Pros and cons of C section (Cesarean) delivery?

Question

Are prenatal classes worth it?

+1 for mentioning the unexpected information about the c-section. No one wants to have a c-section with their first baby, but I know so many women who wound up having to have one and were so emotionally traumatized by the experience because they failed to consider the possibility beforehand. My best friend had some serious post-partum depression because of it.

This comment has received 3 upvotes.

Since I have myself chosen the C section type of delivery for my baby, I am curious to know why would this be termed "traumatic"?

Of course this is a major surgery, but still it isn't the 1530 era where every person having a C section was bound to die.

My doctor has just told me that you'll be having a difficulty in doing heavy duty jobs for sometime but after that it'll be all fine.

What can be the reasons to be traumatized by a C section? Do I need to be wary to some side effects of any kind?

Answer 1

I don't believe it's correct to say no one wants a c-section but it's true that some women that prefer a natural birth are not prepared for that possibility.

From a health & safety point of view, a c-section is not "bad" or "dangerous". It's a very routine operation, but just as with natural births the psychological results vary a lot. See also Rory's answer about the weakened body and lack of muscular strength - this should not be underestimated.

What can be the reasons to be traumatized by a C section?

Some women have a more or less "idealized" perception of what they want their birth to be like, and if they're not mentally prepared for it when things go different than planned, trauma can occur. "Things going different than planned" could be events during the birth: it's messy and can be very gory but I'll spare you the details. It could also be after the birth, when the baby won't feed, doesn't weigh enough or gain enough weight, won't sleep, cries a lot, has a birth defect, and so on. it could also be unrelated to the baby, when the postpartum soreness doesn't wear off fast enough, or a c-section takes long to heal (regardless whether planned or not), or infections. It could also be purely psychological reasons, cases where "bystanders" only see everything going perfectly and still the mother is deeply unhappy.

Do I need to be wary to some side effects of any kind?

First and foremost, I would say the best advice is to realize things don't always go as planned. Plans are good but it's important to know about how that plan can derail, and what getting derailed means to you. Talk to the professionals: the midwives. They've seen it all and can give you good recommendations in advance.

However, you should also realize that even when you think you're well prepared to deal with any kind of unplanned event, it's still tough when that plan collapses. Despite being prepared (or perhaps even more because of it), a depression can still happen, and happens often enough.^{[citation needed]}

But you don't need to be "wary" per se. Que será, será.

Answer 2

As you say, a C section is major abdominal surgery, with all the risks that entails. I don't want to worry you, as it is a common procedure, but recovery is typically a lot harder than a traditional delivery.

Forget about hard work, you may not even be able to lift your baby, or drive, or carry shopping bags etc.

So be aware that these things could happen, but hope that they don't. I hope all goes well for you, but at least you can prepare for all eventualities.

Answer 3

As the husband of a woman who went in expecting to give birth naturally but ended up having a C-section, I think I can answer this. The mentality, some internally-driven, some external, is that a vaginal birth is the "right" way to give birth; women have given birth this way throughout the 50,000-odd years of recorded history and for hundreds of thousands of years before that. Women want to give birth the way their mothers gave birth to them and their grandmothers gave birth to their mothers. A C-section, especially an elective one, is considered "cheating". "At least try to do it the right way" is the pervasive mentality.

My wife had a birth plan, several pages long, detailing how she wanted the process to happen for our first child. She had also spent weeks watching the various reality/documentary shows on giving birth (which of course get to cherry-pick the stories that make for good TV). The biggest point was that she wanted to deliver normally. She was on the fence about an epidural, having her water broken artificially etc, but was sure that she wanted the baby coming out of the birth canal.

The moment she was diagnosed pre-eclamptic, that detailed birth plan went out the window. The delivery date was scheduled for the day the baby hit full term (at 37 weeks), and because the baby didn't get the memo, they induced with pitocin (which immediately produced massive contractions that resulted in my wife begging for an epidural), broke her water artificially, let her "try" for 18 hours of unproductive forced labor, and when an ultrasound revealed the baby was trying to come out nose-up against the pubic bone (an orientation that has only a 10% success rate), her OB said enough's enough and wheeled her into the OR. I came in only after she'd been draped and opened, and sat by her head the entire time. I felt like I'd been thrown backward in time to the era in which I was born, where my mom's "old-school" OB had directed my dad to a chair in the corner, and if he moved he was banished to the waiting room, "where he probably should be anyway". I didn't even get to cut the cord. We were both a little disappointed, her more than me (tempered by the perfect little girl we came home with), and now that she's pregnant with our second, she's that much more determined to have a VBAC.

