Why has CS become so popular lately?
Let's dive a little into history. Just 100 years ago, the birthing process was Russian roulette for mother and baby. When the time came, the woman in labor was left alone, at best, with the midwife and chance. In the records of 1897, obstetrician Dmitry Oskarovich Ott stated that 98% of women give birth without the services of a midwife, since she simply is not nearby. In those distant times, no one could predict whether the mother and newborn would survive...
The first maternity hospital appeared in 1914. Women in labor were given morphine for pain relief, which further increased the risk of a tragic outcome. It’s so good that you and I live right now, isn’t it? What has changed since the beginning of the twentieth century?
Since 1900, according to data collected from the Centers for Disease Control and Prevention, the number of deaths of women during childbirth has decreased by 99%, and deaths of infants by 95%. All this happened thanks to the modern development of medicine, conscious planning of conception (if you haven’t read it yet, be sure to check it out). Today, doctors can timely diagnose hidden pathologies, features of the course of pregnancy and find out whether it is dangerous for a woman to give birth on her own. In cases where a girl and (or) a child is in danger during the natural course of childbirth, a caesarean section is used, which saves a huge number of people. (Planned caesarean section: at what week is it done and in what cases?)
But the negative side of this coin is that some young ladies and medical workers abuse the opportunities that have opened up, resorting to CS unnecessarily...
Why, in the age of development of medical technologies, are pregnant women still afraid to give birth on their own? The answer is simple: some parents from childhood scare girls with stories about painful childbirth, believing that in this way they are being prepared. As a result, these women choose what they think is a less traumatic and dangerous option for delivery - a cesarean section. But is this reasonable? In what cases should a CS be mandatory, and when should you not go under the knife?
And now in detail about caesarean section
I have met women in my life who chose CS without direct medical indications. They were driven by fear... fear of labor pain, fear of losing a child due to an unpredictable turn in childbirth, fear of cosmetic damage to the genitals, etc. But is caesarean really easier and more painless? I can say with confidence that no one will give you a definite answer to this question! Among my friends there are mothers who have experienced both types of childbirth. One of them had her first baby through CS, and the second through ER. The second one is the opposite. (Vaginal childbirth after a caesarean section: is this possible?) And both of them concluded that successful ER is much better than a CS. After all, whatever one may say, the abdominal operation in question is a serious surgical intervention in our body, and after it there is a recovery process for a long time, which is accompanied for quite a long time by pain and not only...
But we must pay tribute - difficult natural childbirth often has much more negative consequences than a CS. That is why in such an important choice one must be guided not by fear, illusions and prejudices, but by the structured recommendations of experienced doctors! So let's look at all the pros and cons that experts voice regarding cesarean section.
When is a caesarean section a woman’s right choice?
The most important indications for a CS are the congenital characteristics of the mother's body, the unfavorable course of pregnancy, and any unfavorable circumstances. Let's take a closer look at the main ones:
The child is too large and the mother’s pelvis is clinically or anatomically narrow.
In most cases, the problem can be diagnosed by comparing data on the size of the woman’s pelvis with the weight of the fetus calculated using formulas (using ultrasound with Dopplerometry). But if a woman in labor has a transversely narrowed pelvis, then measuring the external dimensions will not give a real picture.
Prolonged gestosis in the second half of pregnancy
namely, its severe forms: preeclampsia and eclampsia.
Placenta previa.
A dangerous situation, which, fortunately, can be easily diagnosed using ultrasound. If the placenta is attached in the lower third of the uterus or directly above the cervix, this makes it impossible for the fetus to come out on its own.
Umbilical cord entanglement
in some cases.
The presence of serious pathologies in a pregnant woman
in which natural delivery can aggravate her condition. The main ones include the following: myopia with dystrophic changes in the fundus, epilepsy, severe forms of schizophrenia, cardiovascular pathologies, kidney disease, diabetes, cancer, injuries to the spine, pelvis, perineal muscles and others.
Mechanical obstacles in the body of a pregnant woman
For example, deformations of the pelvic bones, diagnosis of neoplasms in the ovaries, pelvis, uterine fibroids in the isthmus area.
Threat of violation of the integrity of the uterus.
This option is possible in women who have a history of uterine surgery. A doctor can determine the degree of risk after examining the condition of the damaged area. For reliability, the width and nature of the edges of the scar are checked several times - at the beginning of pregnancy, before childbirth and during labor. Aggravating circumstances are:
- the presence of several CS in the past or a large number of EPs that have thinned the walls of the uterus;
- history of severe postoperative period;
- long-term healing of both internal and external sutures.
Premature placental abruption
If the placenta separates during labor or at the beginning, this can lead to hypoxia for the fetus and heavy bleeding for the mother.
Umbilical cord prolapse
This occurs most often with polyhydramnios. The baby's head does not have time to descend into the passage, the amniotic fluid is poured out, and the prolapsed umbilical cord becomes sandwiched between the baby and the pelvic wall. At this time, the blood flow that is vital for the baby, which connects it to the mother, is disrupted.
Transverse position of the fetus.
Having diagnosed this problem, the obstetrician may try to turn the baby over during labor. If nothing works out, then an emergency CS is necessary.
Persistent weakness of labor
If natural labor begins to subside for unknown reasons, and drug stimulation does not bring results, then a CS becomes advisable. In this situation, doctors cannot wait for the resumption of labor, since the risk of developing hypoxia in the fetus is too high.
Negative aspects associated with CS
Like any other abdominal surgery, a cesarean section also carries risks. I don’t want to scare you, but before choosing this delivery option, familiarize yourself with its main disadvantages .
Consequences for the mother:
- Increased blood loss.
- Risk of infection.
- Unpredictable individual reactions of the body to general anesthesia, for example, drop in blood pressure, allergies, shock, etc.
