Concerns over Aussie trend for early C-section births

caesarean section scheduled too early, without a medical reason.

Planned birth by C-section or induction (a medical treatment to start labour) can be an

important intervention in maternity care.

However, according to the findings of the Fourth Australian Atlas of Healthcare Variation, published on Wednesday, the timing of birth should be carefully considered to ensure the best outcome for the mother and her baby.

Where there are certain medical or obstetric complications, such as pre-eclampsia or foetal

growth restriction, early planned birth may be necessary because the risks of waiting until 39 weeks gestation outweigh the benefits.

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“But if there are no complications, waiting until at least 39 weeks is optimal for the baby because the last few weeks of pregnancy are important for the baby’s development, including brain and lung maturation,” the report states.

“Educational campaigns on this issue have emphasised the effects of early birth on brain maturity and the need for admission to a special care nursery if the baby is born early.”

The report – produced by the Australian Commission on Safety and Quality in Healthcare and the Australian Institute of Health and Welfare – found that in 2017 rates of procedures without a medical reason resulting in early births were highest in South Australia (56.1 per cent of Caesareans before 39 weeks), Western Australia (55.5 per cent) and Queensland (55 per cent).

In NSW, such procedures made up 51.8 per cent of the 10,381 early caesarean sections performed during the year. Figures were lower in Victoria, where 44.3 per cent of 10,108 early Caesareans had no recorded medical reason.

Professor John Newnham, former senior Australian of the year and chair of the Australia Pre-term Birth Prevention Alliance, said while at times early birth is necessary, all too often it occurs without a medical or obstetric reason.

“The evidence is clear that waiting until at least 39 weeks is best for the baby’s development, unless there is a medical reason for an earlier birth,” he said.

Prof Newnham added that unnecessary early birth can have a range of consequences, from higher risks of respiratory problems at birth to higher risks of behavioural and learning problems in the long term.

“Every week counts towards the end of pregnancy,” he advised, adding that the risks to the newborn are greater at 37 than 38 weeks, and greater at 38 than 39 weeks.

He said “relatively new” advice as to what is a full-term birth was likely partly to blame.

Any pregnancy over 39 weeks is now considered full term. Babies born 37 weeks to 38 weeks and six days are considered early term, according to Healthline.com

“It is also important for parents to have accurate information about the risks and benefits of early planned birth, and access to clinicians and facilities at the right time,” Mr Newnham said.

“I encourage parents to ask questions before booking an early caesarean section, to make sure their birth plans are best for both mother and baby.”

Dr Vijay Roach, president of the Royal Australian and New Zealand College of Obstetricians and Gynaecologists, told the Sydney Morning Herald, the college had been educating its members about risks of early caesarean birth and supported the findings.

“The message is very clear – we need to change our thinking from pregnancy ending at 37 weeks, which is how we were all educated,” he said.