Maternal Request Children LEAST Likely to Develop Psychopathological Problems

"The likelihood of childhood psychopathological problems may be the lowest in children born by CDMR (cesarean delivery on maternal request), followed by those born by SVD (spontaneous vaginal delivery), whereas the highest probability was observed in those born by AVD (assisted vaginal delivery)."


This conclusion appeared in a Chinese study published in November 2010, when at the time (frustratingly), I was too busy finishing my book (with Dr Magnus Murphy) to write about it.

As is so often the case with 'positive' cesarean news stories, it didn't get the same level of media attention that 'negative' stories usually receive, yet "Caesarean delivery on maternal request and childhood psychopathology: a retrospective cohort study in China" (by authors: Li H-T, Ye R, Achenbach T, Ren A, Pei L, Zheng X, Liu J-M) certainly makes for very interesting reading.

It covered 18 counties and 3 cities in China, and included a total of 4,190 preschool children whose emotional (internalising) and behavioural (externalising) problems were assessed.

Differences were Significant

The authors concluded that: "The likelihood of childhood psychopathological problems may be the lowest in children born by CDMR, followed by those born by SVD, whereas the highest probability was observed in those born by AVD."

Why should you care?

Cesarean rates in China have been reported as 46%, with a quarter of these being on maternal request; and so this makes the study important. In many other countries, maternal request is so infrequently cited as an indication for cesarean surgery that it's very difficult to properly analyze this birth type.

Now, before anyone suggests that I'm suggesting this - I am NOT suggesting that this study is a reason for all pregnant women to run out and schedule a cesarean.

Firstly, this is a relatively small study, but secondly, it's also only a small part of a whole range of risks and benefits that you might want to consider when planning the birth of your child. Your perception of each risk and benefit will differ from the next person's.

But what the study DOES SUGGEST, is that the traditional data analysis we've seen in past research (that used mixed cesarean birth type outcomes) - where (all) 'cesarean births' were associated with various health problems later in life - may not be as reliable as once thought, and is certainly not a reason to criticize maternal request surgery.