Risks of having a c Section

Childbirth is among the most personal and intimate passages a woman experiences and carries with it an array of choices informed by personal beliefs, medical expertise, physical conditions, and even cultural pressure.  A woman’s options for labor and delivery extend from natural birth in the home, birthing center, or hospital to medicated birth with a variety of interventions and to Cesarean section. Each option carries difficulties, advantages, and risks for mother and infant.  C-section rates have risen rapidly in the last decades, and the risks of C-section are important considerations for expectant parents and for medical practitioners.

 In the United States, roughly 30% of births are accomplished via C-section, reflecting a growing national trend towards surgical birth. The procedure may be performed emergently, scheduled due to medical indication, or elected.  The climbing rate of C-sections is attributable to rising rates of maternal obesity and concomitant risk factors such as gestational diabetes and to larger babies, who often tip the scales towards surgical delivery.  Additionally, C-sections are routinely performed in the case of previous c-section deliveries, breech presentation of the baby, multiples, and medical conditions like preeclampsia, placenta previa, or an active infection like herpes of HIV.[1]

 Unscheduled C-sections typically occur as a result of failure to progress during labor, fetal distress, and medical emergencies such as prolapsed umbilical cord or ruptured uterus[2]. 

 Modern Cesarean sections are relatively quick surgeries, and often allow the mother and her partner to experience the birth.  Typically, regional anesthesia in the form of a spinal block or epidural anesthesia is used, allowing the mother to remain awake and aware during the procedure.  In emergency C-sections, general anesthesia is frequently used.  Following anesthesia, doctors make an abdominal incision and then a uterine incision and remove the baby and placenta.  Doctors then suture the incision.  The procedure generally lasts less than an hour[3]. Though C-section is a routine and relatively low-risk procedure, it is still a major surgery, and holds very real risks for mother and child. What are the risks?

 Physical risks for the mother during C-section include blood loss, allergic reactions to anesthetic medications, and infections at the incision site.  Aside from these inherent surgical risks, undergoing C-section leads to a higher rate of serious risks during subsequent pregnancies, such as placenta previa and uterine rupture[4].

 Physical risks for infants delivered via C-section are surgical cuts (usually minor), respiratory problems immediately following birth, and a higher incidence of both childhood and adult asthma.  Additionally, infants who are born through C-section are more likely to experience breastfeeding difficulties that reduce the likelihood of being breastfed and reduce the duration of breastfeeding[5].

 The risks of C-section extend beyond the physical realm.  Women who experience C-sections, particularly those for whom the surgery was unplanned, may suffer disappointment, anxiety and sorrow regarding the birth experience. In a culture that paradoxically upholds medical advancement while also pressing the idea of birth as a sacred or definitive experience, women who elect or by necessity undergo C-sections may feel like failures.

 Regardless of physical necessity, medical indication, and personal preference, educating oneself about the details, advantages, and risks of C-sections as they compare to vaginal deliveries is empowering and beneficial.

[1] Heidi Murkoff and Sharon Mazel. What to Expect When You’re Expecting. 4th Edition ( New York: Workman Publishing Company, Inc., 2008.) 321.

[2] Murkoff and Mazel 323.

[3] The Mayo Clinic, “C-section: What you can expect.” 3 February 2012< http://www.mayoclinic.com/health/c-section/MY00214/DSECTION=what-you-can-expect>

[4] Childbirth Connection, “Best Evidence: C-section.” 3 February 2012 < http://childbirthconnection.org/article.asp?ck=10166>

[5] Childbirth Connection.