‘Longer risks of stillbirth’ from vaginal birthing are increasing

Doctors will usually refer women for a cesarean section when signs of labour occur within 22 weeks of conception, as it’s the least likely way to give birth safely.

Many doctors who perform cesareans are trained to keep women awake so they can give birth as soon as possible. However, some opt to keep women awake when they are extremely near to full term, because they are in great pain.

A new study suggests that women who receive prolonged vaginal birthing may be more likely to have a stillbirth than women who give birth the way most doctors advise – a cesarean section.

Researchers conducted a review of the official data for the UK and Australia and determined that women who experience prolonged vaginal birthing before the 20th week of pregnancy are about 70% more likely to have a stillbirth than women who undergo a cesarean section.

“Because stillbirth rates have gone down in recent years, everyone assumed that the reasons for these stillbirths might have changed,” said Sharon Burton, a PhD candidate at University College London who led the study.

“However, we found that prolonged vaginal birthing is still a significant risk factor, and you may not even need prolonged vaginal birthing to have an increased risk of stillbirth.”

On average, among women who choose to have a vaginal birth before 22 weeks gestation, there are 4.1 stillbirths per 10,000 births.

For women who had delayed labiaplasty, prolonged vaginal birthing before 22 weeks of pregnancy, there were 8.7 stillbirths per 10,000 births.

“These stillbirth rates are higher than those for women who have a cesarean section, which indicates that the woman’s choice of hospital should be factored into decision making for fetal placental care in pregnancy,” said Burton.

“Currently, women who have their labia reconstructed are informed that longer term risks of having a stillbirth might occur, however the expert opinion is that the risk is small.”

Burton noted that she and her co-authors would like to see further research in the area to find out whether there is a “specific number of hours that are necessary to enable the woman to give birth.”

“Time is a concern for mothers and families,” she said. “Understanding this risk factors may help to reduce longer term risks for these women.”

Burton said there may be reasons for why women with additional risks of stillbirth after having their labia reconstructed are more likely to choose this option, “such as resulting from previous medical complications or medications used to take an aggressive approach to labor.”

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