Any woman who’s ever given birth can appreciate the quick and relatively painless process of a Caesarean birth. The advances in medicine and the changing norms for parenthood have catapulted C-Sections into one of the top spots for most common surgeries performed in America. Of the over 7 million surgical procedures performed each year in the United States, 1 million of these are C-Sections. More C-Sections are performed on American women than women in the U.K., Canada and most European countries. So why the sudden surge of C-Sections? That’s a hotly debated subject. Some say convenience, while others cite risks, for some, it’s a combination of both.Jane* was in labor for a painful 10 hours before delivering her first child by C-section. After consulting with her doctor, she opted out of vaginal delivery with her second child, in part because it would just be easier to have another C-section and avoid all the unnecessary pain. In Jane’s case, the matter of convenience was also compounded by the risk factor. For women who have already had C-sections, there is an increased risk to delivering another baby vaginally. Most women who’ve had a prior C-section choose the same method with subsequent births. In Mandy’s* case, her due date hovered around the same time as a cross-country move she and her husband needed to make for his job. Although this was Mandy’s first child and though no risks existed, for her, it was a no-brainer. She spoke with her doctor, and scheduled a C-section just in time to make the move. Because of stories like these, many doctors are beginning to worry that women and, more importantly, the doctors that serve them, have become too cavalier about C-sections. “You can come in and have your baby an hour after you have arrived and I can sew you up neat and tidy and you’re all done,” says one critic of the high rate of C-sections. “Nowadays, women are so busy, and have so much going on, they don’t want to wait another few days or weeks to allow their bodies to go into labor by itself. Then, in addition to that, they don’t want to have to deal with the pain. I think we’re engaged in huge uncontrolled experiment with regard to cesarean sections.” On the other side of the debate, there are doctors who maintain that vaginal deliveries are just as risky as C-sections, and ultimately, each mother needs to make her own informed decision in consultation with her doctor. “If we’re achieving the goal of having healthy mothers and babies, why should we have to apologize for our C-section rate?” says one proponent of the procedure. It has now come down to dueling deliveries. Natural deliveries are universally accepted as the safest and least invasive method of childbirth. While C-Sections are usually up for debate depending on who you speak to. All agree, however, that if a woman is considering a C-section, she should know the pros and cons associated with the procedure. This article is written to do just that. For mothers-to-be with their hearts set on a natural delivery, a C-section can thrust her and her partner into an abyss of disappointment, fear, and stress. For mothers-to-be who have long decided upon a C-section as the birthing method of choice, the procedure can still be quite daunting and filled with uncertainties. However, with emotional and mental preparation, and a good working knowledge of what’s about to go on “down there”, you’ll be ready when that big day finally arrives.When is a C-Section the best optionWhile some C-sections are performed due to pregnancy complications, previous C-sections or convenience, most first-time C-sections occur unexpectedly. Sometimes a C-section is safer for mother or baby than is a vaginal delivery. A C-section may be recommended if:
- Your labor isn’t progressing
- Your baby’s heartbeat suggests reduced oxygen supply
- Your baby is in an abnormal position
- Your baby’s head is in the wrong position
- You’re carrying twins, triplets or other multiples
- There’s a problem with your placenta
- There’s a problem with the umbilical cord
- Your baby is very large
- You have a health problem
- Your baby has a health problem
- You’ve had a previous C-section complications associated with a C-section
- The recovery from a vaginal birth is much quicker than from a C-section. A Caesarean delivery also carries a higher risk of complications, just as with other types of major surgeries.
- Complications that may affect the baby include:
- Breathing problems for babies
- Fetal injury
Complications that may affect the mother include:
- Inflammation and infection of the membrane lining the uterus
- Increased bleeding
- Urinary tract infection
- Decreased bowel function
- Reactions to anesthesia
- Blood clots
- Wound infection
- Additional surgeries
What to expect during a C-section Whether your C-section happens unexpectedly or you’ve planned it well in advance, you may be anxious about the experience. Here is what you can expect during the 30-45 minute procedure.
- Preparation – cleansing of the abdomen, catheter placed in the bladder, and intravenous lines providing fluid and medication will be placed in a vein in your arm
- Anesthesia – Regional (epidural) anesthesia numbs only the lower part of your body. General anesthesia may be needed in case of an emergency. With this type of anesthesia, you will more than likely be unconscious.
- Abdominal incision – the doctor will make a horizontal or vertical incision through your abdominal wall near the pubic hairline.
- Uterine incision – the uterine incision is usually made horizontally across the lower portion of the uterus.
- Delivery – if you have regional anesthesia, you will likely feel some movement as the baby is pulled from your uterus, but you won’t feel pain. The doctor will clear your baby’s mouth and nose of fluids, and clamp the umbilical cord.
Recovery in the hospitalUsually after a C-section, mothers and babies stay in the hospital for around three days. As the anesthesia wears off, you may adjust the doses of intravenous pain medication as needed. Later, you may utilize oral pain relievers. You will be encouraged to walk with assistance soon after the C-section. This speeds your recovery and helps prevent constipation and potentially dangerous blood clots. The catheter and IVs will more than likely be removed within 12-24 hours after the C-section. Your healthcare team will monitor your incision for signs of infection while in the hospital. They will also monitor your appetite, fluid intake, and bladder and bowel function. At Home and Breast-feeding:
- Relax – get a lot of rest and until your six-week checkup, don’t lift anything heavier than your baby
- Maintain abdomen support – use good posture, and hold your abdomen near the incision during sudden movements, use pillows or the like for extra support during breast-feeding sessions
- Limit visitors – too many visitors in the first few weeks will reduce your rest time
- Drink lots of fluids – additional fluids will replenish those lost during delivery and breast-feeding and will prevent constipation
- No sex – wait six weeks before resuming sexual activity
- No driving – until you can handle sudden movements don’t drive
- Take the necessary medications – take medications as recommended by your doctor
- Contact your doctor when needed – promptly report any signs of infection or flu-like symptoms accompanied by pain in one breast
* names have been changed
Sources: Mayo Clinic, World Health Organization, New York University
This information is intended as reference and information and not as medical advice. All treatment decisions should be made by medical professionals.