"Many women and many babies have benefited from a cesarean when the fetus is sick," Fleischman said. "But in fact, there is very little an obstetrician can do after 34 weeks of gestation other than deliver a baby," he said.
Fleischman thinks too many babies are delivered early to minimize risk, in part because the outcomes of infants delivered after 34 weeks are good. "But not as good as [a full-term birth]," he said.
"Cesarean section should be done at the right time and for the right reason," he insisted. "Some cesarean sections are being done too early and not for the right reason. Convenience for the woman or her doctor isn't the right reason."
Cesarean delivery can be dangerous for the mother, Fleischman added. Complications can include blood clots, excessive bleeding, infection, longer recovery time and injury to the bladder, uterus or bowel, according to the report. The risk of complications is even higher in obese women, where a cesarean is a major operation, Fleischman noted.
In addition, infants born before term can also experience problems, Fleischman said, warning that there is an increased risk of complications such as breathing difficulties and even death.
Women need to understand how important it is for a delivery to go to term, Fleischman pointed out. "Fetuses are not just getting fatter in the last month," he said. "They are actually growing and developing. Their lungs and brains and kidneys are developing," he stated.
The findings are published in a report titled HealthGrades 2011 Obstetrics & Gynecology in American Hospitals.
Other highlights in the report include:
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