The more extreme of the natural-birth advocates say the rise in C-sections is a conspiracy; the dramatic increase in percentage of babies born by C-section in the US (and indeed the entire idea of giving birth in a hospital in the first place) has not been mirrored in other industrialized nations, and yet the U.S. has higher maternal mortality rates than most of these countries. Therefore, C-sections (and hospital births) can't possibly be seen as "safer", and so there must be another reason (the linked documentary poses many possibilities, from C-sections being billable to insurers at higher rates, to doctors wanting to end their on-call shifts on time).

There's a little "correlation implies causation" in those arguments; there are other factors that can be causative. Increasing maternal obesity during this same time, which in turn aggravates conditions like maternal hypertension and pre-eclampsia that make OBs want to deliver early (meaning induction), is one of them. Increased maternal age in the U.S. also contributes to "high-risk" pregnancy status that has higher C-section rates. Patience is another factor; I dunno about other mothers, but when my wife hit 9 months she was very much "over" being pregnant. This can influence decisions regarding induction and elective C-section; when the doctor suggests it for medical reasons, it seems more palatable than waiting around on bed rest. Induction itself is also targeted; forcing a mother's body to try to give birth before it's ready requires intervention after intervention, some of them (like pitocin vs epidural drugs) contradicting each other in a downward spiral leading to C-section.

Answer 4

This is the kind of question I wish we had more women on the site to answer. The comment you quoted is in response to my wife's reaction. I will convey her experience as accurately as I can.

The actual procedure was not traumatic at all for her. She was smiling throughout. I kept asking if she was okay, and she would respond that it wasn't her favorite thing ever, but it was much more pleasant than she anticipated. Apparently, the anesthetic is really good.

The recovery was worse than her previous vaginal birth, but not overwhelmingly worse. She had pain for two or three additional weeks. She was still allowed to hold the baby, but was cautioned not to lift anything heavier. However, my wife expected this part and dealt with it. It was painful, but not traumatic.

The emotional trauma came when she first considered the possibility she might need a C-section during our class, and then again about a month before the birth when she found out it was a certainty. The biggest component of the emotional trauma was mourning the loss of a "normal" birth. Our first daughter was born three months premature due to an unpreventable and rare infection, but my wife still blamed herself. She saw the second pregnancy as a chance to redeem herself. To not be able to accomplish a natural, full-term birth made her feel like a failure as a mother. That's not true, of course, and she came to terms with it later, but that's how she felt at the time.

The other big component of the emotional trauma was that a C-section removes options down the road. It wasn't just about this one birth, it was about not being able to ever have a vaginal birth again, and being limited in the number of safe C-sections. Yes, many women in good shape and overall health overcome those limitations, but my wife's individual case made it highly unlikely.

In our case, we had a significant amount of time to prepare. I imagine an emergency C-section is significantly more traumatic, especially after a trial of labor.

Answer 5

C-Section surgeries have a purpose. They're designed to save babies in distress. As I'm sure you'll agree, babies are not aliens from Ridley Scott's movie. Nature did not design them to jump out of your belly. C-Sections were developed by medical science (as early 2500 years ago) as an emergency procedure where vaginal birth is not progressing well, or encounters problems which risk the health of the baby.

My wife delivered our two children vaginally and our third in an emergency C-section. It took my wife a year+ to return to normal function after that surgery vs a few weeks after normal birth. Loss of feeling parts of her stomach, non responsive muscle tissue, pain that put her on narcotic painkillers for months and other ill effects.

After what my wife endured, both me and her are baffled at those who would choose to go for C-Section in advanced without an emergency. Maybe we just had bad luck, but we did our C-section at a top NJ hospital (Valley) with superb surgeons. We were planning a 4th child, but are now re-thinking -- to put it accurately, my wife prefers to die rather than having another C-section. It was that bad for her.

Answer 6

I think I might actually be the one who left the comment you referred to in your post, so I'll explain a little bit what I meant:

Sometimes it's easy to romanticize labor and delivery--especially if you've never experienced it. I don't know how it is in your country, but here in the US this idea of "birth plans" has gotten perhaps a little out of control--where woman plan out every moment of their labor and delivery sometimes down to the music they have playing, the candles they have lit, etc. This is all well and good, but sometimes women become too attached to the idea of the birth plan and feel like the whole birthing experience is ruined if things don't go according to their birth plan.

But even women whose birth plans are less scripted can have a very difficult time emotionally if they don't accept and deal with the fact that not every birth ends up with a baby who is born vaginally, or a baby who is completely healthy, or a baby who latches perfectly. For my best friend, she had never allowed herself to consider the possibility of anything other than a vaginal delivery. During labor, though, they discovered that the umbilical cord was wrapped around her daughter's neck multiple times and that she would probably not be able to descend through the birth canal as the cord was tethering her too far up in the canal.

For weeks after her daughter was born, my friend was very upset that she was not able to deliver her daughter "naturally". Combine this with the fact that she was having a lot of difficulty breastfeeding and she pretty much felt like a terrible mother.

