Should a Cesarean Section Be a Choice?

A great debate often rages in an expectant mother's mind as her pregnancy draws to a close. Besides choosing the cutest bedding, installing an infant car seat and gathering all of the other essentials, her mind often drifts to the day her child will arrive and the methods behind the arrival.

More and more women are having cesarean sections instead of vaginal deliveries in this modern age of medicine. Before we discuss the pros and cons, we should look at how this method originated. There has been some documentation of cesarean sections since around 1500 A.D. according to the online National Library of Medicine, but they were originally spurred on because of religious beliefs, such as being able to baptize the infant even if it wasn't expected to live in order to save its soul. They were performed after the mother had died or her end was near. Later, doctors or midwives performed the operation in order to save the mother's life, not really thinking of the infant. The mother had to be kept alive to take care of the rest of her family and the infant was something inside the mother's belly that had not been seen yet. The lack of anesthesia and the high risk of infection made the procedure averse to most people. After all, during those times hardly any births occurred in hospitals so cleanliness and disease were always factors.

After 1940, c-sections became safer with the use of anesthesia and sanitary standards of hospitals. If a mother was not in tremendous pain, she was able to bear the surgery better so anesthesia played a vital role in the operations. By the 1970s, there was still a low percentage of births by c-section, around 1-5%. By the 1990s, the rate was around 26-28% and it continues to hover around that amount today. Just think: over a quarter of births occur by c-section today! What has caused this great increase?

One of the reasons attributed to surgical birth is the amount of malpractice suits aimed at doctors from long labor and complications. This reason may motivate doctors to say it is in the best interest of the mother and child to have a c-section. Another cause of the rise of c-sections is that mothers are actually asking to have their babies by this method. The fear of pain, the attributes of birthing a baby that are often described as disgusting and gross, and the fear of the mother of tearing, stretching, or other horrifying complications. Some women simply decide they like one day over another and choose to schedule a c-section. Lastly, there are those who absolutely medically need it because of preeclampsia (a narrowing of blood vessels causing reduced blood flow with symptoms of high blood-pressure, swelling of the hands and feet, and protein in the urine.), apparent fetal distress, or other emergency factors.

Those who are considering a cesarean section over labor need to truly think about their decision and its consequences. Unless it is a medical emergency, a cesarean section should not be a first choice. Besides the much higher cost and longer hospital stay, there can be just as many complications with the surgery, perhaps more. It is a longer recovery time and it is often a more painful recovery. A patient is often prescribed pain killers to help her get up and perform daily tasks, but the medication often makes the patient sleepy, causing even more difficulties for handling a new infant. There will be a scar and with that comes scar tissue, effecting future pregnancies. Some doctors will limit the amount of c-sections they will perform, advising the mother not to have more children. Also, if a woman has one c-section, she is most often stuck having consequent c-sections because many doctors are not willing to let her go into labor for fear of uterine rupture, although that chance is less than 1% after one previous c-section, according to vbac.com. Recent studies have also indicated more psychological trauma after c-sections than vaginal deliveries. Finally, mothers who have had a c-section and then go through a vaginal delivery feel the vaginal delivery was actually easier and it is proven the infant usually suffers from less trauma.

Yes, there maybe a benefit to knowing when your child will arrive through a planned c-section, but many doctors feel the risks far out-weight the benefits of a cesarean birth unless it is medically necessary. If a mother is having a slow labor and the baby refuses to budge down the birth canal, if the baby falls into fetal distress, if there is a prolapsed umbilical cord, or if you have placenta previa (when the placenta covers part or all of the cervix), a c-section will be needed to relieve the mother and the infant. These are all valid reasons for having a cesarean birth, just be sure to go over all of your options with your physician before any procedures if there is time.

As women, we must remember that are bodies are designed to perform the miracle of giving birth. Sometimes it doesn't work out, and that should not make us ashamed, but if we are capable and do not try, how will we ever know how much we can accomplish? It is a choice and everyone is free to make her own decision, but please make it an informed decision.