The Link Between C-Section Births and Asthma
April is Cesarian Awareness Month (I know, what a fun fact!). Did you know that babies born by Cesarian section (c-section) are more twenty percent more likely to develop asthma?1 A large study, with data collected over a time period of 35 years, determined that there is an overall higher risk of developing several different medical conditions, including asthma, juvenile arthritis (10%) and other immune system problems (40%).1
Immune system development and asthma
It is thought that these health issues that can be linked to the immune system’s development (after all, asthma and allergies are an immune over-reaction to normal substances). When babies are born by c-section, they are exposed to significantly less bacteria than babies who are born naturally.2 This bacterial exposure is thought to be a good thing for the infant’s developing immune system, as it provides helpful probiotics (good bacteria - learn more about probiotics here) and assists the baby in developing immunity, which can help prevent illness throughout the lifespan.2 When you consider the context of the hygiene hypothesis—which is, that kids now are more likely to get asthma and allergies because they are kept in much cleaner environments than in decades past—this lack of exposure to bacteria and its potential link to development of asthma makes a lot of sense.
I was born by c-section in 1991. Like my mom, many parents don’t have a choice and for their safety as well as the baby, must give birth by c-section. However, many are not emergency c-sections: in 2014, nearly a third of births in the US occurred by c-section, at 32.2%.3 In the last 15 years, c-section births have tripled, and many are not medically necessary—however, in 2010, non-essential (elective) c-sections accounted for just 10% of c-section births, which is a good thing!4,5
While the data shows that c-sections are often medically necessary, elective c-sections should be weighed against the data about chronic diseases by parents making the choice regarding their baby’s entry into the world. While new techniques, including introducing babies born by c-section, to the bacteria that they’d have been exposed to through vaginal birth via a compress containing this bacteria from the mother, are being studied in Sweden, this is still new research—while it may provide a future option to babies born by c-section to prevent risk of immune disorders, elective c-section delivery should still be avoided given the greater risk of children developing asthma, allergies or other immune-related conditions during childhood, that may have been prevented through the bacterial exposure of natural childbirth.2
Of course, I won’t ever know what caused my asthma: my genetics and family history, my c-section entry into the world, my low birthweight and prematurity, or something else completely--one respiratory therapist I met with for asthma education once told me if I ever needed emergency care for asthma to inform them of my prematurity (which I am still unsure how this might impact my care). It is, however, interesting to consider how our starts in this world can potentially pre-determine some of our asthma risk, without us even making a mark on the world yet!
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