The Truth About C-Sections (cont.)

Also, as the number of primary C-sections rises, so does the number of subsequent C-sections.

"Women are not being educated on vaginal birth after C-section, or VBAC," Kriebs says. "And in fact, many institutions will simply not even allow this procedure after a woman as already had a C-section."

As a result, births that could have occurred "naturally" are being performed as C-sections, pushing the number even higher. In March 2010, an NIH advisory panel recommended that hospitals end bans on VBAC.

Risk also comes into play -- medical and legal, Kriebs says. More health care providers are turning to C-sections at the slightest hint of a complication during childbirth. "When a situation turns complicated during a delivery, today there is a greater tendency to perform a C-section to minimize the risk to the child," Kriebs says.

The number is also creeping upward because women are tapping into C-sections as a childbirth "option" more frequently.

"Women are worried that something will happen to their baby during labor, so maybe they opt for a C-section upfront," Economy says. "Or, they don't want to go through labor pain, because it is painful, and think they can handle the pain of surgery better because it's a controlled setting."

Age also plays into the expanding number of U.S. C-sections. Hoskins says that more women are delaying childbirth until they're older, and, as a result, are more likely to need a C-section; especially if they're over 40, because of the increased risk of complications in older moms.

Waiting until later in life to have children may also mean more need for fertility treatment, which could increase the chance of having twins. And that, in turn, makes a C-section more likely.

After the C-section

"Recovery from a C-section isn't easy," Economy says.

The typical hospital stay for a C-section is four days, compared to the two that new moms need after a vaginal birth, Economy says.

Immediately after the procedure is over, you'll still have a catheter in, the effects from the regional anesthesia will linger for a few hours -- which means you'll be numb from the waist down -- and you'll need narcotics for the pain.

The good news is by the next day, the catheter will come out and you'll have feeling again in your feet and legs. But you'll still need the narcotics, especially because the nurses will want you to get out of bed and move -- which will hurt -- to minimize the risk of blood clots.

C-section recovery isn't over when you go home. "Once you're out of the hospital, you can't lift anything heavier than baby for the first couple of weeks," Economy says.

And, no driving for about two weeks, no exercise for 4-6 weeks, and no sex for six weeks, Economy says.

"You are really going to feel worn down and tired after a C-section, and on top of that you have a newborn baby to take care of, so the load and the demand on your body is very high," Hoskins says. "Don't expect any great miracles before 3-4 weeks, and many women will go up to three months to be 100%."

A C-section may sound intimidating, but thousands are successfully performed in the U.S. every day, resulting in happy and healthy moms and babies.

"The important message is that both [vaginal and C-section births] are safe," Economy says. "But it's also important to keep in mind that if you compare a vaginal [birth] that goes well and a C-section that goes well, a vaginal [birth] is still far safer."

Katherine Economy, MD, MPH, maternal fetal medicine specialist, obstetrics-gynecology department, Brigham and Women's Hospital/Harvard Medical School, Boston.
Iffath Hoskins, MD, chair, obstetrics-gynecology department, Lutheran Medical Center, Brooklyn, N.Y.
Jan Kriebs, certified nurse mid-wife, obstetrics, gynecology and reproductive sciences department, University of Maryland Medical Center, Baltimore. 
Ellen Spencer, Hanson, Mass.
WebMD Health News: "NIH Panel: End Bans on Vaginal Birth After C-Section.
Medically Reviewed by Melissa Conrad Stöppler, MD on April 29, 2011
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Last Editorial Review: 4/29/2011 5:04:16 PM