Pregnancy and C-Sections

Over the last ten years, the number of cesarean sections or C-sections performed in America has nearly doubled. Today, large percentage of all babies born in the United States are delivered by C-section. But the main question is why so many American women are opting for C-section. Is it a matter of convenience? Or, are there some serious medical reasons driving the trend?

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The C-Section is usually recommended when complications with pregnancy make traditional vaginal delivery difficult, or puts the mother or child at risk. They are done most often when the mother has had a previous delivery by C-section, or the baby’s health might suffer if delivered vaginally or if the baby’s heart beat slows abnormally during the prolonged labor. However, studies have found that C-section is not risk free, despite its high prevalence. Just like in any other surgery, there are several risks and complications associated with cesarean deliveries, including severe blood loss, anesthetic and cardiopulmonary complications, injury to bladder or uterus and wound complications.

Many obstetricians believe that once a woman has undergone C-section, the subsequent deliveries will be performed the same way because of the higher rates of complications associated with vaginal deliveries after having previously having a C-section. And most of the women opting for C-section are first-time mothers. To reduce the number and risks of Cesarean deliveries, the American College of Obstetrics and Gynecology and the Society of Maternal Fetal Medicine have outlined new clinical guidelines. The goal of these guidelines is to reduce the number of C-sections all across the country. According to the International Federation of Gynecology and Obstetrics, performing cesarean deliveries for non-medical reasons is not ethically justified and steps should be taken to minimize the number of C-sections.

Under the new guidelines, only cases with high risk pregnancy should be considered for C-section. The low-risk pregnancy cases should be encouraged to allow labor to progress longer before shifting from a vaginal birth to a C-section.

One of the major reasons of recommending C-section is the increased maternal weight. Heavier moms are likely to deliver bigger babies and to avoid the risk of trauma during vaginal delivery, obstetricians opt for C-section. By keeping weight gain under check during the pregnancy phase, there are chances that C-section can be avoided. Turning the baby to reduce the risk of breech delivery can also avoid C-sections. Most of the institutions do not attempt vaginal delivery after C-section (VBAC), which has resulted in increase in number of C-sections. However, according to ACOG, the success rate of attempting a VBAC is in between 16 and 80 percent.

Although C-sections are considered safest option for women with certain medical conditions, it is important to weigh all the possible risks against possible benefits when opting for the procedure. It is important to clear discuss your individual case with your obstetrician to rule out any possible risks. Choose your obstetrician wisely as she/he can guide and support you mentally and emotionally throughout this important phase.