Mild Induced Labour Prior to Planned Caesarean Sections to Improve Neonatal and Maternal Outcomes (Lacarus Trial)


Epidemiological studies indicate that mothers who deliver their babies by caesarean section (C-section) are more likely to experience breastfeeding difficulties than mothers who deliver their babies spontaneously. Thus, as birth rates by C-section rise – and in some regions outpace those of spontaneous birth rates – further investigation is needed to better understand the initial findings and develop potential solutions.

Led by the University Hospital of Zurich, and in close cooperation with the Cantonal Hospital Baden, the Cantonal Hospital St. Gallen, the Klinik St. Hedwig at University of Regensburg, the University Children’s Hospital in Basel and the University Hospital Basel, this clinical study has been launched with the help of a donation from the Family Larsson-Rosenquist Foundation of CHF 680,000. 

“The Lacarus trial harnesses a key principle of every natural birth, the power of labour, which is instrumental to prepare the mother and the baby for delivery, postnatal adaptation and outcome. By applying mild labour prior to caesarean section we aim to help those women and babies who lack this natural preparation and thereby aim to improve their short- and long-term outcomes.” – Sven Wellmann, Prof. Dr. med., Chair of Neonatology, University Children’s Hospital Regensburg (KUNO); Research Group Leader, University of Regensburg and University of Basel

Should results be positive and robust, they could form the scientific basis for improving the medical protocol for C-sections on a global basis.

References and further reading

Wellmann S, Manegold-Brauer G, Fischer T, Schäffer L, Gaertner VD, Malfertheiner SF, et al. Improving neonatal and maternal outcome by inducing mild labor before elective cesarean section: The Lacarus randomized controlled trial. Neonatology. 2021;118(1):116–21. DOI: 10.1159/000512752

Fill Malfertheiner S, Bataiosu-Zimmer E, Michel H, Fouzas S, Bernasconi L, Bührer C, et al. Vasopressin but not oxytocin responds to birth stress in infants. Front Neurosci. 2021;15:718056. DOI: 10.3389/fnins.2021.718056

Wilbaux M, Kasser S, Gromann J, Mancino I, Coscia T, Lapaire O et al. Personalized weight change prediction in the first week of life. Clin Nutr. 2019 Apr;38(2):689-696. DOI: 10.1016/j.clnu.2018.04.001.

Wellmann S, Koslowski A, Spanaus K, Zimmermann R, Burkhardt T. Fetal Release of Copeptin in Response to Maternal Oxytocin Administration: A Randomized Controlled Trial. Obstet Gynecol. 2016;128(4):699-703. DOI: 10.1097/AOG.0000000000001594.

Prior E, Santhakumaran S, Gale C, Philipps LH, Modi N, Hyde MJ. Breastfeeding after cesarean delivery: a systematic review and meta-analysis of world literature. Am J Clin Nutr. 2012;95(5):1113-35. DOI: 10.3945/ajcn.111.030254. Epub 2012 Mar 28.

Evans KC, Evans RG, Royal R, Esterman AJ, James SL. Effect of caesarean section on breast milk transfer to the normal term newborn over the first week of life. Arch Dis Child Fetal Neonatal Ed. 2003 Sep;88(5):F380-2.