The belief is widespread that it is more useful to be born for a child than to be extracted from the uterus as a result of cesarean section. We decided to check if this position is confirmed by scientific data.

About what childrenBorn during vaginal genera, significantly Excess born as a result of cesarean section, write many Media. It is reported that the babies who were born in different ways Intellectual, Psychological And physical Differences. So, “Caesaryats” is supposedly harder to give mathematics, they are capricious and do not finish the matter, they work worse for the nervous and immune systems. In this case, some of the problems are associated precisely with the lack of experience through the tribal channel: for example, "when the child goes through the birth canal, he inevitably meets with the mother’s microflora - and normally it helps him to populate the intestines with the most useful bacteria." Particularly dangerous for those born thanks to the Caesarean section is called barotrauma. Her Describe So: “Under ordinary conditions, the fruit slowly leaves the mother’s body, amniotic fluid disappears around it and it gets used to atmospheric pressure. With a cesarean section, the baby can get damage to the brain due to a sharp pressure drop. ”

To begin with, we note that the options for the delivery of it are by no means reduced to vaginal childbirth and the Caesarean section, each of them has its own subspecies. So, vaginal birth can be complicated and uncomplicated, normal or rapid, conducted with or without epidural anesthesia, instrumental (using forceps and/or vacuum-extractor) or not, in a special chair and without it (for example, in water). Caesarean section, in turn, is emergency and planned, planned can occur before the birth process and during, during the procedure, epidural anesthesia or anesthesia can be used. Moreover, in the vast majority of cases, the way the baby is born minimally depends on the desire of the expectant mother - even if she leans to the Caesarean section, the operation in most countries will be prescribed only according to the totality of indications, and in the event of rapid vaginal births, it still will not be able to slow down the process.

Therefore, comparing the “utility” of different scenarios from the point of view of both the child and the mother as a whole is incorrect - a set of conditions for each woman in labor is individual. For example, if in case falling of the umbilical cord The woman will abandon the emergency cesarean section and prefer vaginal birth, it will end, most likely, intranatal death of the fetus. There is no question of any benefit in such a situation. Or consider another option, not directly threatening the life and health of the child, is the growth of the placenta. When conducting a vaginal birth, the placenta, sprouted into the muscle layer of the uterus, will not be able to separate itself, and its manual separation will most likely cause massive bleeding, which will lead to the death of a woman. Physiologically, in this case, nothing threatens the child, but it is hardly possible to measure the experience of orphanage with the concept of “useful”. And vice versa, when the placenta is increased, a planned cesarean section, along with a hysterectomy (uterine removal), spent at a period of 34 weeks, retains the life of both the mother and the child - moreover, it is this period that provides them with the least risks.

In some countries, cesarean section allowed Carry out at the request of the woman in labor without the availability of appropriate indications. The main one cause Such a choice, according to WHO, is "a desire to avoid intolerable pain and accelerate the process of childbirth." Such a reason can also be rational in terms of benefit for the child. Transferred generic pain and generic injuries Significantly Raise The risk of postpartum depression for the mother. She, in turn, has a serious negative influence For many years to the child: provokes delays in linguistic and emotional development, increases the risk of dangerous behavior and obesity, increases the frequency of mood swings and emotions for various, often insignificant reasons, causes problems with the control of anger and complicates social adaptation.

A reliable comparison of vaginal genera as a whole and cesarean section is also impossible also because it cannot be taken into account by all other aspects of the birth process that may affect the child. These are the ratio of the diameter of the fetal head and the generic paths of the mother, the position of the fetus in the uterus, the features of the placenta of the placenta, the features of the arrangement of the umbilical cord relative to the fetus, etc. Such a detailed comparison is the topic for a comprehensive scientific study in the field of obstetrics and gynecology.

Nevertheless, there are scientific works devoted to the advantages and disadvantages of one or another method of birth in the presence of one or more of the above conditions. We make a reservation that most of the available studies include data from different qualities. This is due to the fact that it is simply impossible to get really reliable evidence for a number of reasons. For example, scientists cannot create conditions for twin Research (this method is considered one of the best in medicine and related areas), when one of the couple would be born vaginally, and the second - with the help of cesarean section, exclusively at the request of a woman, and not for medical reasons. Conducting Double blind Studies are also impossible for ethical reasons: both the doctor and the patient should know what tactics will be used and why.

Therefore, we turned to meta -analyzes and reviews of Kokrain's cooperation as a database, which collects the most complete and reliable information about all aspects of human life and health in terms of evidence -based medicine. In the publications of Kokrainovsky cooperation, the following data can be found:

