One advantage of planning your C-section is that it's likely to take place during bankers' hours. When you deliver vaginally, especially if your labor isn't induced, you don't have much say about when your baby is born. Some older studies, done in the 1970s, suggested that the timing of a delivery could affect its outcome. Babies born during the daytime and on weekdays, when doctors, nurses, and other hospital staff tend to be more rested and numerous, were found to have lower death rates than babies born at night or on weekends. More recent research findings about the time of day or day of the week have been inconsistent, though. In a study of nearly 700,000 births, published in 2003, scientists from Stockholm's Karolinska Institute found that babies born at night had a higher risk of dying shortly after birth than babies born during the day. (Remember, though, few babies died overall, so the difference in the actual number of deaths between the two groups was quite small.) However, another huge study -- this one of more than 1.6 million live births in California -- found no evidence that the quality of care before, during, or after delivery was compromised on weekends.
For the most part, preplanned C-sections appear to be safer and, not surprisingly, more acceptable to moms than unplanned emergency C-sections. Recent research by obstetricians at the University of Vienna in Austria suggests that as far as psychological factors, pain levels, and birth experience, there's no comparison between the two types of C-sections. Using questionnaires and psychological tests, the researchers evaluated 1,050 pregnant women 2 weeks before their due date and 3 days and again at 4 months after delivery. A total of 147 women delivered by planned cesarean -- 3 for medical reasons and 44 at the patients' request. Another 93 women had unplanned C-sections. The women who had elective cesareans reported having the best birth experience, while the 41 who had vaginal deliveries with vacuum extraction reported having the worst. The researchers concluded that elective C-sections were safe and "psychologically well-tolerated," and that the results were similar to uncomplicated vaginal deliveries.
In a recent study of more than 18,000 pregnancies, Nova Scotia researchers found that if you deliver by a planned C-section, you tend to fare better overall than if you deliver by emergency C-section or vaginally with the help of forceps or vacuum extraction. The scientists identified only one minor drawback to preplanned cesareans: Afterward, you're twice as likely to run a fever of more than 100.4 degrees than if you had labored before delivering. Still, your actual risk of an elevated temperature is pretty low. Fewer than 1 percent of all women in the study developed a fever.
This is reassuring: A University of Washington study suggests that planned C-sections are just as safe as vaginal deliveries, at least as far as your risk of dying afterward, which is extremely low to begin with. Only 11 out of the 265,471 women in this study died of pregnancy-related causes within 6 months of giving birth. After accounting for advanced maternal age and severe preeclampsia, there was no difference in pregnancy-related death rates between the C-section group and the vaginal delivery group. The researchers concluded that it wasn't C-sections that raised the risk of dying, but the medical conditions that necessitated them.
