Risks For The Baby

During the final weeks of her third trimester, Michelle Ferguson of Tampa got the news that she had a very big baby  -- close to, if not more than, 10 pounds. Such babies are at higher-than-normal risk of birth complications. When labor begins, the obstetrician stands ready to perform a c-section if it suddenly becomes necessary. "My doctor told me I could go ahead and attempt labor and see how it goes," says Ferguson, "but I decided I didn't want all the drama." She opted to schedule her cesarean for the next day.

Declan did indeed weigh more than 10 pounds, but he emerged blue, with breathing difficulties. Luckily, he was fine after a brief resuscitation.

Such breathing problems are more common in babies born through c-sections, even if they're planned. The risk is highest if the procedure is performed before 39 weeks  -- such premature birth can happen if the due date has been misjudged. Overall, though, the risk of serious respiratory distress is low.

Some moms and experts worry that even a successful c-section may interfere with breastfeeding and bonding, since the mom and the baby may be separated for hours during recovery. But new research has revealed that bonding is a long-term process, and the method of delivery doesn't seem to affect it.

Benefits For The Baby

Vaginal birth is no picnic for the baby. The U.S. death rate for full-term babies is approximately 2 in 1,000. Most occur in otherwise normal babies, leading some experts to say that scheduling a cesarean during the week before a woman is due  -- the 39th week  -- would save lives.

The main reason is that the trip through the birth canal can cause head injuries. Those risks go up if a fetus weighs more than 10 pounds, is in breech position, or is one of multiples. In each case, it's more likely that forceps would be needed to bring the baby out, and this procedure can cause head damage in rare instances. So obstetricians routinely give women the option of having a cesarean delivery under those circumstances.

"From the beginning of my pregnancy, I really wanted a c-section," says Sue Zeilnhofer of Bayville, New Jersey. "I had heard all the horror stories about twenty-four-hour labors and babies pulled out with forceps." Her fears worsened a week before her due date, when her doctor concluded from her final sonogram that her baby would weigh around 8 pounds, 11 ounces. "I thought, she's going to rip me apart," she recalls. The sonogram also revealed that her baby was in breech position, and her doctor told her he wanted to consult with a colleague about trying to turn the fetus. "But I said, 'No, really, I prefer a cesarean.'"

Zeilnhofer delivered Emma on a Wednesday and brought her home that Saturday, happy with her decision. "If I ever have another, I want it the same way," she says, three years later.

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