With premature birth, women with uniform pregnancy are neither vaginal birth nor a cesarean section Do not affect at the frequency of asphyxia in childbirth, respiratory distress syndrome or injuries of the child in childbirth;
In the case of a second pregnancy, if the first ended with Caesarev, not one of the methods of delivery (planned vaginal birth and planned cesarean section) did not show statically significant advantages over another from the point of view of infant mortality or incidence;
With the pelvic presentation of the Caesarean section is reliably reduces Infant mortality and risk of serious injuries, but with some probability, can weaken health under the age of two years. Science does not know how the transferred cesarean affects the pelvic presentation on children when they become older;
type of anesthesia (epidural or anesthesia) does not affect on breastfeeding, mother’s attitude to the baby and the duration of the time necessary for the full inclusion in the care of the child;
No data About whether the cesarean section can reduce the risk of transmission of the hepatitis C virus from mother to child compared to vaginal birth;
Unknownwhich is better - planned vaginal births or planned cesarean section for the health and life of the mother and child in the case of heavy Preeclampsia;
There are no sufficient dataTo determine what is better from the point of view of the child, if premature births have begun: to be born with cesarean or vaginally. In both cases, there are many variables, the most correct tactics are to provide the doctor with the opportunity to study them and leave the decision at his discretion;
No unambiguous recommendations regarding the preference of vaginal instrumental births or cesarean section with weakness of labor in the second period;
None of the methods of childbirth (induced and unindered vaginal, instrumental, operational) I was not more dangerous or, on the contrary, more reliable for children born of women with diabetes gestational sugar;
If the mother has hypertension, then the birth of a child for a period of 34 weeks by induction of childbirth or cesarean section is safer for a woman and Has not Static significance for the child, in comparison with the hospital in the hospital before the start of spontaneous births.

As can be seen from these materials, the child does not give significant advantages a vaginal way to the child. Information about the long -term state of the health of children born in one way or another was not found in the database. At the same time, there are several large population studies that compare different aspects of the life of children that were born in one way or another.

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For example, in 2017, scientists Analyzed School performance of almost 1.5 million Swedish adolescents who were born between 1982 and 1995 through vaginal births without medical intervention, childbirth using vacuum explosor and obstetric forceps, planned cesarean sections (before the birth) and emergency cesarean section. It turned out that there is no statistically reliable difference in school performance between these children.

Another major study concentrated On the features of neur development of children born in different ways. Scientists noted that the people who were born with a cesarean section are 1.33 times higher than the probability of an auto spectrum disorder and 1.17 times higher than the probability of ADHD. Although these results may seem frightening, scientists warnthat they need to be interpreted with caution. Firstly, it is worth considering the total population prevalence of these states-1% for autism and 7% for ADHD. That is, a child born during vaginal birth will be diagnosed with an autism with a probability of 1%, and a child born using cesarean section is 1.33%. Secondly, the study does not indicate a causal relationship, but only notes the correlation. The influence of the third factor cannot be excluded - for example, It is knownthat cesarean section is often performed for women with obesity, asthma, autoimmune diseases and at an older age. Each of these features can be a reason not only to decide on the need for surgery during childbirth, but also to a factor for the child predisposing to neuro -explosions. The article is scientists Summing up: “Future research should include further adjustment in order to avoid false associations and take into account genetic characteristics. Such studies can be a comparison of brothers and sisters, twin studies or the study of adopted children. The mechanisms underlying the observed associations remain unknown and require an empirical study to find out whether the cesarean section plays a causal role in the development of neuro-abruptness and mental disorders. ”

There is also no reason to believe that the lack of contact with the bacterial microflora of the mother at the time of passing through the birth canal seriously affects the health of children born with cesarean section. Metaanalysis spent by Chinese scientists, showedThat by the third month of life, children who were born during vaginal genera have a richer microflora, but by the sixth month there are no more differences.

In 2008, scientists from the University of Bergen (Norway) Published The results of a population study that covered more than 1.7 million births from 1967 to 1998. It turned out that the planned and emergency cesarean section is associated with an increased risk of developing heavy asthma in the child. However, the increase was insignificant: in general, the Astma population occurs with a frequency of four cases per 1000 people, while in children born with a planned cesarean, this indicator was 5.6 per 1000, and those who were born during emergency cesarean were 6.3 per 1000. Moreover, a significant role in the cause of the causes of asthma. Playing genetic predisposition, and women suffering from severe bronchial asthma are doctors They prefer Do not allow vaginal birth. That is, there is a possibility that not birth with Caesarean plays the main role in the future development of asthma, and the fact of its presence in the mother.

As for the barotrauma: the pressure in the uterus and outside it does not differ as significantly as, for example, when diving a diver under water. No scientific data that the child can be at risk could be found. But for the mother, the risk of barotrauma exists - True, mainly when flying on long distances by plane immediately after Caesarean. In 1991 there was Described A single case of barotrauma in a woman who at the time of its receipt took place a cesarean section. Unfortunately, there is only a brief description of the case in the public domain, which does not allow to draw more complete conclusions.

Thus, large meta -analyzes from the Kokrain library do not show any advantages of vaginal genera in the Caesarean section. The results of large population studies demonstrate that school performance in children has no statically reliable differences depending on the method of their birth. There is a small correlation between the Caesarean section and the risk of autism and ADHD, as well as asthma. However, firstly, the data obtained indicate the presence of a very symbolic difference in risks, and secondly, in these scientific works there is no amendment to the characteristics of the mother’s health before childbirth. Finally, each birth is relatively unique in dozens of different indicators, and scientists have not yet been able to conduct a fairly reliable study that would contain generalized conclusions.

Image on the cover: Iuliia bondarenko from the site Pixabay