New Childbirth Research Has the Potential to Empower Women’s Decision Making

New Childbirth Research Has the Potential to Empower Women's Decision Making

PLoS Medicine publishes two research articles with new data that should help women and clinicians make better informed decisions about childbirth. These studies touch on a highly emotive and controversial area–the risks associated with planned mode of birth. The research findings stay well away from recent debates, widely publicized in the media, around whether a woman has the right to a caesarean section on request.

One study, conducted by Dr. Caroline Crowther and colleagues in Australian maternity hospitals, aimed to compare the benefits and risks of planned vaginal birth versus planned elective repeat caesarean section following a previous caesarean section. The study enrolled just over 2,000 pregnant women who had had a single previous caesarean section delivery and were judged eligible to deliver the current pregnancy either vaginally or by repeat caesarean section. Critically, the researchers found that the risks of very severe outcomes–such as fetal or infant death–were lower among women who planned a repeat caesarean section than among women who planned a vaginal birth.

The second study examines the risk of a very rare and serious outcome in childbirth: uterine rupture. Dr Chris Fitzpatrick and colleagues collected data for all cases of uterine rupture in the UK that occurred between April 2009 and April 2010. The researchers then examined predictors for this event and showed that the risk of uterine rupture is higher among women who have had two or more previous caesarean sections, and if the time period since the last caesarean section is less than 12 months.

These data provide a counterpoint to the findings of the study by Crowther and colleagues in that it cautions women who wish for a larger family about the risk of certain very rare outcomes associated with multiple repeat caesarean sections.

The bigger issue raised by these findings relates to how clinicians and women can work together to make the best possible decision when so many questions remain unanswered.

For example, as highlighted by Crowther and colleagues, much longer-term follow-up, and more knowledge about the risks arising from multiple caesarean sections, are needed. Together, these findings highlight the importance of pragmatic research studies, with the overall goal of improving care for future generations of mothers and babies.

Posted by George Daniels on Friday March 30 2012, 4:42 AM EST. Ref: Dr. Caroline Crowther, et al. Link. All trademarks acknowledged. Filed under Featured News, Health. Comments and Trackbacks closed. Follow responses: RSS 2.0