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Downside to Cesareans
November/December 2008
by Jenny
Blair '97, '04MD
Expectant
mothers around the world are opting in growing numbers for cesarean sections
that are not medically necessary. This surgery, developed to save lives, has
become the preferred mode of delivery in some countries. But research by Yale
child psychiatry professor James E. Swain and his colleagues may give voluntary
cesarean patients pause. In an exploratory study, key brain regions of six
women who had given birth vaginally were more responsive to their babies,
several weeks after delivery, than were those of six counterparts who delivered
by elective cesarean.
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Oxytocin, the “cuddling hormone,” promotes bonding.
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Each
mother listened to three kinds of recordings while her brain was scanned by
fMRI: her own baby’s cries (during diaper changes), another baby’s cries, and
white noise. The brains of those who had given birth vaginally showed a consistent
pattern of increased activity in regions that direct motivation, emotion
regulation, and empathy. The activity was strongest when they heard their own
babies. (The work appears in the October Journal of Child Psychology and
Psychiatry.)
Swain
suspects the reason is oxytocin, the "cuddling hormone" released during vaginal
birth (as well as breast-feeding and sex) but not during a cesarean. Oxytocin
promotes bonding. But a preliminary look at other data his team is analyzing
suggests there may be less of a difference after a few months. Perhaps women
who have cesareans catch up later. Most importantly, nobody knows if the
difference Swain found affects the child’s or mother’s well-being.
“We’re
not saying ‘Don’t have cesarean sections,’” says Swain. But he hopes his
findings will promote research, as well as "a little extra caution" from women
and their caregivers regarding elective cesareans.  |
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