Pregnancy     Childbirth    

Convenience and fear lead some moms to C-sections



Planned C-sections address several issues

A fear of a long and agonizing childbirth motivated Elizabeth from Rhinebeck to plan a C-section in advance.

 

“When you’re pregnant, everyone tells you horror stories about giving birth,” she explains. “You hear about people being in labor for 48 hours and then needing a C-section. You never hear anyone telling about how great their labor and delivery was.”

Convenience also played a part in Elizabeth’s decision. “Everyone is so busy these days,” she says. “Women want to and often have to keep working up until the last minute.”

 

She felt that scheduling her baby’s birth allowed her mother to know exactly when to fly in from out of town to be there for the baby’s birth. “When you pick a Cesarean birth instead of vaginal delivery, you know ahead of time exactly what’s going to happen, and which doctor will be there. I found that comforting,” says Elizabeth. “It was a positive experience, and I wouldn’t hesitate to do it again.”

 

Sujata Athavale from Westtown disagrees. She feels that for many women, especially first-time moms, there will inevitably be fear in the back of their mind. She certainly wasn’t ready for the birth of her daughter, her first child, who came two weeks early. Her labor lasted nine hours. “When you see that beautiful face and hear that tiny cry for the first time, all of your fear turns into joy instantly,” says Athavale.

 

Convenience aside, a C-section is considered major abdominal surgery, and although safer today than ever before, it still carries some serious potential side effects such as hemorrhaging, infection, and blood clots. Other possible risks of Cesarean sections include:

 

  • Longer recovery time. While it takes 6 weeks to recover from a vaginal childbirth, it can take 6 months or longer to recover from a C-section.
  • Inability to bond immediately with baby. Because both mother and baby are being attended to after a C-section, some mothers may find it difficult to initially bond with their baby.
  • Difficulty breastfeeding. Having a C-section can make breastfeeding more difficult, because of the location of the incision and because nursing causes uterine contractions after birth. Also, any drugs given during the C-section can affect the nursing relationship, causing the baby to be groggy or having latching issues.
  • Difficulty caring for baby. The combination of recovering from abdominal surgery and caring for a new baby can be exhausting.
  • Injury. There is greater possibility of damage to organs adjacent to the enlarged uterus, including the bowel, bladder, or blood vessels.

 

It’s important to note, however, that C-sections can be life- or health-saving for many mothers and babies. Fetal distress, breech babies, twins or other multiples, or diseases that make labor risky for the mother can all be important reasons to have one.

 

According to Dr. Shanahan, a C-section delivery is actually safer for babies. “It eliminates the risks. It takes away the risk of low oxygen, the risk of getting stuck, birth trauma, and shoulder dystocia [the baby’s shoulders get stuck in the mother’s pelvis].”

 

Some C-sections are unexpected emergency deliveries performed when complications arise with the mother or baby during pregnancy or labor. An emergency C-section may be required if:

  • Labor stops or isn’t progressing as it should.
  • The placenta separates from the uterine wall too soon (placental abruption).
  • The baby’s shoulders are stuck in the birth canal.
  • The umbilical cord becomes pinched (which could affect the baby’s oxygen supply) or enters the birth canal before the baby.
  • The baby is in fetal distress – heart rate drops, or is too fast or too slow.
  • The baby’s head or entire body is too big to fit through the birth canal (very rare).

 

Dr. Broslovsky claims that if there are obstetrical indications for both the mom and baby, a C-section is the right choice rather than a difficult attempt to induce labor. “I would opt for an elective scheduled repeat C-section where the situation for the most part is under controlled circumstances,” says Dr. Broslovsky.

 

“I am still on the fence for agreeing to an elective primary C-section,” he adds. “Most of the time, patients have a strong anxiety to the pain of labor and think a C-section would be better. I try to educate them about pain management and see if that changes their mind.”

 

“We encourage all patients with no contraindications to have a vaginal birth. It’s safer for the mother,” says Dr. Shanahan.

 

That being said, he adds that most healthy women should try to have a vaginal birth, but they “should be aware that there is enormous fear by all parties. That fear is driving the C-section rate upward. Maybe it’s better to have a C-section to prevent those few adverse outcomes.”

 

It’s important to discuss your views and all of your options with your doctor during your pregnancy. Both you and your doctor should be aware of how you feel about your labor and delivery, as well as what to expect should an emergency C-section arise. A healthy mother and a health baby are the ultimate goal.                                                                            

 

Patricia Hurd is a freelance writer specializing in health issues.