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Cesarean Section (c-section)

What is it?

A C-section is a surgical procedure where an incision is made through the abdominal wall and uterus to remove the baby and placenta.

Why C-section?

Some C sections are done by choice of patients. Some women avoid labor whether it's due to pain or other reasons. While others opt in to avoid a vaginal birth. Other reasons for C sections include fetal distress, uterine rupture, umbilical cord prolapse (cord presents in the vagina before baby's head) placenta previa (placenta blocks the birth canal/cervix) placental abruption, preeclampsia (maternal high blood pressure, protein in urine) etc.

History of C-Sections

The first documented C-section of a living mother and child was performed as early as the 1800s. C-sections were considered dangerous well into the 1900s. In the state of Georgia, the C-section rate for 2023 was 35.8% meaning 35.8% of births in Georgia were birthed by C-section. In 1990 the C-section rate for the state of Georgia was 23.5%. In the US the average C-section rate per 100 births was 23.5% in 1990 in 2023 that number rose to 32.4%.

Risk associated with C-Sections

C-section births increase the risk of future placenta previas, placenta accretia, and uterine rupture.

• Placenta previa is when the placenta partially or completely covers the cervix.
•  placenta accretia is when the placenta attaches too deeply into the uterine wall causing it to be difficult to be removed.
• Uterine rupture is when the uterine wall ruptures.

Why is the risk increased with C sections, because of scarring. Induction after a c-section can increase the risk of uterine rupture. With induction of labor the contractions are usually stronger, faster, and more frequent, which puts stress on the c-section scar. If you've had a previous classical C-section, meaning you were cut vertically. Your chances of uterine rupture also increase. The risk of uterine rupture increases with each C-section you may have.

Risks of infection increase with C sections if you experience obesity, diabetes, and/or previous C sections. Infection can develop at the incision site, uterus, and/or abdomen.  Infection is caused by bacteria entering the site during or after surgery. Signs and symptoms of infection are pain, fever, redness, swelling, and discharge at the site. Some people also experience malaise (feeling discomfort, illness, weakness, tiredness).  Always contact your provider if you experience fever, chest pain, leg pain, shortness of breath, opening of the surgical site, loss of feeling around the site, and/or difficulty urinating.

Education

C sections are major surgery. Not all C sections are needed. You should do a trial of Labor if you've had a C-section before. Getting a C-section because you had a previous one is not a valid reason to opt in for a C-section again, unless the risk outweighs the benefits.

What is my baby is too big to push out?

This is a myth that warrants many women to opt in for C sections. Many women have successfully delivered big babies.  ultrasounds are not always accurate, and from my experience I've seen ultrasounds be off by 1 to 2 lbs.  size alone shouldn't be the deciding factor in whether you should have a C-section. Other factors should be taken into consideration such as baby's position, shape of the mother's pelvis, whether you have had interventions such as induction etc. In my doula training, my teacher once said, “your body will not produce anything it cannot push out”. Also, there are various positions you can labor/push in that will help facilitate the opening of your pelvis.

Should I let them break my water?

When laboring it's beneficial to let your water break on its own, especially when baby has not descended into the birth canal.  When you opt in to artificially break your water you increase your chances of having a prolapsed cord (when the umbilical cord drops through the cervix before baby's head, which restricts oxygen to the baby) this is an immediate call for a C-section.

My labor isn't progressing do I need a c-section?

Unless you or your baby are in distress, this is no reason to get a c-section. Especially if you are a first-time mom, labor is not a race, it's a process. If labor isn't progressing there is often a reason. maybe you need to change position, maybe you need to rest, maybe you aren't emotionally present, maybe your baby doesn’t feel safe (as my midwife would say), whatever the reason gives your body time unless it's life threatening.

 

Until Next Time….Wombmen are the Future.