Risks of caesarean section

Personally I believe there are risks and benefits to various types of births and birth settings.

I believe it is a woman's right to be given evidence based, up to date information on the risks of c/section or any medical intervention and very importantly to be given the information why the midwife or on believes the benefit of the procedure outweighs the risks in each situation. And of course to have the oportunity to make an informed decision and consent to a procedure. Unfortunately this doesn't always happen and in medically urgent situations the may only be time to outline the major risks.

Personally I have found a lot of the information is readily available and I like to be informed so I have looked into various birth issues and considered my options, I know of women who prefer to leave those decisions to their carer's, that's not for me but it is a choice women can make. At the end of the day having a capable health care professional caring for you whom you trust and who works through decisions with you will help you understand any risks.

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Or, in my case, risk of not having a caesarean section: -

1. Death of mother
2. Death of daughter

Let's not forget that ceseareans are not always by choice. But, faced with the "choice" I was given, I would choose a cesearean every time.

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And that's the situation where a c/s should be performed, when, to loosely quote Michel Odent, it is a magnificent rescue operation. When it is life saving. Thank goodness we have access to this!

Unfortunately, the magnificence of saving lives has been diminished by the overuse and misuse of c/s for less heroic reasons. Compounded by the lack of info provided to mothers who are not fully informed of the risks.

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Just so you know, the WHO pulled that number out of thin air with no research behind it all. No one knows what an acceptable number is.

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Just wondering how you came to that conclusion?

I didn't, they admitted it.

I am pulling this out of thin air too, but I would think that the WHO statistic for CS is an IDEAL.

If there are so many births per capita, then what percentage of those are deemed necessary cs (life saving, for mum and bub) as opposed to how many are "elective" (I use this term loosely)
I know there are stats available for some hospitals in regards to this..
Can;t remember where I was going with this but anyway...

At the moment this is the best I can find. I will look more in depth later.

BBC News - Should there be a limit on Caesareans?

The only stats from WHO on c/s I could find we're that they should be no higher than 10-15% of births. It's from this publication https://www.bellybelly.com.au/birth/...h-organisation.

I couldn't find any other refs either Little Chicken, but I suspect the BBC quote from WHO means that no country should be aiming for a particular percentage but that the percentage should drop considerably with better care and processes.

I think i was at the same talk that PZ was at when Rhea Dempsey spoke. I don't remember her quoting the WHO, but she went through some calculations and came up with a similar figure. The number wasn't pulled out of the air, but was in optimal conditions based on the rate in some populations (from what i remember). Yep, it an ideal number that you could work towards. It is certainly preferable to decrease the rate rather than continue the increase. Decrease the rate in order to decrease the potential risks, not just to 'make' women go through labour unnecessarily.

I remember a middy at the classes i did when preg with DD1... "Labour is for lots of reasons, if there were no purpose to it we would have evolved zippers" She was a pretty strong personality but that phrase stuck with me.

Yes, it was about an ideal number. That encompasses all interventions that lead to an unnecessary csections, drugs, positions, etc etc. it wasn't a number any nation is actually achieving. From what I recall it was from the WHO.

It is always important for the woman to have a choice and be aware of the risks and consequences - in general medical professionals will be dealing with the here and now so they are looking at what is happening in that particular labor but the woman might want to think further ahead for future pregnancies for example. Although in my situation it wouldn't have changed needing an e-c-section for DD, I certainly wasn't aware till afterwards how big an impact that c-section has on future birthing options - and IMO that is quite a big deal. Yes you can have a VBAC but it is a much more difficult proposition. I personally would say to anyone to try to avoid c-section because it makes your future birthing options more problematic and you never know what you might want in the future. When there are lists of risks of C-Section as Hot I has listed is good to see a list of risks for future pregnancies in medical terms but also think should be stressed more that it makes your future birth choices more complicated.

I thought it was interesting that in a VBAC class I went to the midwife advocated saying you wanted more children after the current pregnancy because if you said it was your last then if is a c-section no future impact, but if you stated you wanted more the doctors might be more co-operative about VBAC due to the risks of repeated c-sections.

Thanks for the article HotI.

I'm confused as to why birth is labelled risky. Is it because the odds are high or the stakes are high? The chance of a mother dying from a maternal related death in her lifetime is very low in developed nations (compared to sub-Saharan Africa for eg). But obviously maternal death is only one piece of the equation with birth, because infant mortality is at stake too.

I think we need to be careful about perpetuating the cultural fear of birth as inherently 'risky'. The rhetoric about women dying in childbirth for centuries has no place in a developed country like Australia with excellent hospitals and educated population. The women at risk of maternal death are those who have no access to medical care during pregnancy or after birth, who get infections, pph and no medical personel to help. That is hardly the reality in Australia. Instead our risks are associated with the over medicalisation of birth...but these are still fewer than no medical treatment at all.

Also I too have heard the figure of csec births being an ideal...I've read an who stat that was saying it should be no more than 10%...based on their understanding of the certain rate of particular issues that def do require csection.

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Thanks for the article HotI.

I'm confused as to why birth is labelled risky........... Instead our risks are associated with the over medicalisation of birth...but these are still fewer than no medical treatment at all.

Also I too have heard the figure of csec births being an ideal...I've read an who stat that was saying it should be no more than 10%...based on their understanding of the certain rate of particular issues that def do require csection.

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Exactly exactly what I was getting at, thanks :)

If births aren't inherently risky in some way, why have a midwife attend the birth? No, it is nowhere near as risky as It used to be, but no matter what there are and will always be, some risks that can't be controlled out. Things like cord malposition, bleeds etc.

In 2005 the world total of maternal deaths (so 42 days after birth or termination) was 400 per 100 000 live births. So 0.4% or 4 out of every thousand and that includes dveloping nations.

We have to define 'risky'...everything has a risk.

Just for the record, that's more risky than skydiving. You have a one on 600,000 chance of dying while skydiving apparently.

Lol thanks n2L...so maybe Im braver than I thought! I am too chicken to go skydiving, but I do have an inherent fear of heights!

I think all risk needs to be managed, which is why I wear seatbelts, go to the doctor for check ups and have a midwife present at births. Some people manage risk differently.

I reckon no matter how you do it, having children is an act of courage - and not just because of the childbirth thing!

We are all brave.