- Painful sensations after surgery during the healing of sutures (last about 4-8 weeks), long recovery period.
- The next pregnancy is desirable no earlier than a year later, and sometimes longer. Everything will depend on the rate of scarring of the internal suture on the uterus.
- There is a risk of repeated operations, for example, removal of the uterus, reconstruction of the bladder, etc.
- Inability to immediately put the baby to the breast and feed him during the first days. But when using epidural anesthesia, the baby can be offered the breast after it is removed.
- It is mandatory to have outside help, since a woman after a CS cannot lift more than 2 kg or do housework.
- A ban on sports for a period of 3 to 6 months, depending on the speed of recovery after surgery. (When can I exercise after giving birth?)
- Unsightly seam in the lower abdomen.
- The risk of adhesions in the abdominal cavity.
With epidural anesthesia, serious inflammation of the meninges, puncture sites, and spinal injuries are likely. After general anesthesia, circulatory arrest, shock, pneumonia, and serious damage to brain cells occur.
Consequences for the child:
- There is a higher risk of developing problems with the respiratory system (pneumonia, rapid irregular breathing).
- Suppression of the central nervous system (drowsiness, lethargy, babies do not latch on well).
- Intrauterine trauma (although rare, such cases do occur).
- Lack of expression of reflexes.
Many women mistakenly assume that surgery will relieve them of labor pain. How wrong they are! After a cesarean section, the pain is so strong that it requires the use of painkillers. Also, after abdominal intervention in the abdominal cavity, complications and side effects are possible, the signs of which will remain reminiscent of themselves for a long time.
When newborns meet the world through CS, they do not receive the mother’s microflora they need. But this moment is very important for the further development of their immunity, the functioning of the intestines and other body systems.
Psychologists believe that the “Caesareans” are more passive, they have no desire to win in the future, or psycho-emotional stability of character. Do you agree with this? As I already wrote above, my friends gave birth to babies through CS, but I did not notice that the latter were more apathetic than the children after EP. I personally think that this opinion of psychologists is wrong!
Keep in mind that... serious complications after CS occur 12 times more often compared to EP.
To conclude this section, we will consider two more questions that concern expectant mothers: how long does the CS last and when will the baby be given after the operation?
Answer: It is impossible to give an exact time, since a caesarean section can be planned or emergency. In the first option, the woman goes to the surgeon prepared and this shortens the whole process a little. If we consider an emergency operation under general anesthesia, then on average its duration is about 40 minutes. None of the doctors can give an accurate prognosis, because everything will depend on the complexity of the process and the individual characteristics of the mother’s body.
The newborn will be delivered to the woman when she has completely recovered from anesthesia. But she will be able to feed him no sooner than every other day. The doctor will determine the application time depending on the amount of medications that the mother received during the operation. The female body will need time to cleanse itself of their effects.
Indications for emergency caesarean section
During childbirth, a situation may arise when an emergency caesarean section is required.
- clinically narrow pelvis (discrepancy between the fetal head and the mother’s pelvis);
- premature rupture of amniotic fluid and lack of effect from induction of labor;
- anomalies of labor that are not amenable to drug therapy;
- acute fetal hypoxia;
- abruption of a normal or low-lying placenta;
- threatening or incipient uterine rupture;
- presentation and prolapse of umbilical cord loops with unprepared birth canal;
- incorrect presentation (frontal, anterior view of the face, posterior view of the high straight position of the sagittal suture) or insertion of the fetal head;
- a state of agony or sudden death of a woman in labor while the fetus is alive.
What are the benefits of natural childbirth?
It is not without reason that nature intended for man to come into this world in a natural way. During the passage of the birth canal, the baby gradually prepares for life in a new environment that is aggressive for him. In this, stress hormones actively produced during the entire process come to his aid: norepinephrine, adrenaline, adrenal hormones. Despite the pain, fear, duration of torment and other unpleasant accompanying natural childbirth, they have a large number of advantages. For example, upon their successful completion, a woman will be able to:
- get up within a few hours, fully take care of yourself and the newborn;
- breastfeed the baby on demand;
- do not experience any pain if there is no additional damage to the perineum;
- in 3 days you will be at home, completely forgetting about the difficulties of the process you experienced.
Do not forget that after general anesthesia the baby is not immediately put to the breast; for the first days he eats formula. But we all know how great the benefits are for both the mother and the child if he is given colostrum immediately after birth. From a few drops of this product, the baby’s sterile body will receive immunoglobulins and important components for the formation of intestinal microflora. It has been proven that colostrum has a laxative effect, which helps meconium (original feces) pass more easily and envelops the intestinal mucosa with a protective white film.
I recommend reading: How to cope with the difficulties of breastfeeding after a caesarean section?
During the first application on the birthing chair, the lactation process starts for the woman in labor, and the uterus contracts better. A huge psycho-emotional connection arises between mother and baby. The risk of developing postpartum depression is reduced.
Communication between mother and baby
The first hours, days and weeks together are very important for establishing contact and emotional closeness with your mother. Feeding with colostrum in the first hour not only helps the baby understand that he is born - if he is given the opportunity to independently crawl towards the nipple, the natural mechanism of awareness of what is happening is triggered. The first acquaintance with the outside world and the microflora of the mother takes place on the breast. It's better than a sterile nurse's uniform.
In the maternity ward, the child can be placed under the supervision of nannies, however, if possible, doctors advise spending maximum time together. Of course, it can be difficult for a mother to be with her baby around the clock in the first days after the baby is born without any help. It is inconvenient to go to the toilet and bath, leaving the child alone. In addition, fresh stitches may hurt. In any case, it is better to think about your strategy for staying in the maternity hospital in advance. In the case of CS, this is not difficult to do; with natural ones, everything is a little more spontaneous.
