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Cesarean predisposes to long labor later.

Cesarean predisposes to long labor later

Women attempting vaginal birth after previously giving birth only by cesarean section normally have long labors, similar to women giving birth for the first time. This new finding may encourage obstetricians and women attempting vaginal delivery after previous cesarean sections to be more patient and to wait longer before opting for another cesarean section, says Cynthia Chazotte of the Albert Einstein College of Medicine in New York, who coauthored the report in the March OBSTETRICS AND GYNECOLOGY.

She and her co-workers studied 204 women: 44 women attempting vaginal birth after previously delivering only by cesarean section; 24 women attempting vaginal delivery who had previously given birth first vaginally and later by cesarean; 68 women in labor for the first time and 68 women who had previously given birth vaginally. The researchers found cesarean-only and first-time mothers averaged six to eight hours longer in labor than women who had previously delivered at least one child vaginally. Longer labor times in mothers who had never delivered vaginally probably result from less efficient uterine contractions and stretching of soft tissues around the pelvis, Chazotte says.

"Although most obstetricians intuitively suspected these results, the study gives us confidence that it's a good practice to allow these women to labor longer," says Russell Laros of the University of California, San Francisco.

Nearly one in four U.S. babies are delivered by cesarean section each year, according to the American College of Obstetrics and Gynecology, who in 1988 recommended that women who had previously delivered by cesarean have the opportunity to try vaginal delivery with subsequent births. But until now, sketchy scientific data existed for obstetricians to determine whether labor abnormalities in these women, including very long labors, should be judged by the same or by different criteria as those used for women who attempt labor without having had a previous cesarean section.

And in a study of 3,917 women in New York City comparing the risks of first-time birth in women 30 years and older with those women between the ages of 20 and 29 finds that women in the older group had more pregnancy complications, including a higher cesarean rate. The study in the March 8 NEW ENGLAND JOURNAL OF MEDICINE also finds that the older group didn't have an increased risk of having babies who were premature, who died shortly after birth, who were small for their gestational age or who had a low Apgar score, which assesses a newborn's physical health.
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Title Annotation:Cesarean birth
Author:Decker, C.
Publication:Science News
Date:Mar 10, 1990
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