Could C-Sections Lead to Long-Term Disorders?

C-section babyBy: Taylor Newman
There's some big scientific news on the childbirth front right now, so strap on your nerd glasses and let's do this thing: Tamas Horvath, chairman of the Department of Comparative Medicine at Yale University School of Medicine, has discovered that "a key protein related to brain development in newborns is activated during natural childbirth, but impaired in Caesarean section births." (Crib note: Impaired is the key word in that sentence.)

The protein, UCP2, impacts a range of functions within the brain itself - like the creation of memory-related circuits - and within the rest of the body. One of these functions, for example, plays a key role in the metabolism of fat. Another crucial one is that it promotes cells' adaptation and survival under stress. Because the protein's activation is kicked off as a physical response to the birth process, when that process is curtailed by a C-section - Horvath's research shows - the protein won't kick off in its normal way, and those functions it's supposed to initiate also won't get the message to do their thing as they're supposed to.

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More research is needed to track the long-term effects of this - impaired fat metabolism could very well make children more susceptible to obesity, for example - and Horvath plans to conduct that research. Meanwhile, that C-sections have a direct negative effect on the release of UCP2 - and thus the healthy physical processes it's supposed to initiate - within a baby's brain is big news, and doctors, nurses and midwives across the country are waiting attentively for insight into its long-term implications.

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At the risk of stating the obvious, adult human bodies are also complex organisms controlled and regulated by countless, interconnected physical and chemical processes like those UCP2 is involved in. Labor and delivery is one such process, and a great deal is already understood about how each process within it affects the next, in a mother's body, in order to move a baby from womb to world. As a University of Minnesota childbirth website states, "We don't fully understand what makes labor start, but changing levels of hormones influence the softening and preparation of the cervix and the onset of contractions." After that, in a nutshell, contractions then help dilate the cervix and - in conjunction with a pushing mama - bring on the main event ("It's a Boy/Girl!").

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It's also well known that disrupting this process - aka employing interventions during birth - tends to beget the need for additional interventions. Besides making medically-necessary C-sections more likely, and thus putting mothers more at risk, as a result, this disruption also affects the normal release of certain hormones and chemicals in the mother's body and brain; this is one of the key reasons people advocate for natural birth in the first place. Now emerging scientific research on childbirth's impact on the baby's brain indicates all the more that aiming for an intervention-free birth is not simply a matter of personal philosophy; it allows both mother and baby's brains and bodies to function properly, with a potentially life-long impact on baby's health. As Horvath says, "It's becoming very clear that the perinatal environment has an impact on later onset disorders, such as obesity and diabetes. The hours of delivery are the stress that moves you from one form of existence to another."

Being born tops the list of dramatic changes we experience in life; our surrounding environment transforms rapidly from womb to world, and this places serious demands on our brains and bodies. If the labor and delivery process creates the 'stress' that initiates our adaptive responses so we're ready for the next big thing - life outside the womb - it's logical to conclude that we want this stress in the picture, and that minimizing or avoiding is not actually helpful to us (or, rather, to our babies). This is exactly what Horvath's research shows.

I think this stress thing presents an interesting parallel to what contemporary natural birth advocates have been saying about pain for quite some time; in the same way we think we must minimize stress, we're generally taught to fear pain, to panic in its presence, and to subdue it by any means necessary. But childbirth hurts, right? Pain is a part of it. And one's acceptance of, and approach to, pain's place in the process is in fact an integral - and ultimately empowering, even rewarding (more so than painless-by-intervention) - part of the process. Since avoiding, rather than managing, pain in childbirth bumps up the likelihood of complications, and since those complications can (and often do) lead to C-sections, and those C-sections cut short the 'stress' needed to shift baby's brain so that her body will be ready for life outside the womb, well… It seems a shift in our understanding of, and attitudes toward, both pain and stress will benefit from reassessment.

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Interventions in childbirth - C-sections included - are of course sometimes necessary to a mother or baby's survival (though not nearly as many as are taking place in our country today: 1 in 3 births!). In these cases, without question, they should be performed. Certainly, too, many a happy, healthy baby and mama have emerged from C-section operations. (Read: If it happens to you, don't freak out.) But since understanding is expanding around C-sections' impact on mamas (see above), and as more becomes known around their impact on babies' long-term health, I'm guessing an increasingly savvy public will opt to trust in the childbirth process in lieu of electing for surgery.

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What do you think? Would the baby-health factor influence your feelings around C-sections more than the (already established) mom-health risk factor? Do you think emerging research will slow our rapidly rising C-section rates?

PS. Horvath's research has thus far been conducted on mice, and he needs - and intends - to extend it to humans. Suffice to say here that 1) animal testing is the standard in medical research, so it's predictable that his current findings have been attained in this way, and 2) Ethical questions - important as they are - aside, animal testing is relevant enough to medical research (i.e. human applications) to make it standard. Horvath's results are attracting the attention of childbirth professionals for a reason; they are, most likely, applicable to people.

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