A joint effort of the March of Dimes, the U.S. Centers for Disease Control and Prevention and the Albert Einstein College of Medicine analyzed data on the rising premature birth rate, and found that 92 percent of the increase in singleton premature birth is due to c-sections. Birth data from 1996 to 2004 showed an increase of almost 60,000 singleton preterm births per year. Late preterm babies, born between 34 and 36 weeks, accounted for the majority of this increase.  The study is published in the June issue of Clinics in Perinatology.

At this point, the thing we don’t know is how many of these c-sections were medically necessary. The climbing c-section rate in the US has been met with concern that too many doctors are allowing women to schedule c-sections merely for convenience. The problem arises when these c-sections are allowed to occur before 39 weeks. According to the American College of Obstetricians and Gynecologists, NO ONE should be induced to deliver their baby before 39 weeks unless there is a medical necessity.

Unfortunately, there is poor awareness among obstetricians and the general public about the risks of delivering a late preterm (sometimes called “near term”) baby. Recent studies have shown that babies born during this critical period of development, between 34 and 36 weeks gestation, have reduced fat stores, immature lungs and livers, and a brain volume that is just 60% of a baby born at term. As many as three-quarters of babies born at 34 weeks end up in the neonatal intensive care unit to receive specialized care. In addition, babies born between 34 and 36 weeks are 6 times more likely to die in the first week, and 3 times more likely to die in the first year than their term peers.

There is also little awareness among women about some of the risks of delivering by c-section, including increased risk of complications in subsequent births, and the possibility that it could cause you to be denied coverage by private health insurance companies.

So, the good and the bad news (depending on how you look at it) here is that many of these preterm births may have been totally preventable. If this turns out to be the case, proper education among OBs and moms-to-be could significantly reduce the rate of late preterm birth, resulting in significant health benefits and reduced healthcare costs for these babies. Of course, there are many reasons why it can be better for a preterm baby to be delivered by c-section, but delivering a baby prematurely just to get a specific c-section date is where the potential problem lies.

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