Effect of Supine or Prone Position After Caesarean Birth

Respiratory Distress is a frequent clinical diagnosis of babies delivered by elective Caesarean birth. There has been no study comparing the efficacy of immediately positioning a newly born infant prone vs. supine for the first 30 60 seconds of life after delivery by Caesarean birth.

The investigators hypothesize that when the infant is prone they will have postural drainage, better dorsal lung expansion, less vagal response from suctioning and less agitation secondary to the righting reflex.

The investigators will compare 1033 term babies divided by randomization into two groups prone and supine. The investigators will check for incidence and severity of Respiratory Distress, Use of FiO2 or respiratory support, admissions to NICU.

• Respiratory Distress
• Transitory Tachypnea of Newborn
• Delayed Transition of the Newborn
• Persistent Pulmonary Hypertension

Inclusion Criteria:All women not in labor, who are undergoing elective Cesarean birth at term, 37 to 41 completed weeks gestation.

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Exclusion Criteria:any woman with prior rupture of membranes, diabetes mellitus, gestational diabetes, any woman receiving sedation; medication such as Demerol, magnesium sulfate or general anesthesia, any woman who has a known drug history, any known macrosomia, known congenital anomalies or meconium stained fluid. We will also excluded any woman with maternal fever, chorioamnionitis, severe neonatal distress, obviously compromised infant at delivery, oligohydramnios or history of antenatal steroids.

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