About 32 percent of all births in the United States are Cesarean or C-section deliveries, with a rising trend every year – while 2005 data showed that 1 in 4 babies was born via C-sections, 2015 data puts the number at 1 in 3.1 While medical emergencies or complications like the position of the baby make it essential for some women to have C-sections, some others opt for this method out of choice. Many of these decisions stem from a simple lack of awareness of what a C-section really involves and underestimation of the procedure or recovery. Here are things you should not know about C-section side effects, risks, and more.
1. C-Sections Are Major Surgery
Calling C-sections Cesarean “births” won’t cushion the reality of what they entail. While it may seem like they are just routine alternatives to traditional vaginal births, that is not the case. In fact, they count as major abdominal surgery. Which is why you are given anesthesia – general or local – to help numb the pain as incisions are made to your abdomen. The incision is usually 10 to 20 cm long and is horizontal, just below your bikini line. For the first 12 hours after the birth, you will have a catheter fitted to help you pass urine. Your wound will have a dressing on it for at least 24 hours, sometimes more.2
2. Maternal Mortality Can Be As Much As 5 Times Higher For C-Sections
While the United Nations is working to reduce maternal mortality rates worldwide, a recent feature in the Time magazine highlighted how the United States, shockingly, has actually seen an increase in these numbers in recent times.3 From 18.8 maternal deaths per 100,000 live births in 2000, the number rose to 23.8 maternal deaths per 100,000 live births in 2014. Barring a few states like California that bucked the trend, there has been an overall increase across the country.4 This has, in part, been attributed to the rise in C-sections.5
Maternal mortality rates are higher for a C-section than for a vaginal delivery.6 According to data from the World Health Organization, maternal mortality and morbidity from a C-section is five times that of a vaginal birth. This is because of the greater risk due to complications like sepsis and hemorrhage.7
3. C-Sections Raise Risk Of Complications During Future Pregnancies
If you have a C-section, it could also increase the risk of your having certain complications in future pregnancies. These include complications like a uterine rupture, placenta previa, where your placenta covers your cervix, and placenta accreta or abnormal placental attachment.8
4. Recovery Time Is Longer For C-Section
A C-section birth means more hospital time for mum and baby. As with any major surgery, you will need to give your body time to heal and recover before you can get back to routine activities and vigorous exercise. You will also need to take care not to infect the wound. Watch out for any signs of pus or infection or unusually heavy bleeding that may be an unwanted outcome of the surgery.
In the first few days after the birth – usually 3 to 4 days – you may need to stay in the hospital under observation and with quick access to emergency care should you experience any complications. This also gives you time to start the healing, with the assistance of medical staff and nurses on hand. Painkillers will help you manage the pain and may be mild medication like paracetamol. Stronger alternatives like ibuprofen and co-codamol will be prescribed in some cases.9
5. Doctors Don’t Have To Agree To An Elective C-Section
Professionally, a doctor does not need to give a woman a say in the mode of delivery. A committee opinion from the American College of Obstetricians and Gynecologists mentions that even if a patient asks for a C-section, the doctor can refrain from performing the surgery should they feel that a C-section delivery will be more detrimental to the health and welfare of the mother and baby than a vaginal birth. The doctor is also obliged to ensure you, as a patient, are completely informed about the procedures. If your doctor hasn’t agreed to your personal choice of having an elective C-section, there could be some reasons for this. Speak to your doctor to allay concerns you might have about a vaginal delivery.10
6. Carrying Twins/Multiples Can Make You More Likely To Need A C-Section
If you are carrying multiples, you may be more likely than other expectant moms to need a C-section delivery. The more babies you have on board, the greater the chances of a Cesarean birth.11 This is because they are more likely to be born very early, may not be able to cope with the challenges of a vaginal delivery, or could be in some form of distress that needs a quick birth and medical support thereafter. In the United Kingdom, for instance, nearly all triplets and over half of all twins born in the country are born via a C-section delivery.12
7. C-Sections Are The Safer Choice For Some
In spite of all the possible risks, it is sometimes actually safer for you and your baby to have a C-section delivery rather than a vaginal delivery. Here are some of the instances when a C-section is the best choice13:
- Large baby. This might make it a very difficult delivery for the mother, putting her at risk of complications from a vaginal birth. A C-section may be a more viable option.
- Breech presentation, where the baby has not turned to align itself to move down through the birth canal.
- Abnormal heart rate of the baby.
- Any other signs that the baby is in distress.
- Umbilical cord compressed or pinched, endangering the life of the baby.
- Issues with the placenta.
- Maternal infections like herpes or human immunodeficiency virus (HIV) that could infect the baby during a vaginal birth.
- Maternal health problems like high blood pressure or diabetes that might make a vaginal delivery too stressful for the mom and puts her and the baby’s lives at risk.
- Complications for a woman carrying multiples/twins, like the babies arriving too early.
- Labor not progressing as it should. Sometimes, the contractions don’t lead to the cervix opening enough to allow for the baby’s movement into the vagina. This may necessitate a C-section.
8. A Previous C-Section Doesn’t Mean You Cannot Have A Vaginal Delivery
Contrary to hearsay, women who have undergone a C-section for their previous pregnancies don’t necessarily have to one again. Of course, this also depends on what the reason was for the first C-section. If your health or medical condition was the cause, chances are you will need to have a C-section again. However, there are women who can safely have vaginal births too.
The ultimate decision on whether or not you are a candidate for this depends on, among other things14:
- Number of previous Cesarean deliveries
- Type of incision in previous C-section
- Your medical/health conditions
9. C-Section Births Can Make The First Breaths Hard On A Baby
A C-section delivery can be a very different experience for a baby, just as it is for the mother. Because of the speed with which the baby is born, without being squeezed through the narrow birth canal, breathing issues may occur right after birth. Babies born from a C-section usually require a little more help with their breathing just after delivery than babies born the traditional vaginal route. Which is why a pediatrician or specialist is usually present during a C-section birth to help with this and any other challenges arising from the procedure.15
10. Your Baby May Be Sleepy Due To The Anesthesia
You will be given anesthesia as you undergo the procedure. Depending on the situation you could be given a choice of local or general anesthesia. In case of emergency C-sections, the latter is usually needed. Some of this does pass on to your baby, so expect him or her to be a little sleepier than other newborns. This effect may linger for six to twelve hours after the delivery. Help your child nurse as soon as you feel able, as the milk usually helps the baby wake up a little.16
|↑1||Births – Method of Delivery. Centers for Disease Control and Prevention.|
|↑2, ↑9||Recovering from a caesarean section. National Health Service.|
|↑3, ↑5||Why U.S. Women Still Die During Childbirth. Time.|
|↑4||MacDorman, Marian F., Eugene Declercq, Howard Cabral, and Christine Morton. “Recent Increases in the US Maternal Mortality Rate: Disentangling Trends From Measurement Issues.” Obstetrics and gynecology 128, no. 3 (2016): 447-455.|
|↑6||Risks of a Cesarean Procedure. American Pregnancy Association.|
|↑7, ↑8||CAESAREAN SECTION OR VAGINAL DELIVERY IN THE 21ST CENTURY. World Health Organization.|
|↑10||Hannah, Mary E. “Planned elective cesarean section: A reasonable choice for some women?.” Canadian Medical Association Journal 170, no. 5 (2004): 813-814.|
|↑11, ↑13, ↑14||Cesarean Birth (C-section). American College of Obstetricians and Gynecologists.|
|↑12||Giving birth to twins or more. National Health Service.|
|↑15, ↑16||Delivery by Cesarean Section. American Academy of Pediatrics.|