The Risks Of C-Sections for Both Mom & Baby
Science continues to uncover the purpose and design behind God’s natural created order. It is no different with nature than it is with our own bodies. There are special reasons for natural processes and what we find is that the more we try to circumvent them, the more we find ourselves dealing with unexpected repercussions of our decisions.
In the area of natural birth, we are starting to see just that. After a sudden rise of cesarean sections from 1996 to 2011 we have found ourselves at whopping 32% cesarean birth rate in the United States. For the past few years, the rates have plateaued possibly because of the growing awareness of the risks of cesarean births to both mother and baby.
Although a cesarean can be an extremely timely surgery to save the life of either mother or child, the research clearly shows that once the rates of cesarean begin to rise above 15%, we start to see the risks outweigh the benefits. For healthy first-time moms, this balance of risks outweighing the benefits begins even lower at an 11% cesarean rate.
In other words, when cesareans are used at a rate above 11% of childbirths, healthy moms and healthy babies now become "at risk” for complications that could have been avoided if vaginal birth had been chosen. Cesarean rates in hospitals in the US often range from 20% to 30% and sometimes depending on the hospital, upwards of 40% to 50%.
Interestingly, during the rapid rise of cesarean rates, we did not see a decrease in maternal or neonatal morbidity or mortality in the United States. In fact in 2010, at the peak rise in cesareans, the US ranked number one for the highest rates of infant mortality in industrialized nations. So the question remains. Are cesareans saving lives or are they being overused to produce an outcome that may come with a cost?
According to ACOG (American College of Obstetricians and Gynecologists), “the potential risks of cesarean delivery on maternal request include a longer maternal hospital stay, an increased risk of respiratory problems for the baby, and greater complications in subsequent pregnancies, including uterine rupture and placental implantation problems. It is not recommended for women desiring several children, given that the risks of placenta previa, placenta accreta, and the need for gravid hysterectomy increase with each cesarean delivery.”
Let’s look closer at the potential risks of a cesarean and why we believe it should only be used in the case of a true emergency.
Risks for Mom
Cesarean section is major surgery. The host of complications of surgery are too numerous to name, but research accumulated by the Coalition for Improving Maternity Services shows that mothers who undergo cesarean section are more likely to have any number of the following complications when compared to experiencing a vaginal birth:
Accidental surgical cuts to internal organs
Emergency hysterectomy (because of uncontrollable bleeding)
Complications from anesthesia
Deep venous clots that can travel to the lungs (pulmonary embolism) and brain (stroke)
Readmission to the hospital for complications related to the surgery
Pain that may last six months or longer after the delivery
Adhesions, thick internal scar tissue that may cause future chronic pain, in rare cases a twisted bowel, and can complicate future abdominal or pelvic surgeries
Endometriosis (cells from the uterine lining that grow outside of the womb) causing pain, bleeding, or both severe enough to require major surgery to remove the abnormal cells
Negative psychological consequences with an unplanned cesarean. These include:
Poor birth experience, overall impaired mental health, and/or self-esteem
Feelings of being overwhelmed, frightened, or helpless during the birth
A sense of loss, grief, personal failure, acute trauma symptoms, post-traumatic stress and clinical depression
Surgery that comes with anesthesia also interferes with the body’s natural hormonal progression of labor, reducing the body’s production of oxytocin which is critical for helping mom with bonding, breastfeeding and the prevention of postpartum depression after the baby is born.
Further risks include future pregnancies. It is suggested that nearly 90% of first-time cesareans go on to future cesareans. However multiple surgeries increase the risk factors mentioned above, finding the mom with a difficult decision to make as she must choose between the increasing risks of a further cesarean or risk a vaginal birth with a uterus that has been under multiple surgeries. Ina May Gaskins, as well as many others, recommend insisting on a double-stitch closure for the uterus if desiring a future vaginal delivery after cesarean. Single-stitch closures have been known to rupture during attempted VBAC (vaginal birth after cesarean) labor. Discussing these things with your surgeon and insisting on proper suturing of the uterus is key.
Risks for Baby
According to the research done by the Coalition for Improving Maternity Services, the many risks of being born cesarean for a baby include:
Accidental surgical cuts, sometimes severe enough to require suturing
Being born late-preterm (34 to 36 weeks of pregnancy) as a result of scheduled surgery
Complications of prematurity, including difficulties with respiration, digestion, liver function, jaundice, dehydration, infection, feeding, and regulating blood sugar levels and body temperature
Respiratory complications, sometimes severe enough to require admission to a special care nursery, even in infants born at early term (37 to 39 weeks of pregnancy)
Childhood development of asthma, sensitivity to allergens, or Type 1 diabetes
Death in the first 28 days after birth
Iatrogenic prematurity refers to a baby being born early by medical intervention. In the cases the cesarean was necessary, this is a life-saving moment. However, there are too many cases in which uncomplicated pregnancies are undergoing elective cesareans and risk the chance of the baby coming out premature due to a possible error in the due date calculations. This is unfortunately too common and deprives the baby of its last vital weeks in the womb when important brain, lung, liver and other body functions are in final preparations for the outside world. During the last few weeks of pregnancy, the lungs are in their final stages of preparation as they lay down surfactant to keep the alveoli in the lungs from collapsing.
Surgery also possesses an unfortunate start to the development of the baby’s microbiome, also known as our bacterial “make-up” which in essence is the foundation of our immune system. By circumventing a vaginal birth, the baby misses out on the vital flora in the vaginal canal that was designed to help baby upon entrance into the outside world. Anesthesia along with IV antibiotics are medical standards for a mother during a cesarean, and unfortunately, these destroy the good flora in mom’s body, ultimately lessening the chances that baby will receive high amounts of good flora even in the breast milk.
For more detailed risks on how cesareans affect the breastfeeding relationship and future pregnancies, the Coalition for Improving Maternity Services has created a detailed report of the literature to help mothers stay informed and make the best decision.
What can we do?
For anyone who has experienced a cesarean whether by choice ahead of time or in a life-saving moment, do not be dismayed. There is still hope! God's perfect design is still working for us, simply waiting for us to partner with it. There is no condemnation for anyone who has had a cesarean or anyone who may have one in the future because of an emergency. God is loving, caring, and a healer. If you've had a c-section here are some natural ways to help you and your child heal after surgery and optimize your health going forward.
We must start educating women about the facts regarding cesarean. It is no doubt that there are times when a real emergency arises during labor requiring a cesarean. However, by looking at the statistics, we can plainly see that cesareans are being used far and above medically necessary situations. We can only speculate the reasons for this but it seems that when you compare the average rate of hospital cesareans (20% to 30% or higher in some hospitals) to the average rate of cesareans that were originally planned home births with midwives (ranging from 3%-5% depending on the midwife) it begs to conclude that the problem lies within the present hospital model for birthing rather than with the laboring mother and her child.
Could it be the lack of knowledge of natural labor and even more unfortunate the lack of importance placed on the design of the human body that has led us to trust in a man-made solution? If we take a sincere look at the documented risks involved with a cesarean, it is hard to justify what we are seeing in the hospital birth setting.
More than ever we are in great need of the wisdom of our Creator. The God of design and natural created order has given us great benefits by following these seemingly simple natural processes. A vaginal birth is and always will be the best start to any child’s life by allowing them to come into this world with vital organs in full development, primed lungs from the waves of labor contractions and healthy flora by way of the vaginal canal. Let’s teach the next generation about these truths that were once so common-place and now nearly forgotten.
“When you change the way you view birth, the way you birth will change.” ~Marie Mongan