SOURCES: Sally Curtin, M.A., statistician, U.S. National Center for Health Statistics, U.S. Centers for Disease Control and Prevention; Mark DeFrancesco, M.D., president, American College of Obstetricians and Gynecologists; Catherine Herway, M.D., assistant director, maternal-fetal medicine, Staten Island University Hospital, Staten Island, N.Y.; May 20, 2015, report, Maternal Morbidity for Vaginal and Cesarean Deliveries According to Previous Cesarean History: New Data from the Birth Certificate, 2013
WEDNESDAY, May 20, 2015 (HealthDay News) -- Women who deliver their first baby by cesarean section are more likely to need blood transfusions and be admitted to intensive care units than women who opt for a vaginal delivery, U.S. health officials reported Wednesday.
In addition, after that first C-section, nine out of 10 women will have their next infant delivered the same way, said report author Sally Curtin, a statistician at the U.S. Centers for Disease Control and Prevention's National Center for Health Statistics.
"Having that first cesarean changes everything," she said. "It changes the picture of whether you are even going to attempt labor next time."
There are more health risks for mothers for repeat cesarean than vaginal deliveries, Curtin said. These risks include the need for transfusions, a ruptured uterus, the need to be admitted to an intensive care unit and an increased likelihood of requiring a hysterectomy, she added.
Curtin noted that cesarean deliveries still account for only 15 percent of all births. Most mothers, 85 percent, do not have a cesarean the first time they give birth, she said.
"It would be more fruitful to try to reduce the rate of primary cesareans, because if that woman has that first cesarean, the chances are nine out of 10 she'll have a second," she said.
Dr. Mark DeFrancesco, president of the American College of Obstetricians and Gynecologists, said, "Today's report on maternal complications underscores the importance of efforts to avoid primary cesarean deliveries."
Although cesarean sections can be lifesaving procedures, they are overused in the United States, he said. "In recent years, roughly one in three deliveries was performed with a cesarean," DeFrancesco said.
Dr. Catherine Herway, assistant director of maternal-fetal medicine at Staten Island University Hospital in New York City, said many doctors opt for a second cesarean delivery to avoid the chances of being sued if something happens to the baby.
"To offer a vaginal delivery, you have to be in the hospital and be prepared for complications," she said. "Repeat cesareans are so much easier and quicker. I have seen the number of people who are offering vaginal deliveries after a cesarean has really dropped off," she said.
Herway said the way to avoid repeat cesareans is not to have the first one. "Women should educate themselves," she said. And doctors shouldn't be in a rush to do one unless there is a real medical reason for it, she said.
Other key findings in the report include:
Visit the American Congress of Obstetricians and Gynecologists for more on C-sections.