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With increasing push for women to be offered elective C-sections including from NICE it becomes more important that we are able to fully counsel these women fully about the potentials risks of their decisions. It is well known among obstetric and paediatric staff that transient tachypnoea of the newborn is more common in babies deliver by caesarean section, but on the whole this does not usually cause any evident long term effects. A 2008 paper showed that C-section have a 20-60% increased risk of suffering from childhood asthma.
A new study from Moore et al's team in Australia (published in this months ADC) has shown that hospital admission from bronchiolitis is more common in infants delivered by elective C-section. Although the increase is slight, the data is significant and the numbers included in the study are considerable.
Given that the human body have evolved over thousands of years to facilitate natural child birth and that midwives are often keen to point out that pregnancy is a physiological process, not an illness should we work to fully understand the potential long terms risks to mother and baby before we start allowing free access to elective C-sections through the NHS?
- Are the numbers in this study given the marginal confidence intervals quoted?
- What further work is needed before we can advocate the safety of elective caesarean sections?
- Should we ensure that women are fully aware of the risks to longer term health of their babies before they consent to C-section?