As medical advancements make more and more contributions to the way patients receive treatment, there seems to be an all time high in the rate of Caesarean sections amongst normal births. Reasons for this include the desire for quick, uncomplicated labor, and fears and lack in confidence regarding natural childbirth (Childbirth Connection, 2007). As a result of this increased incidences of C-sections, there has been more research exploring long-term effects of this method of birth on the children. The most significant findings have been increased rates of asthma, allergies, and chronic bronchitis amongst children delivered by c-section versus those delivered vaginally. In a retrospective cohort study, children that had been recently diagnosed in the past decade with any respiratory disorders, including allergies and dermatitis were investigated on their birth statistics, including birth weight, delivery method, gestational age, and maternal behaviors (Renz-Polster, 2005). This investigation found a significant correlation between delivery by c-section and incidence of respiratory problems and allergies later in life. The pathologic process is thought to be due to the lack of microorganism exposure during the birthing process (Renz-Polster, 2005). The thought rises from the idea that decreased exposure to environmental organisms in the first few days of life leads to increased rates of allergy development; the normal intestinal flora of the newborn is generally acquired as it is exposed to organisms in the vaginal tract during the birthing process. This phenomenon is thought to be one of the most important factors contributing to this study, because it is associated with the necessary introduction to environmental organisms that leads to the development of immune system tolerance outside the sterile fetal environment (Renz-Polster, 2005). When the infant is removed by c-section, there is no contact with the maternal vaginal flora, and microbiotic exposure is experienced differently through skin contact over the next few days, with introduction of a different type and quantity of microorganisms (Renz-Polster, 2005). Furthermore, natural mechanical processes of a vaginal birth allow the expulsion of amniotic fluid from the lungs of the infant as its chest is compressed through the birth canal. In this manner, the infant’s lungs are better primed for the first breath, as opposed to during c-sections, where there is no mechanical compression of the chest, and fluid removal is often extracted by suction mechanisms, often leaving the infant with fluid still in the lungs, making it harder for it to begin breathing on its own.
With these findings, it is imperative that as health care providers we stress the importance of avoiding birth by Caesarean if at all possible. We need to provide out patients with the education necessary over what to expect during the birthing process, and how to appropriately manage delivery without surgical interventions. This is probably the most critical factor to implement, to explore delivery options before maternal stress and exhaustion from labor is experienced. This will lead to better informed consent, and will likely reduce the incidence of delivery by c-section. Furthermore, it is also important to inform our patients that subsequent deliveries after a c-section are often routinely performed as c-sections, further increasing the amount of risk for developing allergies and respiratory problems in the family later in life.
Childbirth Connection (2007). Choices in childbirth. The New York guide to a healthy birth.
Renz-Polster, H. (2005). Caesarean section delivery and the risk of allergic disorders in childhood. Clinical & experimental allergy, 35: 1466–1472. doi: 10.1111/j.1365-2222.2005.02356.x