Women with diabetes are more likely to give birth by Caesarean section, the main reasons being are that their babies tend to be larger, labour tends not to progress as smoothly and/or if the mother’s safety is at risk. If the mother to be has diabetes complications, this can make vaginal delivery of the baby more dangerous for both mother and baby. However giving birth by Caesarean section has disadvantages:
- Diabetes increases the chances of infection and can slow down wound healing so making surgery such as a Caesarian section more risky.
- Caesarean section means a longer stay in hospital, greater chance of transfusions and a slower recovery.
If a woman has had one Caesarean section does it mean that this will happen with the birth of subsequent children?
A study published in The Journal of Reproductive Medicine [Dec 2000] looking at 127 women most of whom had already given birth by Caesarean showed that only 43.7% of diabetic women that attempted vaginal birth after a Caesarean, succeeded but in women without diabetes 60 – 80% of them had successful vaginal births after a Caesarean. The authors of the study called for more research because they felt unable to conclude that vaginal birth after a Caesarean was safe for women with diabetes.
Techniques for Caesarean sections
Research carried out in Austria, published in the Journal Obstetrics and Gynaecology [January 2003], describes a new technique for Caesarean sections which is less painful and far quicker than current methods, taking about 20 minutes in all. The new method reduces blood loss in the mother by half so cutting the length of the procedure and allowing the mother to recover more quickly.
The newer method means that doctors use a sharp knife to cut the skin but then blunt instruments to gently pull the uterine wall apart and deliver the baby. This compares with sharp dissection used by some doctors. The women need fewer stitches because only three layers need to be stitched compared to between four and seven in other methods.
Professor James Walker of the Royal College of Obstetricians and Gynaecologists reported to the BBC that many aspects of this technique are already in use in Britain as this is ‘good practice’. Perhaps this is a question that mothers-to-be should raise during pregnancy.
Note: One in five births in Britain is now by Caesarean section and the World Health Organisation state that just one in ten births is by Caesarean section.
The National Institute for Clinical Excellence [NICE] has published on Caesarian Section which provides information for pregnant women, their partners and the public. This can be obtained by visiting the NICE website: