Cesarean delivery, also called c-section, is surgery to deliver a baby. The baby is taken out through the mother's abdomen. Most cesarean births result in healthy babies and mothers. But c-section is major surgery and carries risks. Healing also takes longer than with vaginal birth.
Most healthy pregnant women with no risk factors for problems during labor or
delivery have their babies vaginally. Still, the cesarean birth rate in the
United States has risen greatly in recent decades.
Public heath experts think that many c-sections are unnecessary, so it is important for pregnant women to get the facts about c-sections before they deliver. Women should find out what c-sections are, why they are performed, and the pros and cons of this surgery.
What Are The Reasons For a C-Section?
Your doctor might recommend a c-section if she or he thinks it is safer for you or your baby than vaginal birth. Some c-sections are planned,
but most c-sections are done when unexpected problems happen during delivery. Even so, there are risks of delivering by c-section. Limited studies show that the benefits of having a c-section may outweigh the risks when:
- The mother is carrying more than one baby (twins, triplets, etc.)
- The mother has health problems including HIV infection, herpes infection, and heart disease
- The mother has dangerously high blood pressure
- The mother has problems with the shape of her pelvis
- There are problems with the placenta
- There are problems with the umbilical cord
- There are problems with the position of the baby, such as breech
- The baby shows signs of distress, such as a slowed heart rate
- The mother has had a previous c-section
Can a Woman Choose to Have a C-Section (Patient Requested C-Section)?
A growing number of women are asking their doctors for c-sections when there is no medical reason. Some women want a c-section because they fear the pain of childbirth. Others like the convenience of being able to decide when and how to deliver their baby. Still others fear the risks of vaginal delivery including tearing and sexual problems.
But is it safe and ethical for doctors to allow women to choose c-section? The answer is unclear. Only more research on both types of deliveries will provide the answer. In the meantime, many obstetricians feel it is their ethical obligation to talk women out of elective c-sections. Others believe that women should be able to choose a c-section if they understand the risks and benefits.
Experts who believe c-sections should only be performed for medical reasons point to the risks. These include infection, dangerous bleeding,
increased need for blood transfusions, and blood clots. Babies born by c-section
have more breathing problems right after birth. Women who have c-sections stay
at the hospital longer than women who have vaginal births. Plus, recovery from this surgery takes longer and is often more painful than that after a vaginal birth. C-sections also increase the risk of problems in future pregnancies. Women who have had c-sections have a higher risk of uterine rupture
in subsequent pregnancies. If the uterus ruptures, the life of the baby and mother is in danger.
Supporters of elective c-sections say that this surgery may protect a woman's pelvic organs, reduces the risk of bowel and bladder problems, and is as safe for the baby as vaginal delivery.
The National Institutes of Health (NIH) and American College of Obstetricians (ACOG) agree that a doctor's decision to perform a c-section at the request of a patient should be made on a case-by-case basis and be consistent with ethical principles. ACOG states that "if the physician believes that (cesarean) delivery promotes the overall health and welfare of the woman and her fetus more than vaginal birth, he or she is ethically justified in performing" a c-section. Both organizations also say that c-section should never be scheduled before a pregnancy is 39 weeks, or the lungs are mature, unless there is medical need.
Medically Reviewed by a Doctor on 2/13/2014