with Rachael Droege
A cesarean section is a surgical procedure for childbirth in which the baby is delivered through an incision in the woman’s abdomen. This practice was developed as an alternative method of childbirth in cases where a vaginal birth would endanger the life of the mother or newborn. This procedure, nicknamed "C-section," can indeed save lives in the event something goes wrong during pregnancy.
However, in reality C-sections are often used when the possibility of a natural, vaginal birth still exists, which is extremely unfortunate since there are many benefits to a natural birth. In fact, one in four babies in the United States are now born through surgery. The United States already has one of the highest rates of cesarean section worldwide (over 24 percent), and the number is growing. According to the World Health Organization, no country is justified in having a cesarean rate greater than 10 percent to 15 percent.
As I mentioned earlier, there are times when a C-section is necessary, such as in the event of a prolapsed umbilical cord (the umbilical cord slips through the cervix before the baby and may endanger the baby"s oxygen supply) or placenta previa, which occurs when the placenta grows in such a way that it blocks the baby"s exit through the cervix. Other situations, including when the baby is in a transverse (sideways) position or if the mother is having an outbreak of genital herpes, may also call for a cesarean section.
Unfortunately, the growing fanfare surrounding cesarean sections is another health care "illusion." The rising rate of C-sections is not due to an increase in the complications mentioned above, but rather to an increase in elective cesareans for reasons such as patient or practitioner convenience, pain-free labor or provider liability fears, none of which constitute a valid reason for C-section.
Cesarean section is major surgery and brings with it many risks to both mother and baby. Babies born by C-section do not receive the natural stimulation that comes from moving down the birth canal, and therefore must often be given oxygen or a rub down to help them breathe. They also miss out on the natural hormones that are released during vaginal birth to help the baby during his first moments of life.
There is also a risk that the surgeon’s knife could accidentally cut the baby or that the baby could be born prematurely if the surgery is performed too soon. A recent study in the August 2003 Journal of Allergy and Clinical Immunology also found that cesarean section might increase the infant’s risk of developing a food allergy.
Women who undergo cesareans are at an increased risk of many complications compared with a natural birth. These include:
- Increased risk of mortality
- Infection to various organs including the uterus, bladder or kidneys
- Increased blood loss
- Increased risk of complications in future pregnancies
- Decreased bowel function
- Respiratory complications
- Longer hospital stay and recovery time
- Adverse reactions to anesthesia
- Risk of additional surgeries such as hysterectomy or bladder repair
One of the complications of a C-section that is hardly ever addressed is the problem that the resulting surgical scar has on the mother. It frequently blocks the proper flow of energy through the autonomic nervous system and seriously impairs her ability to stay healthy. Fortunately, this block is relatively easy to repair with a simple injection of procaine into the scar, however very few physicians are aware of this issue and do not check for it.
Cesareans also have a psychological effect on women. As written in "Having a Baby, Naturally," which is an excellent resource for all mothers-to-be, "Most women who have cesarean sections reported that the experience was traumatic." Women are also less able to care for the newborn immediately after childbirth and therefore may miss out on bonding opportunities.
While there are times when a C-section cannot be avoided, there are things you can do to make your pregnancy as healthy as possible and minimize your C-section risk:
Use a midwife and consider a home birth. Midwives have a lower C-section rate than hospitals. Midwifery Today is an excellent resource to help find a good midwife.
Get a Doula (also known as a "labor assistant" or "montrice’). They have been shown in published studies to lower C-section rates, as well as provide other benefits (Abstract 1, Abstract 2). Doulas of North America (DONA) is a good organization to help you find one.
Make a Birth Plan. This is a document that states the expectant mother"s or couple"s interests or desires for their birth experience. It is not a legal document but simply a good way of letting the doctors and hospital staff know of your wishes. Many interventions (such as epidurals, pitocin, etc.) can lead to an increased risk of C-section and can be avoided by making your desires clear.
Talk to Your OB/GYN. Be sure to talk to your doctor early in the pregnancy, or even before hand, about different issues, including C-sections. For example, you can ask how often they perform C-sections (women have a higher chance of having a C-section if their doctor is male rather than female).
Avoid epidural/pitocin if possible. These will increase your chances of needing a C-section.