Thanks Britany. Thanks Posh “too Posh-to-Push” Spice.
I see this all the time online now. I hear it in real life. First time moms thinking about scheduling an elective c-section. Why??? People honestly believe it's easier, better, safer, etc. My brother came to visit in the hospital after my VBAC and I told him something along the lines of how it was okay for him to make me laugh this time since I didn't have a c-section (laughing post c-section is PAINFUL!!!). He said he thought a c-section would be easier. I looked at him and asked why the heck I would travel an hour to have a vaginal birth if a c-section would have been easier?
Pain? Eh… it can be managed with a percocet. Why go through something as barbaric as labor? It’s okay if I don’t hold the baby right away. It’s okay if I spent extra time in the hospital. No big deal, right? C-sections are perfectly safe for mom and baby since the doctor is in control. Right?
How about these facts:
PROBLEMS FOR THE MOTHER
Mother is 2.84 times more likely to die according to one study. After adjustment for potential confounders, the risk of postpartum death was 3.6 times higher after cesarean than after vaginal delivery in another study (odds ratio 3.64 95% confidence interval 2.15-6.19). Both prepartum and intrapartum cesarean delivery were associated with a significantly increased risk. Cesarean delivery was associated with a significantly increased risk of maternal death from complications of anesthesia, puerperal infection, and venous thromboembolism. She is also more likely to lose her uterus, suffer infections or hemorrhage.
The risk of hysterectomy triples in the next pregnancy. Subsequent pregnancies are more likely to result in ectopic pregnancies. The risk of still birth doubles in subsequent pregnancies. The chance of a placenta abruption (where the placenta tears aware from the ueterine wall) and uterine rupture in subsequent pregnancies also increases (scheduling a c-section does NOT prevent uterine rupture).
20% of women develop fever after CS, most due to iatrogenic infections requiring diagnostic fever evaluation for both woman and baby.
Maternal death in the US ranks 41st in the world. We also have one of the highest c-section rates in the world. In 2004, the US maternal death rate was 13.1 per 100,000 live births. In NJ (where we have the highest c-section rate), our maternal death rate was 21 deaths per 100,000 live births in 2004. Optional Caesareans resulted in hospital stays that were 77 percent longer and cost 76 percent more than normal deliveries. Mothers who had the optional surgery were 2.3 times more likely to return to the hosptial within 30 days, usually because of wound complications or major systemic infections. Increase in the chance of placental abruptions and hysterectomy. In a planned primary c-section vs a planned vaginal birth, a mother is:
2.5 times more likely to be rehospitalized in the first 30 days post partum 1.8 times more likely to suffer major pueperal infection 1.9 times more likely to suffer delayed and secondary postpartum hemmorrhage 2.8 times more likey to suffer infections of the genitourinary tract 14 times more likely to suffer complications of obstetrical wounds PROBLEMS FOR THE BABY Babies are more likely to die after a c-section birth. The neonatal mortality rate for Caesarean delivery among low-risk women is 1.77 deaths per 1,000 live births, while the rate for vaginal delivery is 0.62 deaths per 1,000. That is nearly a 3 fold increase in death rate after you correct for risk factors that would have necessitated a c-section. 2-6% of babies are cut during c-sections. On a side note, my baby was one of them. Not a serious cut, thank heavens! But the hospitals lied and said it must have happened in utero. I talked to a woman who saw a baby with a severed leg after a c-section in her hospital NICU after the birth of her own baby. Babies born by elective c-section are twice as likely to end up in the NICU and 3 times more likely to suffer from pulmonary disorders. Babies born by c-section are 20% more likely to develop type 1 diabetes. Babies born by elective c-section are more likely to suffer from breathing problems. At 37 weeks, they were almost four times as likely as others of the same gestational age to have respiratory problems, at 38 weeks three times as likely, and at 39 weeks almost twice as likely. The differences remained even after controlling for maternal age, smoking, alcohol intake and other variables Premature births have