C-Sections remain a poor substitute for labor — additional reasons from a new study


Tim Robinson

For years, research has shown that babies born by cesarean section are more likely to develop health problems. Now, a groundbreaking study suggests that not all C-sections are equally risky.

The research looked at all full-term, firstborn births in Scotland over a 15-year period and tracked the babies’ long-term health. It is one of the largest and longest studies to explore how planned C-sections differ from other deliveries.

Surprisingly, the data showed more health problems among babies born by planned C-section than among those delivered by emergency C-section or vaginal birth, even though the planned surgery is done under more controlled conditions. The finding suggests that the arduous experience of labor — that exhausting, sweaty, utterly unpredictable yet often strangely exhilarating process — may give children a healthy start, even when it’s interrupted by a surgical birth.

The new findings…are important because the number of babies born by C-section has increased tremendously. In the United States, nearly one in three babies are born by C-section…

Dr. Mairead Black, the University of Aberdeen obstetrician who led the study, said that as cesarean births had increased in Scotland and worldwide, the researchers wondered what, if anything, children born by C-section “are missing out on.”

“Our thinking was: If a baby is born naturally, it comes into contact with bacteria from the mother, which might help with immune system development,” Dr. Black said.

Even attempted labor may provide some exposure to bacteria, she said. But babies delivered by a planned C-section, which is usually scheduled to take place well before the first pang of labor, may miss out entirely…

Studies have consistently found that children born by C-section are at higher risk for health problems like obesity and allergies. C-section birth has also been associated with a higher risk for Type 1 diabetes.

The Scottish study took advantage of the small country’s rich trove of linked birth and medical databases to track the long-term health of 321,287 babies. Nearly 4 percent were born by planned C-section and 17 percent were delivered by emergency surgery. The remaining 252,917 were vaginal births.

The researchers compared a range of health outcomes among the babies, including asthma, irritable bowel syndrome, obesity, Type 1 diabetes, early death and cancer…

No one knows exactly why labor may be protective, but the spontaneous onset of labor prompts fluid to clear from a baby’s lungs, said Dr. Aaron Caughey, who helped draw up 2014 guidelines for the American College of Obstetricians and Gynecologists that urged providers to let women spend more time in labor and avoid an unnecessary C-section…

The step is just one of a cascade of physiological changes that take place in mother and baby during the labor process, including surges in stress hormones and reproductive hormones like oxytocin that may help the fetus adapt during labor, preserve blood flow to the organs, and keep the baby alert and prepared for breast-feeding.

During labor, a newborn absorbs maternal microbes into its mouth and gastrointestinal tract…The theory is that maternal microbes “train” the infant’s immune system, so it doesn’t overreact or become destructive and precipitate autoimmune disorders like Type 1 diabetes…

Dr. Josef Neu said the broad-spectrum antibiotics prescribed to the mother before a surgical delivery were another concern; the antibiotics can be transmitted to the baby through breast milk if not before birth, decreasing the diversity of natural bacteria.

Childbirth and labor are “a physiological process that we’ve evolved to over millions of years,” Dr. Caughey said. “It’s been really well-designed by evolution.”

I’ll second that emotion.

Military contractor wants court help extorting money from sick vets

Private military contractor Kellogg Brown and Root is suing 12 National Guard veterans for $850,000 in legal fees that the company has incurred through defending a suit brought by the 12 for damages related to service on behalf of the company while in Iraq.

Early in 2003, the Department of Defense ordered members of the Oregon National Guard to protect supply convoys and repair facilities operated by KBR. The DoD had hired KBR to restore the flow of Iraqi oil to pipelines supplying the West and Europe. At the Qarmat Ali water treatment facility, severely damaged by American attacks and fleeing Iraqis, members of the Guard were exposed to hexavalent chromium, a cancer agent.

After developing health problems consistent with hexavalent chromium exposure, the veterans sued KBR for negligence in Federal Court in Portland. After a month long trial, the jury awarded the veterans $85 Million in 2012. KBR appealed, and sought $30 Million in legal fees and damages from the veterans for initiating the lawsuit.

The soldiers, residents of Oregon and under orders from the Department of Defense, placed on loan to a private entity contracted by the DoD, sued in their home state in federal court, not state court. They argued that a chemical used at the Qarmat Ali treatment facility had, to the knowledge of KBR, contaminated the site. Remaining at the site without being informed of the presence of the cancer agent by DoD or KBR constituted negligence. The Oregon jury agreed.

In May of this year, however, the 9th Circuit Court of Appeals reversed the ruling. The Court, persuaded by KBR lawyers, determined that an Oregon court, even if a federal circuit court, was not the proper jurisdiction for the case. Rocky Bixby, Ronald Bjerklund, Charles Ellis, Matthew Hadley, Colt Campredon, Vito Pacheco, Brian Hedin, Charles Seamon, Aaron St. Clair, Byron Greer, Jason Arnold and Larry Roberta must now take their case to Houston, Texas, where KBR is located.

A magnanimous KBR was pleased that the 9th Circuit ruled that the Oregon court did not have “personal jurisdiction” over the Texas based company. KBR executive vice president and general counsel Eileen Akerson said, “This ruling is another major step in resolving the few remaining legacy tort claims related to KBR’s work supporting the U.S. military in Iraq. We look forward to bringing closure to all of those matters.” Closure for KBR includes hiding behind its military contractor indemnification clause, and suing the Oregon soldiers for fees and damages incurred through the long course of this trial.

Creeps who should have been indicted as co-conspirators in the lawsuits should have included all the Republicans who profited from the war – starting with Dick Cheney with his ties to Halliburton. Yes, KBR was a subsidiary of Halliburton while Cheney’s firm was getting all those juicy no-bid contracts from the War Department.

Then, we get to confront our less-than-equal rights before American courts. Of course, we must move the retrial into KBR’s backyard. Makes it easier for lawyers, judges and politicians to discuss the case over cocktails.

Meanwhile, the Oregon soldiers contemplate zero compensation for their abuse and ill health in the Bush-Cheney War.