A cesarean section or c-section is often recommended if there are concerns about the mother or baby’s health. The procedure, however, has both benefits and drawbacks. A planned c-section can reduce the risk of pain during and after birth, injury to the vagina, heavy bleeding after delivery, loss of bladder control or pelvic organ prolapse.

According to Adil Bhaloda, Clinical Lead at Prescription Doctor, “A cesarean section is a life-saving intervention when medically indicated due to problems during birthing but this procedure can lead to both short-term and long-term health effects for them mums and their children. Maternal mortality and maternal morbidity are higher after a c-section than after vaginal birth. It is also associated with increased risk of abnormal placentation, uterine rupture, ectopic pregnancy or still/preterm birth.”

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For the mother, potential c-section risks include infection of the wound or lining of the womb, bleeding that necessitates a blood transfusion or removal of the womb, heart attack, problems with conceiving or pregnancy in the future. In addition, c-sections performed late in labor have been associated with a risk of preterm birth in future pregnancies.

“Long term issues are related mostly to the complications in the next pregnancy which may result in abnormal position of the placenta and abnormal placental growth, which increases the risk of uterine rupture, small baby and placenta being extremely adherent to the uterus where it cannot be separated from the uterus once the baby is delivered, which in some instances may result in the need for hysterectomy,” said Dr. Alex Polyakov, MBBS(Adel), FRANZCOG, MClinEpid, MReproMed, GradCertEBM.

“This scenario is more common after cesarean delivery compared to vaginal delivery. There are groups of patients whose risks are increased compared to the general population. These include women who are overweight or obese, women with pre-existing medical conditions, women who are older, among others. It must be stressed that vaginal deliveries carry risks as well,” he added.

For the baby, a c-section can result in cuts to the skin, NICU admission or breathing problems. None of the aforementioned risks are a given or even necessarily likely, yet they are considerations that a pregnant woman may want to discuss with her doctor and midwife.

There as some studies that suggest that when a baby isn’t exposed to bacteria in the mother’s vagina, called the microbiome, during delivery, they may be less protected against asthma and obesity during childhood, yet these studies are not conclusive. Women who need to be induced can often choose to have an induction or a planned c-section, both of which carry benefits and risks that can be discussed with your doctor and midwife.

After a c-section, you will need a longer recovery period than if you had a vaginal birth. It may be painful or uncomfortable to move and may prove more physically challenging to care for your newborn. It will also be more difficult to begin exercising after delivery and some mothers find it harder to establish breastfeeding.

According to Leigh Anne O'Connor, IBCLC, a private practice lactation consultant in New York City, “Caesarean birth can make breastfeeding more challenging for various reasons. Depending on the reason for the surgery the parent and/or the baby may experience trauma - physical or emotional. The anesthesia can make both parent and baby sleepy and dysregulated. The fluids given intravenously can elevate the baby’s weight which can lead to a higher drop in weight and alarm staff which can lead to mismanagement of feeding. Feedings can be complicated in the early days. Often with Caesarean birth, there can be a delay in the milk transitioning to mature milk from colostrum.”

C-sections have also been linked to an increased risk of blood clots; therefore, your doctor may prescribe blood-thinning drugs and compression stockings. You will also be encouraged to get up and move around often and to drink plenty of fluids. Women who have undergone a c-section may experience vaginal bleeding, known as lochia, for two to six weeks and more feelings of postpartum depression.

“Long term implications for the mother would not really be significant, assuming the surgery and postoperative periods were uneventful. For the baby however it is a different story. Not having been exposed to the mother's vaginal flora. the baby's gut gets colonized from the skin of the OT staff. This can impact the baby's immunity drastically. They are also more prone to infections and allergies than babies born vaginally. So an LSCS could be a big price for the baby to pay for safe delivery,” said Dr. Lily Kiswani, MD, author of Endoscopic Gynecologic Surgery.

It can take up to six weeks to recover from a c-section, therefore, you will need to avoid lifting heavy items, drinking, engaging in sexual activity, driving or intense workout. Low-intensity exercise, however, is recommended to help you recover.

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“During the initial two weeks, activities that involve your core muscles will prove to be challenging. This affects your ability to easily get in and out of bed, use the stairs, drive, shower your lower body and pick up things (including your baby). You should plan to spend most of your day near the kitchen and bathroom so they are easily accessible as well as items you may need regularly, such as diapers. Don't lift anything heavier than your baby and you will likely be restricted from driving,” said Juliana Parker, Registered Nurse, Certified in Obstetrics.

If you have any further questions or doubts about c-sections, you should discuss these with your doctor and your midwife.