By Dr. Amy Tuteur
March 18, 2016
IDEAS
Dr. Amy Tuteur is an OBGYN and the author of the forthcoming book, Push Back: Guilt in the Age of Natural Parenting.

Childbirth is dangerous for babies. The charity Save the Children notes that the day of birth is the most dangerous day of the entire 18 years of childhood.

C-sections have done more than any other procedure to save the lives of babies (and mothers). Indeed, it has long been known that C-sections are safer for babies than vaginal birth. Recently, however, some in the natural-childbirth community have questioned whether C-sections have harmful long-term effects on babies.

A new study puts those fears to rest. The study, Planned Repeat Cesarean Section at Term and Adverse Childhood Health Outcomes: A Record-Linkage Study, was published in PLOS Medicine. The authors looked at the risks of asthma and obesity in Scottish 5-year-olds born by repeat C-section and found that they were no different than children born by vaginal birth after C-section.

According to the study: “The findings here suggest that there are no substantially worse outcomes associated with planned repeat cesarean births. They therefore support a process of planning birth after a previous CS that reflects a woman’s values and preferences.”

That’s good news for mothers who have had C-sections, or request C-sections or have to choose between attempted vaginal birth after a previous C-section and an elective repeat C-section. Many C-section mothers have had to contend with guilt as a result of the reflexive demonization of C-sections that is so prevalent today.

C-section mothers have been told that C-sections are dangerous, even though they pose less risk for babies.

They’ve been told that C-sections interfere with mother-infant bonding, even though there is no evidence to support that claim.

They’ve been subjected to mutually contradictory accusations. They are supposedly “to posh to push,” yet simultaneously too compromised by painful C-sections to properly care for their newborns.

The idea that C-sections can cause long-term harm to babies is just another form of demonization. How does it happen? Natural-childbirth advocates often insist that babies born by C-section may miss out on acquiring “beneficial bacteria” typically found in the mother’s vagina.

Some natural-childbirth advocates have recommended “vaginal seeding,” swabbing the mouths of babies delivered by C-section with the vaginal secretions of their mothers. A recent editorial in the British Medical Journal cautioned that not merely is there no evidence to support vaginal seeding, there’s also considerable reason to believe that it could be harmful in some cases because vaginal secretions can contain bacteria and viruses that are deadly for newborns.

We’ve long known that bacteria and viruses in the vagina can be deadly for newborns. Two of the most serious infectious threats to babies are Group B Streptococcus and Herpes virus, both of which can live in the vagina. Recently, preliminary research has shown that the intestinal bacteria (“gut microbiome) of babies delivered by C-section can differ from that of babies born vaginally, the assumption being that C-section babies did not acquire the same bacteria as babies born vaginally typically do. Some researchers have speculated that this difference can have a long-term impact on asthma, obesity and a variety of other health outcomes. That’s what the authors of the PLOS study were looking for. It suggests that’s not the case.

These speculations are just that, speculations, and they reflect the fact that we know so little about the infant gut microbiome that we have no idea whether differences between infants are clinically meaningful or are simply natural individual variation.

There are many things to worry about when you are a new mother, but there’s no reason to feel guilty for having a C-section. There’s no evidence that C-sections cause long-term harm to babies and considerable evidence that they save countless newborn lives.

Contact us at editors@time.com.

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