Early and long-term consequences of intrapartum asphyxia

Myth: babies would choose prelabour caesarean section

Interest in rising caesarean section (CS) rates focuses on the putative relative effects on maternal health and perinatal mortality, especially in 'non-medical', 'request' or 'repeat' planned prelabour CS (PLCS). Shortening pregnancy and avoiding labour affect fetal maturity. Babies who do not experience labour have significantly increased respiratory and other morbidities that may have profound effects on development, determining immediate and potentially life-long disease. It is thus surprising that obstetricians do not advocate awaiting or inducing labour even in women considering CS. Mothers must be fully informed of all the evidence before they can give valid consent and make decisions on their baby's behalf. New evidence about immunological and metabolic differences induced by obstetric interventions continues to emerge, but large knowledge gaps exist. Although all modes of delivery carry potential risk of neonatal morbidity or mortality, we conclude that normal babies would indeed 'choose' labour.