C-sections up mothers’ infection risk

GIVING birth naturally is better for the health of both the mother and baby rather than opting for a caesarean section, research indicates.

Labour may help boost the immune system of women and their babies, according to research carried out at the Coombe Women's Hospital in Dublin.

Dr Eleanor Molloy, who led the research, said the findings suggested the decision to have a c-section may not be as straightforward as had been thought and she called for more extensive studies to be conducted to shed more light on how the immune system responded to labour.

"We tend to think of elective caesarean sections as completely benign but that might not be true. It now appears that even short labour may be beneficial," Dr Molloy said.

"There is obviously a reason [why] we go through labour. There must be some natural benefits, although there can also be complications," she said in an interview with the Irish Medical News.

Dr Molloy, now on a neo-natal fellowship in Rainbow Babies and Children's Hospital, Cleveland, Ohio, studied neutrophils white blood cells that aggressively protect against infection to track the immune response in pregnant women. Neutrophil levels are generally higher in pregnant women than in women who are not pregnant, said Dr Molloy.

"We found that mothers who had vaginal deliveries had higher neutrophil levels than those who had a scheduled, elective caesarean section. Women who have emergency sections after a period of labour also have more active immune systems, which shows labour of any duration may be immunologically beneficial," she said.

Dr Molloy said women who gave birth without labour could be open to infection.

"Labour helps activate neutrophils, which helps prime the immune system. In elective caesareans, neutrophils don't survive as long because women don't experience the same stress. This could leave them more susceptible to infection," she said.

However, she said the research does not suggest natural labour is always the best option.

Dr Molloy said in light of rising rates of elective caesarean sections, the research should encourage people to consider how childbirth affects the immune system.

This research on how labour affects the maternal immune system has been published in the American Journal of Obstetrics and Gynaecology. Dr Molloy will also publish a paper later this year showing that babies' immune systems also benefit from labour.

The number of caesarean sections has trebled in Ireland over the past 20 years, with more than 20% of all babies born this way. Fear of natural labour and litigation are fuelling the increase. There is no breakdown available of the number of c-sections carried out in Ireland for medical or elective reasons, but figures in Britain suggest that 8% of caesareans are now elective.

Master of the National Maternity Hospital in Holles Street, Dr Declan Keane said he would encourage all women to think carefully before opting for such a procedure: "People forget that it's still a surgical intervention and has immediate and long-term effects on the mother."

Spokesperson for the Home Births Association Annah Knight said she was concerned at the growing number of women choosing to have a c-section. She said that while more women would like to opt for a home birth, the health service seems to be putting more obstacles in women's way making it more difficult to access or pay for midwives' services.