C-sections can be recommended by your healthcare team in the event of complications that may affect the health outcomes for the mother, or the baby, if the baby is birthed vaginally. You may also want to request a C-section birth if you have some fear or anxiety surrounding childbirth (Tokophobia). Or if you have birthed before, it may even be your request to schedule a C-section due to previous traumatic birth experience(s).
No matter the reason, it’s important that you can make an informed choice on your birth preferences that’s right for you and your baby.
Elective C-Section: What does it involve?
An elective C-section, or caesarean delivery, is a surgical procedure in which the baby is delivered through an incision made in the mother’s abdomen and uterus. The mother will typically be given anaesthesia to numb the lower half of the body. During the procedure, the surgeon will carefully separate the abdominal muscles and tissues, including the fascia (connective tissue) and peritoneum (lining of the abdominal cavity), in order to reach the uterus.
A new incision is then made on the uterus itself (uterine incision) which allows for the surgeon to carefully deliver the baby. Once the baby is delivered, and the cord is clamped and cut, the surgeon will detach the placenta from the uterine wall.
The surgeon will stitch or close the uterine incision with staples, before moving on to the closing of the abdominal wall incision layer by layer.
The mother will then be monitored post-surgery and administered pain medication, antibiotics, and any other necessary medications to aid her recovery.
There are some risks with C-section births, given this is a surgical procedure.
Risks of elective c-section:
Infection, and adverse reactions: Any surgical procedure can carry a risk of infection. With C-sections there is a possibility of infection occurring at the incision site, or within the uterus. Infections can be treated with antibiotics but in some cases may require additional intervention where needed. There is also a small risk of adverse reactions to the anaesthetic.
Blood loss and blood clotting: According to the North Bristol NHS Trust, the amount of blood loss during C-section births is around two times more than blood loss during vaginal births. In addition to this, the risk of blood clots forming is higher with C-section births, which in turn increases the risk of deep vein thrombosis (the formation of clots in the veins of the legs) and pulmonary embolism (where blood clots travel to the lungs). If you have high risk factors, additional injections can be administered to prevent blood clotting. Occurrence (whilst rare) is around four times more frequent following C-section births in comparison to vaginal births.
Longer recovery time: C-section recovery typically takes longer than recovery from a vaginal birth. Challenges with mobility, pain at and around the incision area, and a longer period of time in hospital are all typically reported to be associated with C-section births.
Impact on future pregnancies: C-sections may increase the risks for complications in future pregnancies like placenta previa, also known as low-lying placenta. This is where the placenta partially or fully covers the cervix and in turns increases the risk of blood loss and serious medical complications, like uterine rupture, during late pregnancy.
Breathing issues for the baby: During labour, fluid can be expelled from the baby’s lungs which helps the baby to adjust to breathing oxygen post-birth. This may not happen to the same extent during a C-section, and so some babies may have a higher risk of developing newborn respiratory distress syndrome (NRDS), where the baby’s lungs cannot provide their body with enough oxygen.
With your healthcare team, it’s important for you to consider all of the potential risks as part of your decision-making process. This is a personal decision, and only you can decide what you feel is right for you and your baby.
Benefits of elective C-section:
Reduced risk of birth injuries: Some parents may have anxieties around potential complications that can occur during vaginal births. Complications like shoulder dystocia or breech positioning can lead to challenges as you reach the second stage of labour (when the cervix is fully dilated up until the birth). These potential complications can increase the risk of oxygen deprivation and foetal distress.
Lower risk of pelvic floor damage: C-sections may reduce risk of damage to pelvic floor muscles for women, lowering risk of incontinence or prolapse.
For personal reasons, you may still be deciding whether a C-section or vaginal birth is right for you and your baby. If you choose to plan a vaginal birth despite the medical recommendation for intervention (C-section), ensure you have informed your healthcare team and fully understand the risks of vaginal birth given your personal circumstances.
The benefits of vaginal birth:
Shorter recovery time: Birthing your baby naturally tends to involve a shorter recovery time compared to C-section births. Generally, mothers will experience less pain and discomfort and can resume normal activities more quickly.
Lower risk of infection: Vaginal births carry a lower risk of infection given there is no incision site. Infection is still a risk, particularly where a perineal tear occurs.
Beneficial hormonal release: During labour, the mother’s body releases a surge of oxytocin and endorphins, which are naturally produced hormones that help with pain management and promote bonding with the baby. These hormonal benefits may be less pronounced in a C-section.
Strengthening of the baby’s immune system: During delivery, contact with the mother’s vaginal bacteria can boost the baby’s immune system and lower the chances of future allergies and asthma.
Improved breathing ability for the baby: Vaginal births aid in removing amniotic fluid from the baby’s lungs, which lowers the risk of breathing problems at birth.
Potential for easier breastfeeding initiation: The hormonal changes during vaginal birth can facilitate the initiation of breastfeeding. Babies born vaginally may have an easier time latching and breastfeeding in the early hours and days after birth.
Ultimately, the decision between an elective C-section and a vaginal birth should be made in consultation with your healthcare provider. Your personal preferences, health, and baby’s needs will all play a role in determining the best course of action. In some cases, a C-section may be necessary for the safety of you and your baby. But with careful planning and medical advice from your midwife/doctor, you can make an informed decision about what’s right for you.
Choosing your type of birth is just one decision among many when it comes to feeling prepared for your baby’s arrival. A birth plan, or birth preferences outline, is often recommended to help guide you in your decision-making process about other aspects of your pregnancy too. A plan can help you begin to answer questions like:
- Who would I like to be present at the birth?
- Do I want pain relief options (and what types)?
- Do I want to use upright positions during labour?
- How do I feel about having vaginal examinations during labour?
- What can my birth partner do to support me?
- Will I be storing stem cells from the placenta and cord?
- Do I want to breastfeed, bottle feed, or combined feed?
Many of these decisions can be difficult to make without first considering the benefits and/or risks to you and your baby. Antenatal classes are a great way to learn more about all of these topics (and more) and guide you in developing a birth preferences outline that’s right for you.
The Parents Class antenatal courses are evidence-led and taught by midwives. Tailored to provide you with the evidence so you can make informed decisions that help prepare you for the birth, and early parenthood, journey.
Find your nearest Parents Class here.
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