Maternity nurse with patient & baby

About the Time-to-Transition Study

Time to Transition Caesarean Birth: A new study is taking place to determine if a Time-to-Transition caesarean birth improves the health of new born babies.

What is this feasibility study about? And why are we doing it?


In the womb, a baby’s lungs are filled with fluid, which helps them develop. During labour and birth, most of this fluid goes away, and the baby adapts to breathing air.

When babies are born quickly by caesarean, they may not have enough time to clear the fluid, so the lungs remain “wet”, making it harder to breathe. They breathe faster and shallower, a condition called Transient Tachypnea of the Newborn (TTN), and often need antibiotics, breathing support, and a stay in a Neonatal Intensive Care Unit.

Reducing TTN could reduce the need for this extra care.

This study will assess a new ‘Time-to-Transition Caesarean Birth’. 

Rather than being born rapidly after opening the womb, the doctor will deliver the baby’s head, keeping the body inside the womb until the baby starts to cry (for a maximum of 2 minutes). This extra time may help the baby transition to breathing air and reduce the risk of TTN.

As with any caesarean, the mother and baby will be closely monitored. If there are any concerns the baby will be immediately delivered. Everything else about the birth and recovery remain unchanged.

How will the research be carried out?


We will recruit 34 women to have a “Time-to-Transition Caesarean Birth”.

Women can take part if they are:

  • pregnant with one baby
  • planning a Caesarean birth
  • and if baby’s position is “head-down”

We will:

  • video the births, to learn from them.
  • collect information about mother and baby from their medical records
  • ask the views of mothers, birth partners, and clinicians

Future Direction

If this study demonstrates that it’s feasible and is acceptable, we will undertake a large-scale study comparing newborn outcomes after Time-to-Transition” and standardcaesarean births.

Project Details:

Chief Investigator: Dr Joanna Crofts, Consultant Obstetrician

Planned End Date: July 2024

Local Ref: 5238