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Friday, 27 April 2012 11:17

The Truth of Cesareans

Cesarean Sections, also known as a c-section, is the surgical removal of the baby directly from the uterus.  While many women now elect to skip labor altogether (and their practitioners usually oblige,) others are determined to avoid a c-section at all costs. C-Sections are major abdominal surgery despite the short duration of the procedure.  An epidural or spinal block is typically administered, although in a true emergency the mother will often receive general anesthesia and be completely sedated for the procedure.  The baby is usually born within the first 15 minutes of the procedure and another 30-45 minutes are spent closing the incision.

Maternal risks involved with having a c-section include blood loss, adhesions, organ damage, infection, and extended recovery time.  Many mothers who have had a vaginal birth and then a c-section report significantly increased pain and healing time.  Having a c-section also increases the risk of needing a c-section for subsequent births.  VBAC (vaginal birth after cesarean) is a hot topic among the birthing community.  Many OB’s will encourage a mother who has already had a c-section to elect to have another one rather than attempting VBAC citing risks for uterine rupture.

Babies born via c-section are at an increased risk for lower APGAR scores, breathing difficulties, and injury from the procedure.  Elective c-sections (performing the procedure before labor begins) also increase the risk of premature birth, since gestation is an approximate estimate rather than an exact science.  Some mothers carry all of their children past 42 weeks and go on to have natural deliveries with healthy babies.  Other moms go into labor naturally around 38 weeks and have the same outcome.  Waiting for labor to begin decreases many of the risks to the baby because the hormones from both the mother and baby work together immediately before and during labor.  It is suggested that in a healthy pregnancy, the baby in some way triggers labor (possibly when her lungs have matured enough) through a biological process that we have yet to determine.  Electing for a delivery before the baby has finished gestating is likely to increase complications after birth.

It should be noted that cesarean section may be the best option in a few circumstances where it is best for the safety and wellbeing of the baby, the mother, or both.  Some of these situations include placenta previa, placental abruption, uterine rupture, cord prolapse, fetal distress, preeclampsia, and active genital herpes in the mother.  There are a number of other reasons for a c-section, (including gestational diabetes, baby being in the breech position, failure to progress, and previous c-sections) but these reasons alone are not often reason enough to elect for a c-section prior to the onset of labor.

Many moms who are having c-sections are speaking to their provider of having an assisted-cesarean where the mother assists bringing the baby out of the uterus.

For more information about VBAC, please visit ICAN, VBACFacts, and Improving Birth. The risk of catastrophic complications from a VBAC are significantly lower than the risk of a repeat cesarean. Please do your own research and decide what is the best decision for your situation. 

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