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C-Section Birth: Life-Saving Benefits & Health Risks Explained

I've said it before and I'll say it again: there is no wrong way to give birth.

Whether you have a vaginal delivery in a meadow of wildflowers or you schedule a C-section for a week before your estimated due date, you are entitled to that choice. Now, birth is unpredictable - so even if you would like to have a delivery without using pain relief, or without getting a C-section, you might not be able to achieve that. I know someone who had spent several hours in labor. She didn't seem to be making much progress and eventually her baby's heart rate started to decline during contractions. That is a definite sign of fetal distress - significant decelerations, especially ones that make it hard for the baby to recover their average heart rate - that's definitely a sign for concern. A responsible obstetrician will be monitoring those decelerations like a hawk!

OBs will check a baby's heartrate during contraction.

My friend's obstetrician knew that she desperately wanted to have a vaginal birth. It was her first child. The obstetrician explained that it was now or never, that the baby's heart rate meant that they needed to do a C-section or the baby needed to be born within minutes. They prepped my friend for the O.R., wheeled her in, and the obstetrician said, "I have an idea. If you can get this baby out in 3 pushes while I assist you with the vacuum, we won't do the C-section." Summoning that otherworldly motherly strength that can only arise during the throes of labor, my friend delivered her baby vaginally and avoided a C-section. Her baby is healthy, thankfully! Those decels didn't harm him. 

The truth is, most women don't want a C-section. Practically speaking, C-sections are a major operation! They require more recovery time and increase risk of complications during - and after - delivery. On a more emotional or psychological level, we still see a stigma around having a c-section. I've seen women so torn up about their perceived failure to birth their baby vaginally that their C-section is deeply traumatic. It causes them lifelong anxiety. This breaks my heart. No form of birth is better than another; they each have their place, their risks, and their benefits. 

Schedule that c-section if you want to!

The World Health Organization, WHO, estimates that 10% of labors will necessarily result in a c-section. That is to say, not every birth can safely be vaginal. Knowing this, we can see that c-sections are a wonderful invention! Without them, up to 10% of births could have really disastrous outcomes.

Before I go any further, I want to add a disclaimer. I don't write this to scare anyone. I don't write it to shame anyone, and I don't write it to point fingers. I'm sharing this information because it is the basic knowledge that a doctor is ethically required to share with a laboring mother before they perform a C-section. If you're a pregnant woman, this is absolutely crucial information to have!

Informed consent is an ethical requirement for practicing medicine in non-emergent situations.

Every time a woman has a C-section, her risk for placenta accreta, increases by 10%. To quote the American College of Obstetricians and Gynecologist (ACOG)

The incidence of placenta accreta has increased and seems to parallel the increasing cesarean delivery rate. The authors of one study found that in the presence of a placenta previa, the risk of placenta accreta was 3%, 11%, 40%, 61%, and 67% for the first, second, third, fourth, and fifth or greater repeat cesarean deliveries, respectively.

Placenta accreta is one of the deadliest maternal health conditions, leading to death in up to 7% of affected women.

Did you know that Kim Kardashian had placenta accreta? That's why she chose to use a surrogate recently!

Because ACOG recognizes that the risk for placenta accreta increases with each subsequent C-section, they recommend that primips (or first-time mothers) get a doctor's best effort to deliver vaginally. That is, a woman who is giving birth for the first time should receive the support and time that her body needs to bring that baby earthside through a vaginal delivery. If there is a risk that the baby might not survive that delivery, or that the mother might not survive, then by all means - use that C-section! But if it is at all possible, if the baby is not at risk, and the mother is not at risk, then a great obstetrician will allow a mother to labor as long as she needs to to achieve a vaginal birth. If a primip delivers vaginally, her chances for each future delivery being vaginal increase.

 

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