Early Elective Deliveries, Especially C-Sections, Are on the Rise


A study by the University of Minnesota School of Public Health, which looked at millions of births in the United States in the last 15 years, found that nearly one in 25 babies were born earlier than medically needed through elective cesarean sections and elective induced labor.

“Our study showed that early elective deliveries are making up between 3 and 4 percent of U.S. births each year,” says Katy B. Kozhimannil, a researcher at the school.

Three to 4 percent of births might seem like a small number, but with nearly 4 million babies born in the United States each year, it adds up to about 140,000 babies. Cesarean births have gradually increased over the past 30 years, and C-sections are now the most common operating room procedure in U.S. hospitals. Despite recommendations by professional organizations—such as the American College of Obstetricians and Gynecologists and the Society for Maternal-Fetal Medicine—medically unnecessary, early deliveries have continued to rise, the researchers found.

“Research suggests that health outcomes are worse for infants born before 40 weeks’ gestation, compared to full-term births,” says Scott A. Lorch, a neonatologist at The Children’s Hospital of Philadelphia. “Unfortunately, many of these earlier births are ‘nonindicated,’ meaning there is not a medical rationale to deliver the baby early.”

There are risks with any major surgical procedure, but as you prepare to deliver your little one, it’s important to understand the risks, both to mother and child, before having a C-section.

“Early-term, nonindicated cesarean sections more than doubled the chance that a baby would have respiratory distress or need ventilation,” Lorch says. “Early-term, nonindicated cesareans and early-term induced labor both lengthened the infant’s hospital stay.”

Risks and complications for mom

If your health care provider has suggested a cesarean and you’re in a non-emergency situation, take time to thoroughly discuss your options regarding the procedure.

Take into account that most of the risks listed here are associated with any type of abdominal surgery. A cesarean birth is accomplished by taking the baby out through an incision in the abdominal wall and uterus rather than through the vagina. Here are some of the risks that come with such a surgery:

  • Infection can occur at your incision site, in the uterus and in other pelvic organs, such as the bladder.
  • There’s more blood loss with a cesarean delivery than with a vaginal delivery. This can lead to anemia or require a blood transfusion.
  • There’s risk of potential injury to organs, such as the bowel or bladder.
  • The amount of time needed for recovery after a C-section can range from weeks to months.
  • There is a risk of additional surgeries, such as possible hysterectomy, bladder repair or another cesarean with the next child.
  • Planned cesarean delivery increases length of hospital stay by at least 0.6 to 2 days compared with vaginal birth.
  • The maternal mortality rate for cesareans is higher than with vaginal births.
  • Some women who have had a cesarean report feeling negatively about their birth experience and may have trouble with initial baby bonding.

Risks and complications for baby

Mom isn’t the only one at greater risk when a C-section is performed. There’s also greater risk to your newborn. Here are some of the problems that could come from a cesarean delivery as opposed to a vaginal one:

  • If gestational age is not calculated correctly, a baby delivered by cesarean could be delivered too early and have low birth weight.
  • When delivered by cesarean, a baby is more likely to have breathing and respiratory problems.
  • Babies born by cesarean are 50 percent more likely to have lower APGAR scores than those born vaginally. Low APGAR scores can be the result of anesthesia, fetal distress before the delivery or lack of stimulation during delivery.