In recent years, the cesarean section rate has increased rapidly, and for many health organizations, this is cause for concern. According to the latest data from the CDC, in the US alone, 31% of births are through C-section.
What has emerged as a somewhat controversial topic is the fact that not all of these C-sections were emergency procedures. It has become more common for women to choose C-section on demand, or an elective C-section. This simply means the expecting mother chooses to have a scheduled C-section for non-medical reasons.
Every mom-to-be has different desires and expectations for how the birth will go, and many argue that women should be able to choose to have a C-section, whether it’s medically necessary or not.
There are various reasons why women choose elective C-sections, yet many medical professionals disagree with this method. The varying opinions on this topic raise the question of whether a C-section on demand is truly best for mom and baby in any circumstance.
What is a C-section?
A cesarean delivery, widely referred to as a C-section, is a method of delivering a baby through the use of a surgical procedure.
Although we do know that C-sections aren’t a new procedure, their history is unclear, as is the origin of the term. It may have Latin roots – for example, the Latin word “caedare” means to cut.
In this type of surgery, the doctor makes an incision in the mother’s abdomen and uterus. Although some C-sections are planned ahead in high-risk pregnancies, most women who end up having an unexpected C-section are not aware that it may be necessary until after labor begins.
Indications for cesarean section
As far as the medical reasons for a C-section go, here are some common ones why you may end up undergoing the procedure:
- Labor isn’t progressing: When you have a hospital birth, it’s common for your provider to intervene with various methods to move labor along. Labor that isn’t progressing even with interventions is a common reason for performing a C-section.
- You’re carrying twins: It’s possible to have a vaginal delivery when carrying multiples, but that does increase the risk of certain complications. Women carrying multiples are more likely to have malpresentation, gestational hypertension, and preterm labor. Depending on the position of your babies, certain providers may recommend a C-section in this case.
- Malpresentation: Towards the end of your pregnancy, your baby is getting into the proper position for birth. Malpresentation means your child is in an abnormal position, such as a breech position, where the baby’s feet are down instead of their head. Sometimes, babies in abnormal positions can move, but malpresentation increases your chances of needing a C-section.
- Baby is showing signs of distress: During labor, medical professionals closely monitor how your baby is doing and how they respond to your contractions. This is often done to check for signs of distress, such as increased heart rate, which may indicate that the baby isn’t getting enough oxygen. If other methods of intervention aren’t effective, a C-section may be the next step.
- Issues with the placenta: In rare cases, some pregnant women may have an issue with their placenta, such as placenta previa – a complication where the placenta grows in the lower part of the womb, either completely or partially covering the cervix. In almost all cases, women with a placenta previa need a C-section due to the placement of the placenta and a severe risk of vaginal bleeding.
- You’ve previously had a C-section: Even if you’ve already had a C-section, it may be possible for you to attempt a VBAC, or vaginal birth after cesarean. However, some healthcare providers recommend having a repeat C-section, and the type of C-section scar is often a factor in deciding the best outcome for mom and baby.
- Other health conditions: In order to protect both mom and baby, it is recommended for women with certain health conditions to schedule a C-section. Although it’s not necessary in all cases, health conditions that may lead your healthcare provider to recommend a C-section include heart disease, diabetes, and high blood pressure.
What’s the reasoning behind C-section on demand?
As someone with a specific interest in birth and related topics, I knew before my 1st child was born that the way I planned to give birth wasn’t for everyone. When I said I was preparing for an unmedicated birth, I received my share of eye rolls and unsolicited advice. I heard everything, from “Just wait until you go into labor; you’ll be begging for the epidural” to “You know you don’t get a trophy for that, right?”
Was there a small part of me that wanted to know I was capable of giving birth unmedicated? Sure, but overall, my motivation stemmed from the years of research I had done, which proved to me that in the case of a healthy pregnancy like my own, the fewer interventions, the better. Not just for my sake but for the health of my baby as well.
Nowadays, elective C-sections are becoming more common for a number of reasons. A study done by the US National Library of Medicine looked at the types of birth and C-section rates at a specific hospital to determine what factors influence a woman to choose C-section on demand.
According to this study, some of the top reasons are:
- C-section perceived as a painless method of birth (37.2%)
- The belief that C-section was the safest method for the baby (57.7%)
- Previous negative experience with a vaginal birth (51.3%)
- Attempt to reduce complications for mother and baby (43.6%)
- Prioritizing emotional health (41%)
I’ve had many friends tell me they could never give birth unmedicated, to which I respond, “You don’t have to.” I’m always eager to share the benefits of birth without intervention, but my main desire is for all birthing women to be informed of their options and able to choose the one that ends with a healthy mom and baby. Unfortunately, the rising number of elective C-sections suggests that pregnant women are not being informed of the potential risks of choosing this type of procedure.
Is C-section truly a painless method?
With over 37% of women choosing the avoidance of pain as their reason for elective C–section, I feel it’s important to answer the question of whether C-section is truly a painless method of delivery. I would argue that a C-section is not a painless method; instead, the pain is delayed. This is because recovery from a C-section takes much longer than recovery from a vaginal birth.
A C-section is major abdominal surgery, and just like any surgery, it will take time before you can get back to your normal life. Even with vaginal delivery, your recovery time could be lengthened if you experience certain complications. With a C-section even when the surgery goes as planned, the healing of the incision can take up to 2 months.
Theoretically, the C-section surgery should be painless thanks to local anesthesia. What you do feel during the procedure varies from woman to woman. Some mothers report feeling pressure or a tugging sensation as the procedure is taking place. If the reason for choosing an elective C-section is to avoid pain during birth, it should be noted that many women choose to have an epidural for this reason and are able to avoid having major surgery.
Should I have a C-section?
It’s quite amazing that C-sections are as safe as they are now because there are many high-risk pregnancies and true emergencies where C-sections become a life-saving procedure for both the mom and the baby.
However, choosing to have a C-section when it’s not medically required puts you and your baby at risk unnecessarily. Based on the number of women who choose C-section on demand because they believe it’s the safest method for them and their baby, it seems that many moms-to-be aren’t accurately informed about the potential risks associated with a C-section. The truth is that for a low-risk pregnancy, they aren’t safer than having a vaginal birth.
Cesarean section complications
When you look at the complications that may come with a C-section, the cons far outweigh the pros. In case of a true emergency, these risks are worth taking to save the life of both the mom and the baby. However, when a pregnancy is low-risk, the extensive list of potential complications seems overwhelming.
Here are some of the potential complications or negative effects of a C-section:
- Compared to vaginal delivery, women are 3 times more likely to die from complications surrounding the birth, including blood clots, infections, and potential complications related to anesthesia.
- The recovery time is significantly longer, mostly due to the healing of the incision and recovery from other complications related to the procedure.
- C-sections pose a greater risk of major bleeding as well as possible lacerations, which could endanger both the mom and baby.
- A recent study has shown that C-section can raise the risk of breathing problems for babies born prematurely(before 37 weeks).
- Breastfeeding may be affected, with studies showing that the rates of early breastfeeding are lower when a C-section is performed.
- Even though a VBAC is a viable option for many women, once you have a C-section, there’s a greater chance you will have multiple C-sections. Multiple C-sections come with their own set of complications, especially with regard to issues with the placenta.
Is it worth the risk?
Even when you have a specific plan in mind for your birth, things don’t always go as expected. C-sections are a necessary and life-saving procedure, but it’s becoming more common for women to have elective C-sections.
No one can make your birth plan for you, but if you’re considering a C-section on demand, be sure to inform yourself of the potential complications for both you and your baby before you make a decision. You might just find that it’s not worth the risk.