been climbing since the mid-1990s and that increase has been linked to the risk in c-section rates since calculation of the baby’s due date may be off or patients and doctors may elect to deliver the baby before it’s ready. Risk of cavities is higher in babies born by cesarean. Cesarean infants acquired cavity-causing Streptococcus mutans 11.7 months earlier than did those born vaginally, said investigators led by Yihong Li, Dr. PH, D.D.S., an associate professor of craniofacial biology at New York University here. They said cesarean-born infants may have weakened defenses against bacteria because of reduced bacterial exposure during delivery. By contrast, vaginally born infants receive more intense bacterial exposure from the vagina and perineum, which may help strengthen their immunity. This may help explain why cesarean babies show greater bacteria levels at an earlier age, Dr. Li said. There might be a positive association with development of asthma--in particular, for cesarean section--that was not explained by gestational age, birth weight, ponderal index, smallness for gestational age, parity, maternal age, or occupation. C-section births may cause genetic changes in babies. Swedish researchers have discovered that babies born by Caesarean section experience changes to the DNA pool in their white blood cells, which could be connected to altered stress levels during this method of delivery. “Delivery by C-section has been associated with increased allergy, diabetes and leukaemia risks” says Professor Mikael Norman, who specialises in paediatrics at the Karolinska Institutet in Stockholm, Sweden. “Although the underlying cause is unknown, our theory is that altered birth conditions could cause a genetic imprint in the immune cells that could play a role later in life. Want to find out what would happen if we followed 100,000 (http://www.lamaze.org/institute/advancing/docs/elective_cesarean_consequences.pdf) 57 more women will die 999 more women will have a hysterectomy 135 more women will have a uterine rupture and 7 babies will die 63 more women will have a cesarean-scar ectopic pregnancy 45,900 more women will have dense adhesions (adhesions make subsequent pelvic or abdominal surgery more difficult, increase the likelihood of injuring organs or blood vessels during surgery, and can cause chronic pain and bowel obstruction) 13,500 more women will experience wound (abdominal vs. perineal) pain for 6 months or more 378 more babies will die in the womb (antepartum fetal demise) without explanation after 34 weeks of pregnancy 7,830 more babies will be born preterm (before 37 weeks completed gestation) 1,620 more babies will born weighing in the lowest 5% for their gestational age 4,244 more babies will have respiratory problems serious enough to require admission to intensive care 3,240 fewer women will have anal sphincter trauma (This assumes an anal sphincter injury rate of 1%, a rate achievable with optimal care [Albers 2005].) BUT 630 more women will have bladder injury 10,260 fewer women will have moderate to severe urinary incontinence BUT 0 fewer women will have later-life urinary incontinence (MCA 2004) What if I've already had a c-section? Isn't it safer to have a repeat c-section??? Risks of choosing a a TOL (trial of labor) vs an ERCS (elective repeat c-section):
More likely to suffer a uterine rupture (there were no ruptures in the ERCS group; the rupture rate was 0.7% in the TOL group (which included VBAC(multiple)C, non-low transverse scars, inductions, pitocin augmentations and women with close pregnancies) 1.4 times more like to have a uterine dehisence (typically a benign, thin area in the uterus) 1.7 times more likely to need a tranfusion 1.6 times more likely to develop endometriosis 1.3 times more like to have another adverse event such as 1.6 times more likely for the baby to die
1.5 times more likely to need a hysterectomy 2.5 times more likely to have a thromboembolic disease (deep venous thrombosis or pulmonary embolism) 2 times more likely for mother to die Risks of a successful VBAC delivery (remember that TOL can end in repeat c-sections) vs an ERCS: 3 times more likely for mother to need a hysterectomy 5 times more likely to have a thromboembolic disease (deep venous thrombosis or pulmonary embolism) 1.5 times more likely to develop endometriosis 4 times more likely to die
Risks of choosing an ERCS over a TOL:
Risks of an ERCS vs a succcessful VBAC
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