C-section, important facts regarding your new born baby’s health, and how can we improve that.
Babies born by cesarean are at risk for health complications, compared to babies born vaginally, especially if the mother did not labour (i.e. not having persistent contractions), as seen in planned C-section.
Disadvantages of C-section to the baby and mother:
Planned Cesarean and Late Pre-Term Birth
Late preterm birth is defined, as a live birth before 37 completed weeks of pregnancy. Being born only one week earlier can make a difference in terms of complications babies are likely to suffer. Low-birthweight infants (less than 2.5kg) are at higher risk of death or long-term illness and disability than are infants of normal birthweight, their lungs are not fully developed, which will impose some breathing difficulties and complications.
Babies born before term have a higher risk of persistent pulmonary hypertension, a potentially life-threatening condition. To facilitate the transition from the uterine environment to the outside world, the blood vessels in the baby’s lungs relax and allow blood to flow through them with the first breaths after birth. This function allows the blood to exchange carbon dioxide for oxygen. When this adaptation fails the blood vessels are contracted and pulmonary high blood pressure (hypertension) occurs. Newborns who experience persistent pulmonary hypertension and low blood oxygen levels can suffer from damage to vital organs and the brain. Persistent pulmonary hypertension is four times higher for babies born by elective cesarean than for babies born vaginally.
Contractions of labor help to prepare the baby’s lungs for respiration at birth. During each contraction of labor, there is temporary reduction in the amount of oxygen that is available to the fetus. Contractions reduce the amount of oxygenated blood that is passed through to the placenta. This causes the baby’s heart rate to slow down. To adapt to this level of stress the baby increases his/her production of catecholamines (act as neuromodulator and hormone like substance, such as adrenaline and dopamine, appears during fight and flight response) which shunts the blood going to his/her muscles, and preserves the energy to the vital organs. This adaptive response allows the baby to receive the same amount of oxygen as before labor contractions. This increased surge of catecholamines accumulated during labor also helps to prepare the baby’s lungs to breath on their own at birth by absorbing the liquid in his/her lungs. Babies born by a scheduled cesarean have lower levels of catecholamines than babies born vaginally. A scheduled cesarean (without labor) is more likely to make it more difficult for the baby to initially breathe on her own.
Increased Risk for Asthma
Some reports have suggested a link between cesarean birth and later development of asthma. Recent studies conducted in the Netherlands and in Norway found that children delivered by cesarean are at an increased risk of developing asthma later in life. Babies were more likely to have a certain kind of bacteria in their intestines if they were born by cesarean. Babies with these intestinal bacteria have a greater risk for developing allergies or asthma later on.
Mother-Infant Attachment is More Likely to Be Delayed
Cesarean operation last between 45min-2 hrs, which requires another 1 supervised hour (i.e. mother follow up tests) post operation, before releasing to the recovering room with your baby to rest. Enhances attachment between mothers and babies, reduces stress in healthy newborns and mothers. The World Health Organization encourage skin-to-skin contact between mother and baby, as soon as possible after the birth for at least one hour and until the newborn has successfully completed the first breastfeed.
Skin-to-skin contact calms the mother and her baby and helps to stabilize the baby’s heartbeat and breathing. The mother’s body heat keeps the baby warm, reduces the newborn’s crying, stress and energy use. Skin-to-skin contact helps with the baby’s metabolic adaptation and stabilizes its blood glucose level.
Oxytocin, the hormone that causes a woman’s uterus to contract, also causes the temperature of her breasts to rise and helps her feel calm and responsive. This hormone stimulates “mothering” feelings as the woman touches, gazes at, and breastfeeds her baby. More oxytocin is released as she holds her baby skin-to-skin. Endorphins, narcotic-like hormones, are also released and enhance mothering feelings. High levels of adrenaline, which are normal in babies at birth, make the baby alert and prepare him to look for his mother, find his way to her breast, and breastfeed.
a Swedish study found that the baby’s father can provide skin-to-skin contact with his newborn and offer the same calming and comforting benefits as the baby’s mother. The researchers of this study recommend that the fathers should be the primary caregivers for their newborns when mothers and babies are separated.
Lack of adequate beneficial bacteria
As your baby passes through your birth canal, it ingests bacteria (which are located in the vaginal “wall”) that contributes to its gut health and boosts its immune system. Although a baby’s microbiome or collection of microbes begins to form in the womb, vaginal delivery is an essential part of the process. Some studies have found that babies born by C-section, who miss out on these crucial bacteria are more susceptible to health problems such as food allergies, asthma, hay fever and obesity later in life.
Lack of sufficient mechanical squeezing pressure over the lungs
While your baby is in the womb, its lungs are filled with amniotic fluid. Hormonal changes that occur during labour start to clear the fluid, and much of the rest is squeezed out as your baby passes through your birth canal (i.e. vaginal delivery). Any remaining fluid is coughed out after the birth or absorbed by your baby’s body. A condition known as Transient Tachypnea of the Newborn (TTN)- is a respiratory problem that can be seen in the newborn shortly after delivery. It is caused by retained fetal lungs’ fluid due to impaired clearance mechanisms. The fluid is normally clear, however, when fetal is stressed, meconium stool can appear in the amniotic fluid (green colour). Routine procedures following a cesarean birth such as suctioning the newborn’s mouth, esophagus and airways can also make it more difficult for babies to begin and continue breastfeeding, and delayed skin to skin contact.
With a Cesarean Breastfeeding is Likely to be Delayed
A cesarean birth makes it more difficult for mothers to initiate and establish breastfeeding. The use of medications (i.e. anestetics, atibiotics) during labour and cesarean birth, cross the placenta and can affect the infant’s behaviour at the time of birth, which in turn affects his/her ability to suckle in an organized and effective manner at the breast. A long labor preceding a cesarean, pain from the surgery, complications such as developing a fever, your reaction to medications, or developing an infection may make it difficult for you to be with your baby right after birth.
How to support new born baby and mother post caesarean operation
In the operation room, after the baby has been born, and completed with all necessary medical procedures by paediatrician. If you are feeling well, seek for skin to skin contact with the baby. baby will be less fussy and more ready to breastfeed.
If mother can’t approach her baby due to medical condition. Ask your partner to provide skin to skin contact with his/her newborn, which offer the same calming and comforting benefits as the baby’s mother.
Ask for your partner, friend, or family member to stay with you in the room to help you lift your baby, change positions in bed, change the baby’s diapers, and help you get out of bed.
You will be in pain after the initial anesthetic wears off. Ask about the safest pain medication available for breastfeeding.
Ask that a lactation specialist help you to recognize your baby’s hunger signs, to position your baby to latch on correctly at your breast, to support you to continue to breastfeed while in the hospital, and to provide you with a list of community resources that you can access once you are home.
During the first 48-72 hrs, the mother needs to show first sign of recovery from the operation, bowel movements are vital. To help initiate that mechanism, try to walk, gently move the hips side to side, in order to achieve the beneficial outcome.
Seek for a trained osteopath to conduct a check-up to your baby. Due to the lack of mechanical compression over the lungs, appears mostly in planed caesarean (no labour), and missing out baby passage through birth canal. Paediatric Osteopath have several techniques that mimic the last phase in labour, which can help to increased rib cage function, hence increasing lungs capacity, reducing the risk to develop respiratory dysfunctions. In addition, the osteopath will help the mother, for better recovery from the operation, by adjusting the compensatory changes caused by the scar tissues, giving advice for healthy and safe rehab exercises. Allowing the body its optimal and efficient functional performance.