How much media attention has this study received? As far as I can see online, none.
Yet the conclusions of researchers Leanne S. Dahlgren et al, just published in 'Caesarean Section on Maternal Request: Risks and Benefits in Healthy Nulliparous Women and Their Infants', are of huge importance in the debate over whether women should be offered the option of planned cesarean delivery in favor of a trial of labor.
They found that, after looking at 1,046 pre-labour cesareans deliveries (with breech presentation)and 38,021 spontaneous labour with anticipated vaginal deliveries:
"An elective pre-labour Caesarean section in a nulliparous woman at term has a lower risk of life-threatening neonatal morbidity than spontaneous labour with an anticipated vaginal delivery."
Unpredictability of planned vaginal delivery is evident
The researchers point out that "the increased risk of life-threatening neonatal morbidity in the spontaneous labour group was associated with an operative vaginal delivery or emergency intrapartum Caesarean section and not a spontaneous vaginal
delivery', and this doesn't surprise me in the least.
But the fact remains that is is extremely difficult, if not indeed impossible, to predict precisely which women will have a spontaneous vaginal delivery outcome with no complications.
More than a third of PVDs did not result in spontaneous VDs
In this particular study, 63% of women with achieved a spontaneous vaginal delivery, and the researchers conclude therefore that these women "would not have benefited from delivery by Caesarean section."
But they too admit the difficulty in isolating these cases at the birth planning stage: "Further research is needed to better identify women with an increased likelihood of an operative vaginal or intrapartum Caesarean section, as this may assist maternity caregivers in decision-making about childbirth."
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