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Making rigid plans doesn’t always yield the best results. At least, apparently, not when it comes to the birthing plan for your child. A new study looking at the long-term health of children delivered via planned C-section versus those delivered vaginally or via emergency C-section found that children in the former category are more likely to develop medical conditions such as asthma and type 1 diabetes as they grow.

In the United States, C-sections—both planned and unplanned—account for nearly a third of deliveries. Even here in the U.S., where childbirth itself is generally not presumed to be a risky endeavor for mother or baby, every option for childbirth carries potential benefits and risks. It is understood in the medical community that children delivered via C-section are more at risk for certain health issues than those delivered vaginally, to the point that the American College of Obstetricians and Gynecologists raised concerns about the overuse of C-sections in its 2014 guidelines. What isn’t clear is what about the different methods of delivery affects long-term outcomes.

That vaginal deliveries generally lead to healthier children holds true in the current study, but researchers have gotten more specific. Now there is evidence that the circumstances leading up to the surgery can carry weight in the child’s development. The findings raise questions about when and why to use the oft-debated procedure.

Researchers suggest that the physiological changes that mother and baby undergo during labor can benefit the child, even if he or she is ultimately delivered via C-section. For example, the onset of labor prompts fluid to clear from the child’s lungs. Changes in hormone levels also affect blood flow to organs and prepare the baby to stay alert to breast-feed postdelivery, should the mother choose that course of nutrition. One theory suggests that the microbes the baby absorbs into his or her mouth during labor could aid the development of the immune system. Jumping to a C-section before it is necessary eliminates these benefits, which is why the ACOG recommends that more time should be given for nature to take its course before opting for surgery.

This is not to say that a planned C-section is never a good choice. Every family’s situation is different at the moment of delivery; it’s risky to make too many blanket statements in a matter as complex and unique as childbirth. What’s certain is that childbirth is a delicate and singular experience, and there’s much more going on than meets the eye.

A mother’s greatest responsibility is to care for her children. In more ways than one, she is wired to give them her best. As science continues to plumb the depths of motherhood, all we can do is use the information we have to make the best decisions for our children’s health and their futures.

Photo Credit: Olivia Leigh Photography