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Why it gives me hope that C-section babies are more likely to be obese

Posted by Dr. Claire McCarthy  May 27, 2012 08:30 AM

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It's not because I want there to be more obese kids. As a pediatrician, I absolutely do not want that--I am really alarmed by the epidemic of childhood obesity. I was hopeful because I thought the news might make some people think twice about doing or having C-sections. And boy, do we need that to happen.

Right now, an amazing one in three births in the US is by C-section. One in three. Now some of those C-sections are truly necessary--some of them absolutely save lives or prevent serious problems for the mother or baby. But not all of them are necessary.

I get that this is really complicated. I don't blame obstetricians for wanting to be extra safe with breech births or multiple births or when the monitors show the baby could possibly be in trouble--especially when they could and do get sued.   

But it's clear that not all C-sections are being done for these reasons. C-sections are more profitable than vaginal births. They are predictable and efficient--no hanging around waiting for labor to progress. Some of them end up being done because we don't even want to wait for labor to start--inductions, which are on the rise (how totally convenient, scheduling your baby's birth!), are more likely to lead to C-sections--that's what happens, sometimes, when you do something before the body is ready.

And there's also the fact that more mothers are obese, which leads to bigger babies and more complicated deliveries--and more mothers are delaying pregnancy, which can lead to situations that make C-sections more likely.

C-sections, though, are not an easy fix to any problem. It's not like obesity is the only risk to the baby--babies born by C-section are more likely to have breathing problems, some of which can be serious (that squeeze through the birth canal is important for getting fluid out of the lungs). And for mothers the risks are far more serious--not just in terms of possible complications of the procedure itself, but in terms of their future reproductive health and safety.

Somehow, we need to put the brakes on this. We need to take a collective deep breath, and take a good, hard look at what we are doing. We need to find ways to let nature take its course when it comes to birth--yes, childbirth can be dangerous and we need to be watchful and at the ready to step in if needed, but we are stepping in too soon and too aggressively right now. And would-be mothers need to be really thoughtful about their health and reproductive choices--what they do matters for their health and the health of their child.

We will need to figure out what we can do to help babies born by C-section not be obese. But maybe, just maybe, the fact that the risk exists will get a few mothers and doctors talking about not doing C-sections unless they are truly necessary. And maybe those few will start talking to their friends, who might talk to their friends...maybe, just maybe, a change will begin.

We can only hope.


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About MD Mama

Claire McCarthy, M.D., is a pediatrician and Medical Communications Editor at Boston Children's Hospital . An assistant professor of pediatrics at Harvard Medical School and a senior editor for Harvard More »

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