Caesarean Section: Can Inducing Birth Decrease Numbers?

The number of women delivering babies through Caesarian section has climbed across the U.S. in recent years. This serious surgery can lead to complications and some doctors want to figure out if there is another way.

A team of medical providers at the University of Utah wanted to explore the question by looking at women who experienced induced labor later in pregnancy. They found that induction at 39 weeks, when the baby is full term, can reduce the need for Caesarean section, according to the findings published on Thursday in the New England Journal of Medicine.

"Electing to induce labor is a reasonable option that may give the best chance for vaginal delivery and improve outcomes," the study's co-author Dr. Robert Silver, chair of Obstetrics & Gynecology at University of Utah Health, said in a statement. He cautioned that not all women should take this route. Expectant mothers choosing this path should be healthy.

If she can do it, so can you.

Talk to your OB team about avoiding #cesarean, if possible, before it is time to deliver.

Thanks https://t.co/WmsjypXMSQ#Unnecesarean @Unnecesareanhttps://t.co/vAPnNhLZEk

— |Brett😷Einerson| MD MPH - Value Us: Wear a Mask😷 (@breinerson) August 9, 2018

Caesarean sections may be necessary when vaginal delivery might pose a risk to the mother or baby – for example due to prolonged labor or because the baby is in an abnormal position. But they can can cause significant complications, leading to disability or even death. Although the proceudre can save lives, it is often performed without medical need. This can put women and their babies at risk of health problems, according to the World Health Organization (WHO).

The latest data from the Centers for Disease Control and Prevention shows that about 31.9 percent of all births in the U.S. are caesarean sections. This represents about 1.2 million births in 2016.

To conduct their study, the researchers looked at 6,106 first-time mothers who enrolled in the randomized clinical trial carried out at 41 hospitals.

On average, women who chose to induce at 39 weeks delivered nearly one week earlier than women who waited for spontaneous labor. Caesarean section deliveries were significantly less likely in women who chose elective induction compared to women who waited for labor to come naturally. About 18 percent of those who were induced needed th procedure versus 22 percent of those who opted to wait for labor to happen on its own.

The induction of labor was also linked to other positive health outcomes. Women were less likely to develop pre-eclampsia, a dangerous condition characterized by high blood pressure. The rates of respiratory distress in newborns also decreased.

Silver said that the placenta tends not to function as well later in pregnancy, possibly explaining why mothers who deliver earlier may see better outcomes.

The study's findings held true regardless of the woman's age, ethnicity and weight.

"We're always trying to find the safest way to deliver babies and take care of our patients," Dr. M. Sean Esplin, an associate professor of Obstetrics and Gynecology at the University of Utah Health and chief of Maternal-Fetal Medicine at Intermountain Healthcare, said in a statement. "If the primary goal is to keep rates of C-sections down, then elective induction is an option."