There is little question that c-sections can save the lives of mothers and babies when performed appropriately.
The World Health Organization (WHO) currently recommends c-section rates should be between 10-15%.
Yet around 30% of women are giving birth surgically by c-section in high-income countries like Australia, Britain and America.
The higher than recommended rates of c-sections are often due to non-medical reasons, such as convenience (for the mother or care provider).
The WHO estimates 6.2 million unnecessary c-sections were performed in 2008.
With numbers of non-medically required c-sections this high, the concern is many women are being exposed unnecessarily to significant risk.
If your baby is showing signs of distress, such as a decelerated heart rate, the objective is to ensure the baby is born as quickly as possible. Fetal distress can occur due to a number of things, often not caused by the baby’s actual health, but due to interventions.
Research shows that in the absence of medical complications, inducing labour increases the risk of c-section by 67% compared to spontaneous labour. Artificially induced contractions are very strong and constant. The intense contractions can compromise blood and oxygen supply, to the degree that the baby can’t cope.
Most often women who are being induced are also limited in movement, and are more likely to request an epidural due to the intense pain. These factors all play a part in increasing the chance of fetal distress and c-section.
The high rates of c-section mean surgical birth is now a highly common procedure, and this may lure some women into a false sense of security. It’s important to understand that a c-section section is a major surgery, and there are risks involved for the mother, as outlined below.
Risks For The Mother Giving Birth By C-section
- Compared to vaginal birth, maternal death following a c-section is increased by 4 times in emergency situations and 3 times in elective surgery.
- Infection is one of the most common complications following a c-section, particularly infection of the bladder caused by use of a catheter for the operation.
- Wound or incision site infection is also very common, and can cause a great deal of pain and discomfort, sometimes leading to long-term problems which require ongoing use of antibiotics and further surgery.
- Women who give birth by c-section section are more likely to suffer from a haemorrhage than women who give birth vaginally. The blood loss is usually the result of blood vessels being cut. The risk of severe blood loss increases substantially with increasing numbers of c-sections.
- As with any surgery, women who undergo c-sections are at risk of thrombophlebitis – inflammation of the wall of a vein, which may result in the formation of a blood clot in the legs or pelvic organs. If a blood clot travels to the lungs, this is known as a pulmonary embolism and can be life threatening.
- There is a risk of endometritis (inflammation and infection of the membrane lining of the uterus). This painful condition can cause fever and a foul-smelling vaginal discharge. Treatment may include evacuating the uterus of any remaining pregnancy tissue, and a course of antibiotics.
- It’s possible to have a reaction to the anaesthesia. For example, some women experience severe headaches when standing upright in the days following the operation which is often referred to as a spinal headache.
- While rarely occurring, c-section surgery carries the risk of surgical injuries to nearby organs, with bladder injuries being the most common. If this happens, additional surgeries may be needed to repair the damage.
- Around half of all women who have c-section sections will have adhesions. These are bands of scar tissue that can cause your organs to join together or attach to the abdominal wall. This causes the organs to twist and stretch, causing pain and future health problems.
- The risk of requiring a hysterectomy during or after c-section birth is greater than vaginal birth.
Effects On Mother-Baby Bonding
Women who undergo c-sections tend to have a longer hospital stay and are more likely to be re-admitted later on. This means more time away from the family in an unfamiliar environment, and physical recovery can have an impact on bonding between mother and baby.
It’s also likely that you won’t be the first person to hold your baby. It’s common after c-sections for the baby to be held by a number of health professionals first. You may get a quick hold or photo with the baby after the procedure, but then you’re wheeled into recovery while your partner stays with your baby. Being separated from your baby after the birth can be upsetting and can impact bonding.
Your first breastfeed may be delayed until you’re out of recovery, unless your hospital has a maternity recovery ward. A midwife is required to be with the baby if you're in general recovery. This may be possible if the maternity ward isn’t busy and has staff available. Recovery time, soreness, breast swelling from IV use and recovering from the anaesthetic may all impact breastfeeding in the first days. Problems with early breastfeeding can result in mothers feeling negatively about continuing.
Risks For Future Pregnancies
Research shows women who've had previous c-section sections may take longer than a year to conceive after planning to fall pregnant again.
Previous c-sections increase the risk of complications such as placenta praevia (when the placenta grows near the opening of the womb) and placenta accreta (where the placenta grows through the lining and muscle of the womb). Both can cause excessive bleeding and are potentially life threatening.
After a c-section, you are automatically considered high risk for future pregnancies if you choose to birth vaginally. The risk of uterine rupture is very small (less than 1%) and is less likely to occur than other rare complications. Yet, potential uterine rupture is often used as an excuse to perform a repeat c-section, which for most women carries a greater risk than vaginal birth.
Clearly these risks are worth taking if medical complications mean the only safe way to birth your baby is by c-section. If you are having a normal, low-risk pregnancy and feel you are being offered a c-section unnecessarily, speak to your care provider about your options.
You are perfectly within your rights to request a second opinion if you'd like to have a VBAC (vaginal birth after c-section). It’s also very important to do your own research and information seeking – there is so much out there that women aren’t told by their care providers. BellyBelly’s article on avoiding a c-section is well worth a read.
- Vaginal Birth After Multiple C-Section
- Risks of Vaginal Birth