tissue of the lungs and make room for the air we normally breathe. It makes sense then that premies would have similar problems with a C-section but infants who aren’t growing well in utero may already be stressed in ways that makes managing this extra fluid more challenging.

It seems that these small, premature infants born by C-section have significantly more problems with lung function and some will go on to have permanent lung changes due to the interventions needed in the newborn period to help them breathe and oxygenate their blood successfully. The stress of being small and premature alone isn’t the biggest factor though when it comes to lung issues. Those infants who were born vaginally fared much better.

Parents who are faced with the stress of a poorly growing infant for whom early delivery is needed should have a detailed discussion with their obstetrician and perhaps even a neonatologist as the decisions about vaginal vs C-section delivery are made. Sometimes C-sections are required but if mom and baby are faring well despite a labor that is slow to progress, even if parents and doctors alike are getting impatient, taking a deep breath and waiting it out to birth your baby vaginally may make sense.