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C-Section Risks: 15 Things That Can Happen

At the moment a mom becomes pregnant she must start planning her options for delivery. Many mothers, seek as a first option, a natural birth. If they can endure it, some moms will try to avoid the epidural at all costs. But the reality is that at the time of delivery many things can happen, which is why it is better to take advantage of the 9 months of gestation for moms to inform themselves and ask their doctor. And even if a C-section is not in her delivery plan, it is good to know what kind of circumstances it is necessary for, such as in the case of multiple pregnancies, if the mother suffers from any medical condition, or if she has a high-risk pregnancy.

Another of the scenarios where it is necessary to perform a cesarean is in case of complications during labor. For example, if labor is not progressing as it should, if the baby is in a bad position, if the baby is too big for a natural delivery, or if the health of the mother or baby is at risk.

According to American Pregnancy, there has been a gradual increase in cesarean births in the last 30 years in the United States. In November 2005, the Centers for Disease Control and Prevention (CDC) reported that the rate of births by cesarean section was the highest up to 29.1%, which is more than a quarter of all deliveries. Which means that more than 1 in 4 women experience a cesarean.

Although having a C-section birth does not imply anything negative, it is important to remember that like any surgical procedure there are certain circumstances that can occur when undergoing this operation, since it is totally different from a natural birth. However, the probability of passing away due to a C-section is about 20 out of 100,000. For this reason today we will discuss in detail about 15 possible complications that mothers may have when undergoing these procedures.

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15 Postpartum Fever And Sepsis

https://www.parents.com/parenting/better-parenting/advice/a-how-to-guide-for-half-ass-parenting-when-youre-sick/

According to the Health Line website, when doctors talk about sepsis as a risk factor in a cesarean, they refer to a significant infection that can occur in the postpartum period. Usually begins in the uterus or nearby, but it is spread throughout the body. At the time that the infection begins to spread it is called sepsis. These types of complications are usually detected in an early period, which means that the infection is usually in a primary phase, and is treated or cured with antibiotics.

However, if the infection is not treated and sepsis occurs, it is more difficult to treat, and in very specific cases it can become fatal. For this reason, it is advisable that mothers pay attention to any irregular discomfort after a cesarean.

For example, a fever in the first 10 days after delivery by C-section is a warning sign for puerperal fever. 

The case of urinary tract infections or mastitis (sinus infections) may also be a sign of this complication. In case of presenting an anomaly it is best to notify a doctor as soon as possible to detect the problem and begin to treat, and in case it is something more serious to prevent the infection from spreading.

14 Too Much Loss

(U.S. Air Force photo by Airman 1st Class George Goslin)
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The loss of blood during delivery is normal. The problem is when the standards are exceeded. According to the Health Line website the average blood loss for a natural delivery is approximately 500 cc, which is approximately two cups. But this is in the case of a natural birth without complications. 

In a cesarean delivery, the loss is greater, usually twice as much as in a natural birth is lost, about four cups or a quarter of a gallon.

This is because the pregnant uterus has one of the largest blood supplies of any organ in the body. At each cesarean delivery, the large blood vessels are cut when the surgeon opens the wall of the uterus to gain access to the baby. Most healthy pregnant women can tolerate this great loss of blood without difficulty. However, the blood loss may be greater than this in case of pregnancies that present complications.

Other ways in which the mother loses blood because of a C-section can be either during surgery or after delivery by cesarean, whether she presents cases such as postpartum hemorrhage, atony, lacerations and placenta accreta. For these reasons, it is advisable to talk with your doctor to give you a detailed explanation of what to expect when going through a cesarean delivery.

13 Clots

One of the most feared complications of cesarean deliveries is blood clots that may form in the legs or pelvic area of the mother.

The problem with these circumstances is that these blood clots can detach and travel to the lungs. If this happens, what doctors call a pulmonary embolism may occur.

Fortunately, clots usually cause swelling and pain in the legs, making it easy to detect the problem early and treat it with an anticoagulant such as Coumadin or Warfarin.

Blood clots are usually more common in the following situations: when the mother is above average weight, after a long or complicated cesarean, or if the mother has been under a long period of bed rest after the operation. However, it should be noted that blood clots used to be more common in the past because complete bed rest was recommended to women after giving birth.

