Q: Is a cesarean indicated for premature babies? If so, how premature? The
study I recall concluded that outcomes were no better having done a
cesarean no matter how premature. Of course I can't find the study now, so
if any of you have any information or studies on hand, please let me know
of them.
-Amy Jones
In the hospital where I gave birth at 25 weeks gestation, preemies are born
vaginally unless medically contraindicated. Even though Olivia's birth
required a section, they did a sonogram for me to check her position
minutes before the surgery (I had an 8 cm fibroid deep in the pelvis; she
was breech with cord presenting) just in case something had changed and we
could chance a vaginal delivery. Since preemies are so small and the
problem is not inducing labor but stopping it, many can be born vaginally
with little additional trauma. But it depends on the baby & mother's
condition. I never thought I would have been happy to have a c-section
until it saved Olivia's life. My midwives were there, of course, through it
all!
-Regina Paleau
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To my knowledge the indicators are similar to term babies, although the
threshold for fetal distress tends to be lower. Also, the risk of
malpresentation is higher. But it also needs to be taken into account
whether or not the lower segment is fully formed, because otherwise the
woman is looking at a 'classical' upper segment cesarean which to my best
knowledge commits her to cesarean birth for subsequent deliveries.
-Kirsten Blacker
Reprinted from Midwifery Today E-News (Vol 2 Issue 11 March 17, 2000)
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