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Entries in cesareans (1)


What ARE the Risks of Cesareans?

This was a recent question in my Navelgazing Midwife Facebook Page. You’d think anyone reading anything on a more natural-oriented site would already know the answer to that, but I was really glad to see someone ask. It gave the readers a change to answer in a way no textbook can describe. 

A: Having the incision tear further when they pull the baby out - causing hemorrhage and complicated repair and possibly eliminating the possibility of a VBAC - this happened to me. Two hours to repair the extension. (I was able to VBAC though, but have talked to other women who were not able to.)

J: Risk of cutting the baby, nicking nerves, increased likelihood of adhesions in the abdominal cavity, increased risk for uterine rupture with future pregnancies, increased risk of placenta accreta with future pregnancies.

N: Nicking the bladder or intestines causing infection and all the complications that come along with that.

R: Post operative infection.

J: Increased likelihood of prematurity and associated morbidities, increased likelihood of blood loss and clotting problems.

M: Hematoma and uterine wall infection which are currently being experienced by a client of mine-landing her back in the hospital.

J: Increased risk of complications from anesthesia, and the risk of surgical complications is higher in obese moms.

C: Hemorrhage, infection, as you noted compartment syndrome, increased maternal mortality with each c-section, decreased fertility, increased pregnancy complications such as placenta accreta, nerve loss, bladder damage (accidents happen even with a catheter in place and an empty bladder), sleepy babies that nurse poorly if at all, late milk coming in, pain (a lot) and pain that stays for many months after delivery, poor incision healing, blood clots... It sort of becomes endless.

S: Significantly increased risk of death for mother.

S: So scary to read these in list form like this.

J:  Your eyes opened to shit you never ever wanted to know or feel, for months and years. Also, disfigurement.

A: In addition to the overall risks of major surgery (infection, reaction to anesthesia, etc), there are the risks to future pregnancies, particularly placental abnormalities like previa and accreta/increta/percreta. And then there are the potential problems (not insurmountable, but notable) of separating mom and babe in the early hours and the impact that can have on establishing breastfeeding. Plus due to not passing through the vagina, babe is not colonized with normal flora, increased respiratory difficulties . . . Where to stop?

L:  Death.

D: Excess fluid in lungs for newborn.

C: My son and I both carry scars from that operation. He was sunny side up, and they wheeled me in pushing. He now has a small scar on his cheek that, as he is getting older and bigger, is becoming more prominent. BTW, informed consent is a joke when your doc has a dinner party to get to on New Year’s Eve. Further risk? Maternal or fetal death. Increased placental placement risks. Fertility risks. Bowel, internal organ healing risks. If I knew then, what I know now....

M: Disgusting, oozing, adhesive burn from the dressing over my incision.

NgM: It's imperative to remember the Risk/Benefit Ratio. One of the things about cesareans is they are proof positive that a mother will lay down her life for her child; she forever has the scar(s) to prove it.

A: I read a lot of medical issues here, but not so much on the emotional issues. I remember feeling "broken" for a while.

R: Emotionally, issues bonding with baby, increased risk of postpartum depression/post traumatic stress disorder/postpartum psychosis.

L: Actual complications in my case, cut hip to hip, hemorrhage, cervical laceration, massive surgical infection that took 8 painful (not to mention shockingly expensive) months to heal. Additional surgery and medical advice to carry no additional children. Between the risk of another preemie, the scar tissue and the extent of tearing of my uterus including the cervical laceration, several docs have strongly advised against further pregnancy.

L: Repeat sections with increasing probability of placenta accreta is the one that scares me most. Freaks me out when this starts with a teen primip (first time mom). High-risk category forever. Bad news if you hoped for more than 2 kids ever.

W: Can we have this same thread with vaginal births, as that isn't a risk-free walk in the park either. Just because this needs to be said, just because it is a risk, doesn't mean it will happen to you. There is a risk of most offbeat things every time you get into the car (even the emotional things) but 99% of us still ride in cars.

NgM: No, it isn’t a “risk-free walk in the park,” but it is true that cesareans carry far more risks for mom and baby than a vaginal birth does. Acknowledging them is fine, but seeing them as equal is flat out wrong.