Blood clots are more common when a woman is pregnant than when she is not for two reasons. First, estrogen is produced in large quantities by the placenta. This increases the body's production of coagulation proteins. It is important that blood forms clots quickly after delivery to avoid bleeding complications. Second, as the baby grows, the uterus puts pressure on the veins that return the blood from the mother's legs. This slows down blood flow during pregnancy. The combination of a slow blood flow and a greater coagulation capacity carries a higher risk of complications of coagulation during pregnancy.

12 Endometritis

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According to the Health Line website, the chances of developing endometritis are 5 to 20 times higher for women who have had cesarean deliveries.

Endometritis is a type of infection that causes the endometrium to become inflamed, that is, the inner lining of the uterine cavity, which is where the process of embryo implantation occurs.

But we must emphasize that this type of complication is usually very rare. In fact, most obstetricians throughout their careers will not see a case like this.

But the reality is that these types of infections are rare, especially when a cesarean delivery has been planned. When a surgery of this type is performed before the membranes are ruptured, the probabilities are much lower, this type of problem is more common in women who have had very long and complicated labors, and when they need to have an emergency cesarean section. Why are the incidents higher in these cases? Because the membranes have already been broken before the surgery, due to the prolonged effort.

For these reasons, it is always recommended to future mothers to talk with their doctors and ask any questions they may have about any complications or anomalies they feel after giving birth. However, I must emphasize that endometritis can be treated with antibiotics when it is detected in time and does not prevent women from having safe pregnancies in the future.

11 Lacerations

(U.S. Air Force photo/Staff Sgt. Rachel Martinez)

According to the Health Line website, in some cases, this disadvantage may arise when the cesarean section is not large enough for the baby to go through, especially when the baby is very large.

As the baby is born or is being removed through the incision, it may happen that it will tear in areas not provided by the surgeon.

And one of the complications faced in these cases is that the areas on the right and left side of the uterus have large arteries and veins that can be accidentally broken.

This is a situation that is seen in the operating room quite often, so each doctor has their way of dealing with the problem. Usually if the doctor notices a rip quickly, it can be repaired safely before too much blood loss occurs. While in less common cases it may happen that the surgeon accidentally cuts a nearby artery or organ during the operation, causing heavy bleeding, which may generate additional stitches to repair the damage.

In very limited cases the damage to other organs requires another surgery to correct it. And as I explained above, in these cases it is best to talk with our doctor, and not panic and not think that all these things will happen to us, because these are rare circumstances. If parents have a trusted doctor with enough experience they can rest assured that everything will turn out well.

10 Risks To Future Pregnancies

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Yes, there may be complications that cause problems to future pregnancies, but this usually occurs in high-risk pregnancies or extremely complicated births. According to the Health Line website, cesareans can only cause problems in future pregnancies in the case of complicated births where a hysterectomy had to be performed, which makes it impossible for the woman to have another baby.

Another one of the cases that can generate difficulties in future pregnancies is that the mother presents complications with the scar tissue in the area of the incision.

In some cases the scarring by cesarean can connect the uterus to the bladder, and when they are connected, this can cause that future caesarean deliveries have higher risk and damage the bladder, or future pregnancies get implanted in areas not suitable for their development.

Additionally, the surgery can also weaken the wall of the uterus, which in the future would complicate trying to have a natural delivery. Although many women can have a successful natural delivery after a previous cesarean delivery, in some cases the uterus will open at the site of the previous cut. If this happens, another cesarean delivery is needed to protect the mother and the baby.

9 Post-Cesarean Incision Infection

Another complication that can occur in a cesarean delivery is an infection at the site of the incision. Some women develop an infection in the outer layers of the skin, instead of in the uterus. Basically, it refers to an external infection or what we commonly known as wound infection.

Usually these types of infections have symptoms such as fever and abdominal pain. These infections, if they are not treated in time, can cause abscesses that would be filled with pus, and if the doctor notices that he can not treat the infection with antibiotics, he will have to reopen the wound to drain and clean the infected area, making the recovery slower.

The most advisable thing is always to notify our doctor in case of any irregular discomfort because in the case of any type of infections, it can spread to other organs.