Be that as it may, there is something in every woman's birthing experience that is less than ideal. It may be having to have an emergency C-section rather than a vaginal birth. It may be that your child is rushed off to the NICU shortly after birth because of breathing issues or an infection. Or your child has difficulty latching and feeding. Or your child has a bowel movement in utero. Or your child has a genetic disorder. Or it may be that you discover something as simple as contractions hurt and you want that epidural after all even though you hadn't originally planned on it. I have yet to meet someone who can say that every aspect of their birth experience was exactly as they imagined it would be.

Answer 7

Having actually experienced an emergency c-section and it's recovery myself, I cannot imagine anyone choosing a c-section when they have another option. That said I am so grateful for the existence of the modern c-section, because when a child goes into fetal distress, a mother needs to deliver immediately due to pre-eclampsia, etc. then a c-section is life-saving and I am so glad it exists. I have a happy child today due to a c-section.

Here is why I would never elect to have a c-section apart from medical necessity:

1. For the several days after a c-section it is difficult to sit up from a lying down position or lie down from a sitting position. It usually requires the use of a pillow or some similar object for counter-pressure. This means it is nearly impossible to sit up, pick up your baby from his or her bassinette, lie down, feed your child, then replace your child in the bassinnette. Forget doing diaper changes yourself. A nurse or family member will be doing them. In the hospital where I stayed bedsharing with my infant was forbidden, so I had to put her back in the bassinette to sleep even if I had wanted to keep her in bed with me.

2. Even once you can sit up, pick up your child, and then attain a feeding position (bottle or breast) successfully you will still be in lots of abdominal pain for a while. Your doctors will place several restrictions on you to ensure that you are active enough to encourage a recovery without being overactive. You cannot lift anything heavier than your baby, you cannot go up and down stairs more than once a day, and you cannot drive for 2 weeks, for example. Life stops when you have a newborn, but it really stops when you had a c-section.

3. While I myself had about an easy a recovery as one can have after a c-section, I have heard some horror stories. There are cases where the incision is not properly repaired and it can cause concerns. So you really want to trust your surgeon, which is what your OB/GYN is in the case of a c-section. There are also plenty of possible horror stories with a vaginal birth, but I find that there are more with a c-section.

4. This one is highly woman-dependent, but since c-sections do have a stigma it can be hard mentally and emotionally telling other women about your own c-section. You may find yourself looked down on, or even find that throw-away comments about high c-section rates are hurtful. That said if you don't care what other's think, you won't have a problem with this.

5. The risk of uterine rupture with subsequent deliveries is higher.

6. There are known negatives for a baby that correlate with a c-section. The rate of asthmaand other breathing problems as well as allergies is higher with c-section babies. The rate of diabetes is also higher. There is also a possibility that some beneficial bacteria are not passed to the baby via c-section as they are via vaginal birth.

Answer 8

I had a c-section at 37 weeks because I was preeclamptic. My initial birth plan was to do the Bradley Method, a natural vaginal birth. One of the greatest things I learned while pregnant was that your plan is a great ideal but not necessarily what ends up happening when it's time to give birth. I kept an open mind and had an absolutely amazing c-section. I got to wake up on a beautiful Tuesday morning anticipating our daughter would be in my arms in a matter of hours. After the spinal block, which was weirdly uncomfortable but not very painful, I went into surgery. My husband stood by my side the whole time and I got to listen to a mix of my very favorite music as we brought our sweet daughter into the world. I feel sorry for women who feel they "aren't enough" or "cheated" because they had a c-section. Clearly, the most important thing about a pregnancy is delivering a healthy child, whether through the abdomen or the vagina. I am grateful for my c-section and would do it again, hands down. If you are reading this and struggling with the idea of having a c-section, just remember it's all over in less than 45 minutes and the end result is the same as with vaginal births: a beautiful, brand new baby to love. Don't get down about how the baby comes out of your body: rather you should celebrate what an incredible job you did creating a new life.

Answer 9

There is one very important fact not mentioned yet. In preparation for delivery, every mother's body is swamped with adrenalin,for energy, and hormones which softens all her joints, to expand and allow baby to come through the canal. Whether she has a c/section or not. This is nature at work. Once baby is born, she has forgotten the last final part of the delivery - she is overwhelmed with a love she has never ever felt before, for this new life she has just produced.

During natural delivery, as baby come down and out of the birth canal, baby's "little switches" get turned on, for feeding, crying as communication, movement and preparation for the outside world. Baby feeds better, knows where the breast is, and their body language is so plain to see.

There are all sorts of reasons for and against natural birth and c/section birth. Mother to be has to go with what feels natural for her, and be guided by her doctors. If she is just plain scared, keep this in mind. If childbirth was so painful and terrible, women world wide would never have more than one baby - ever.