Repeating C-Section Is Safest Bet

CHICAGO —  Another caesarean section is the safest childbirth method for women who have already had a surgical delivery, although the risks from a vaginal delivery after caesarean are lower than previously thought, British researchers say.

A study of 313,238 births in Scotland found that for women with previous caesareans, the delivery-related death rate for subsequent babies was about 11 times higher in vaginal births than in planned repeat caesareans.

Still, the overall infant death rate for vaginal-after-caesarean births was about equal to the death rate in first-time vaginal births--about 1.2 per 1,000 babies, the study found. That compared with 0.1 per 1,000 for planned repeat caesareans.

Often-cited previous research suggested a death rate of 5.8 per 1,000 births for vaginal-after-caesarean deliveries.

Unlike the current study, those figures included many premature babies, who are born before 37 weeks’ gestation and face slimmer survival chances than full-term infants, said Dr. Gordon C.S. Smith of Cambridge University in Cambridge, England.

Smith helped conduct the study, which involved babies born between 37 weeks and 43 weeks’ gestation. It appeared in last Wednesday’s Journal of the American Medical Assn.

Smith said his study should reassure women “that the absolute risk to the baby from vaginal birth after caesarean is very low.”