If the type of bacteria that infects the wound can be very aggressive it would be worse. These infections are rare but can be dangerous, but with the appropriate treatment, such as antibiotics and hospitalization, even the most serious infections can be cured, but for that, we must be alert to any suspicious changes and with the help of our doctor we will obtain the appropriate treatment or solution.

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8 Mothers Can Have A Reaction To Medication

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According to the Health Line website, some women experience complications related to allergic reactions to medications, latex or anesthesia.

These adverse reactions to these substances can range from very mild, such as a headache or dry mouth, to very severe, like anaphylactic shock.

But the reality is that this type of problem or unexpected allergic reaction is more common with emergency C-sections because the doctors do not have enough time to verify all possible drug reactions and how the mother's system handles them and doesn't have enough time to find latex substitutes or provide localized anesthesia instead of general.

Some women may suffer from severe allergies to medications or products used in a cesarean delivery operation. If the doctor does not know about these allergies, it may be impossible to avoid a negative reaction. In addition, general anesthesia is riskier than local anesthesia. But in cases of emergency deliveries, general anesthesia is usually used because there is not enough time to use local anesthetics before the first cut is made, and unfortunately general anesthesia can cause problems for the mother and can also cause drowsiness when the baby is born. However, I must emphasize that when a Cesarean delivery is planned in advance, doctors have the opportunity to ask about allergies and plan anesthesia, and minimizes the risk of this type of eventuality.

7 Low APGAR Scores

First of all, we should start by explaining what the APGAR score is.

According to the website, Kidshealth.org, it refers to a series of tests that are done on newborn babies shortly after birth. "APGAR" means Appearance, Pulse, Grimace, Activity, and Respiration. 

Within a few minutes of birth the baby is tested to check his heart rate, muscle tone, and other signs to determine if he needs additional medical attention. Usually, this test is done twice, the first one minute after the birth and the second, 5 minutes later, and if any of the doctors notice any irregularity or have any doubt about any of the signs shown in the baby's condition, they can repeat the test a third time to rectify. Of the 5 aspects that measure to diagnose the health of the baby, the scale taken by doctors is 0 to 2, and 2 is the best score.

Babies who are born by cesarean usually have low APGAR scores, being 50% more likely to have low scores compared to babies born naturally, and this is sometimes due to anesthesia, suffering before delivery or lack of stimulation during delivery. Usually natural delivery provides natural stimulation to the baby while they are in the birth canal.

6 Breathing Problems For The Baby

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When births are performed by cesarean section, babies can present at the time of birth minor respiratory problems. 

Some studies show the existence of a greater need for respiratory assistance in babies born by C-section. 

This can be caused by various reasons such as a labor that's prolonged and complicated, high-risk deliveries, umbilical cord wrapped around the neck of the baby, or even because of anesthesia, but usually is nothing that parents should worry about, because frequently children who were born by cesarean have low APGAR scores and may require momentary breathing assistance. However, although studies show a greater need of respiratory care in babies born by C-section compared to those born by natural birth, in the long term there is no research that shows a permanent difference in the development of babies born through both options.

According to the website American Pregnancy Org, they explain that when there is a previous planning, this type of problems are minimized, but usually, the respiratory assistance for babies in normal cesarean deliveries are not major reasons to worry because they are minor and temporary complications, which are passed after the baby stabilizes. Moreover, it is always advisable to ask the trusted doctor what kind of complications might arise in mom's particular case, and if they consider that at the time of birth our baby may need respiratory assistance. We must remember that each pregnancy and delivery process is different.

5 Fetal Injury

The website Birth Injury Guide Org, explains that fetal lacerations are cuts, scrapes and other similar injuries caused to a baby during a cesarean procedure if the doctor does not have enough experience to do the task and he performs the procedure in a wrong way. In addition, there are different levels of severity in this type of injury, ranging from mild to severe, and can cause a number of other health conditions, such as Erb's syndrome, Klumpke's palsy, fractures, cervical cord injuries and more.

"What if the baby is hurt?", probably this is one of the biggest fears of many mothers during the surgical process, either when the doctor makes the incision or while performing the removal of the baby.

But according to the website American Pregnancy Org, it is very uncommon for a doctor to cut or hurt the baby during the incision, in fact, 2 out of every 100 babies during the surgery have suffered from fetal lacerations.

