It is certainly interesting to ponder how we as bipedal mammals have 
evolved/adapted in birth.  It is also interesting to consider whether small 
intracranial hemorrhages could be a very normal event occuring in the neonate 
travelling through the birth canal or whether intracranial hemorrhage is a side 
effect of medicalized hospital birth.

However, I do not think considering the normalcy of intracranial hemorrhage in 
vaginal birth is the best response to this study.

I would like to reiterate that the "findings" in this Radiology research study 
are "clinically insignificant" according to the study's own authors.  We are 
talking about a total sample size of 88 babies and only 17 babies were 
identified with varying degrees of intracranial hemorrhage.  The media is to 
blame for taking this small study and reporting it's findings in such an 
irresponsible manner.

Unfortunately, some health care practitioners will take this study(and the 2 
minute news blip) and say "see, c-sections are better/safer."  A great 
response would be to direct them to another recently published study which 
actually has a huge sample size and dramatic statistically significant findings:  

Infant and neonatal mortality for primary cesarean and vaginal births to 
women with "no indicated risk," United States, 1998-2001 birth cohorts.

Division of Vital Statistics, National Center for Health Statistics, Centers for 
Disease Control and Prevention, Hyattsville, Maryland 20782, USA.
BACKGROUND: The percentage of United States' births delivered by cesarean 
section has increased rapidly in recent years, even for women considered to 
be at low risk for a cesarean section. The purpose of this paper is to examine 
infant and neonatal mortality risks associated with primary cesarean section 
compared with vaginal delivery for singleton full-term (37-41 weeks' gestation) 
women with no indicated medical risks or complications. METHODS: National 
linked birth and infant death data for the 1998-2001 birth cohorts (5,762,037 
live births and 11,897 infant deaths) were analyzed to assess the risk of infant 
and neonatal mortality for women with no indicated risk by method of delivery 
and cause of death. Multivariable logistic regression was used to model 
neonatal survival probabilities as a function of delivery method, and 
sociodemographic and medical risk factors. RESULTS: Neonatal mortality rates 
were higher among infants delivered by cesarean section (1.77 per 1,000 live 
births) than for those delivered vaginally (0.62). The magnitude of this 
difference was reduced only moderately on statistical adjustment for 
demographic and medical factors, and when deaths due to congenital 
malformations and events with Apgar scores less than 4 were excluded. The 
cesarean/vaginal mortality differential was widespread, and not confined to a 
few causes of death. CONCLUSIONS: Understanding the causes of these 
differentials is important, given the rapid growth in the number of primary 
cesareans without a reported medical indication.
PMID: 16948717 [PubMed - indexed for MEDLINE]

www.lamaze.org/Research/iTheJournalofPerinatalbrEducationi
 
Someone on this list had a quote near their byline to the effect of "If c-
section is safer than(or as safe as) vaginal birth, just consider how dangerous 
vaginal birth in hospital has become"

There is absolutely no question that cesarean section is the more dangerous 
delivery for both mother and baby in a normal pregnancy.  Study after study 
demonstrates that the risks of major surgery:bleeding, infection, embolism, 
while reduced over the recent years still pose a significant risk to the mother 
when compared with normal birth(3 times the mortality risk and increasing  
exponentially with repeat surgeries).  Risks for baby include prematurity, 
respiratory problems, maternal separation, increased mortality rates, stillbirth 
and then, of course, breastfeeding problems.


Mary Herrington, RN, IBCLC
Lactation, Memorial Hermann, Northwest
Labor & Delivery, Memorial Hermann, The Woodlands

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