Nevertheless, in these cases, it is always advisable to talk to our doctor and ask all our doubts, and if the mother wishes to have a C-section delivery it is best to seek several opinions until finding a doctor with a resume and enough experience to do it.

4 Extended Hospital Stay

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And although this is probably the least of the problems after undergoing a cesarean section, the truth is that hospitals request that the mother stay hospitalized for 3 to 5 days after having given birth, and this is due to the fact that after the operation doctors prefer to keep a continuous check and prevent incidents of complications that can not be known if the patient goes home a few hours after giving birth.

We must remember that a cesarean is a surgery, and like any surgical procedure requires a postoperative and certain care, different to the type of treatment required by a mother who has just given birth naturally. And although we know that hospital food may not be the best and that mothers want to be at home with their babies and their husbands or partners, it is best to take seriously the care assigned by the doctor after performing the cesarean and ask all our doubts before the doctor sends us home. Usually recovering from a cesarean takes more time and there are certain complications that may arise after the operation to which the doctor must be aware, so they require that patients stay more than a day in the hospital after birth.

3 Extended Recovery Time

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And just as doctors request that after the C-section mothers stay in the hospital at least 3 days for checkups and keep an eye on them in case of problems, we can guess that recovery after birth is slower than a natural childbirth. So do not expect to be Jordin Sparks on the red carpet of the movie "Show Dogs" just 3 days after giving birth. It is worth noting that Sparks had a natural birth, and usually women who have natural births have a faster recovery than mothers who went through a C-section.

According to the American Pregnancy Org website, we must remember that each woman is different, so each woman will have a different recovery experience.

However, the average time needed to recover after a C-section can vary from weeks to months. Prolonged recovery can have an impact on the time of bonding with your baby.

1 in 14 reports incisional pain six months or more after surgery. So in case we have to go through a caesarian, planned or in case of emergency, it is good to have spoken before with a relative or with our partners about hiring a third party to help us the first weeks with the baby, so in that way our recovery after the surgery will be calmer and faster.

2 Emotional Difficulties

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According to Health Line, some women after having C-section births suffer from emotional problems once the baby is born. 

This is because some women feel that they are not satisfied due to not being able to experience the natural birth process or delivery, which supposedly creates a greater bond with children.

However, what many women do to try to create that bond with the baby is to spend more time in direct contact with them, is what many people call skin-to-skin, which in fact is an ideal technique at the time that mothers want to breastfeed.

On the other hand, other mothers seek help in support groups (postpartum by C-Section) or discuss their concerns during therapy. This type of aid is ideal for mothers who feel they need it, especially in severe cases such as mothers who had complications in childbirth and had to go through an emergency hysterectomy or mothers who will not be able to have natural deliveries in the future. It is important that women pay attention to this type of emotion because with professional help they can cope with it, and in the case of presenting signs of postpartum depression with the help of a professional, they will be able to obtain the necessary treatment and the tools to understand what is happening and create a better link with their children.

1 Maternal Mortality

Maternal mortality together with fetal injury are among the most frequent concerns of mothers when they talk about going through a C-Section. "But what if ...?", mothers always seem to ask themselves and their doctors. Besides we can appreciate that all the things that are crossing their mind at that moment are not positive when they think about C-Sections. 

And according to the Health Line website, nowadays it is very rare to pass away due to a cesarean because the doctors have updated knowledge and have the most modern equipment to assist any case and reduce risk.

Cases where a mother passes away are almost always due to causes like those listed above, such as an uncontrolled infection, a blood clot in the lung or too much blood loss. Although many of the above complications may also occur after natural deliveries too, the maternal mortality rates after cesarean deliveries is three to four times higher. Though this difference seems very large, maternal mortality after cesarean deliveries is still extremely rare.

Health Line explains that the mortality related to pregnancy, is a 55%  caused by the problems described on this list, the rest are caused by other problems, such as heart problems or high blood pressure. Fatality due to complications of cesarean delivery or any cause related to pregnancy is very rare in the U.S, and in other developed countries.

References: Americanpregnancy.org, Healthline.com, Webmd.com, Lochhavenobgyn.com and Kidshealth.org

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