April is Cesarean Awareness Month, and although I'm a bit late to the party, I think it important to spread the word (whether that be on the first or the thirtieth).
ICAN, the International Cesarean Awareness Network, has challenged each of its members to blog about CAM to talk about the importance of change.
This year, it's especially important to me because I'm trying to avoid another section (as I've mentioned previously).
In preparations for our impending birth, I've had to face some emotions that I wasn't quite ready to and/or wasn't aware even existed. Because I've had to come to peace with my previous two births so that I can move on to a new chapter. There's a piece in the
Business of Being Born where a woman whose name escapes me says something to the effect of, "women are going to be transformed by their birth, whether they want to or not." This was a huge "aha" moment for me because although it's a rather simple concept, it's so overlooked in today's world of modernized medicine.
Many members of my family have expressed their misgivings about us wanting to pursue a completely natural birth this time. "You won't win a medal, you know", "Why not use the drugs we have access to? It makes no sense!", and my personal favorite "Your tolerance for pain is so low, Meg, this will never happen for you". I've tried to explain this simple concept to them of wanting to be positively transformed after New Baby's birth, but most just don't get it. And it's so sad to me because it's a representation of how society views childbirth as well.
Most of my friends who have had sections say that it doesn't bother them. And I just cannot fathom that thought. How can it not bother someone to give birth in a bright, sterile, medicalized environment? How can it not bother someone to not give birth the way God intended? But then I realize ... most of these women are uninformed. Uneducated with regard to c-sections. They take their OB's word that it was "necessary" and "life saving" when, in fact, if they'd never started down the road of interventions to begin with, no one's life would have needed saving!
But therein lies the rub. Education about childbirth is severely lacking in this country. And until people start talking about it, we as a society are going to continue down this path ... a path we took a wrong turn to many years ago.
So in the interest of education, here are some
cesarean facts:
- CESAREANS are serious. There is no need for a ‘catchy phrase’ to tell us that this is a mainstream problem. It affects everyone. One in three American women every year have surgery to bring their babies into the world. These women have lifelong health effects, impacting the families that are helping them in their healing, impacting other families through healthcare costs and policies, and bringing back those same lifelong health effects to the children they bring into this world.
- When a cesarean is necessary, it can be a lifesaving procedure for both mother and baby.1 However, psychological outcomes such as negative feelings, fear, guilt, anger and postpartum depression are common consequences of both emergent and elective cesarean sections.2,3,4 A cesarean section is only indicated in the following situations:
- Complete placenta previa at term
- Transverse lie at complete dilation
- Prolapsed cord
- Abrupted placenta
- Eclampsia or HELLP with failed induction of labor
- Large uterine tumor that blocks the cervix at complete dilation (Most fibroids will move upwards as the cervix opens, moving it out of baby’s path.)
- True fetal distress confirmed with a fetal scalp sampling or biophysical profile
- True absolute cephalopelvic disproportion or CPD (baby too large for pelvis). This is extremely rare and only associated with a pelvic deformity (or an incorrectly healed pelvic break). Fetal positioning during labour and maternal positioning during second stage, most notably when women are in a semi-sitting position, cause most CPD diagnosed in current obstetrics.5
- Initial outbreak of active herpes at the onset of labor
- Uterine rupture
- Many reasons given for cesarean, especially prior to labour, can and should be questioned. This includes macrosomia (large baby), maternal age, and parity, assisted reproductive technology, CPD, dystocia, failure to progress, breech, fetal distress or even prolonged second stage. There are very few true indications for a cesarean section in which the risks of surgery will outweigh the risks of vaginal birth.
- A cesarean poses documented medical risks to the mother’s health. These risks include infection, blood loss and hemorrhage, hysterectomy, transfusions, bladder and bowel injury, incisional endometriosis, heart and lung complications, blood clots in the legs, anesthesia complications, and rehospitalization due to surgical complications, rate of establishment and ongoing breastfeeding is reduced, and psychological well-being compromised and increased rate emotional trauma. Potential chronic complications from scar tissue adhesions include pelvic pain, bowel problems, and pain during sexual intercourse. Scar tissue makes subsequent cesareans more difficult to perform, increasing the risk of injury to other organs and the risk of chronic problems from adhesions. One-half of all women who have undergone a cesarean section suffer complications, and the mortality rate is at least two to four times that of women with vaginal births. Approximately 180 women die annually in the United States from elective repeat cesareans alone.
- Each successive cesarean greatly increases the risk of developing placenta previa, placenta accreta and placental abruption in subsequent pregnancies. Both of these complications pose life-threatening risks to mother and baby. Cesareans also increase the odds of secondary infertility, miscarriage and ectopic pregnancy in subsequent pregnancies.
- A cesarean poses documented medical risks to the baby’s health. These risks include respiratory distress syndrome (RDS), iatrogenic prematurity (when surgery is performed because of an error in determining the due date), persistent pulmonary hypertension (PPH), and surgery-related fetal injuries such as lacerations. Preliminary studies also have found cesarean delivery significantly alters the capability of cord blood mononuclear cells (CBMC) to produce cytokines. An elective cesarean section significantly increases the risk to the infant of premature birth and respiratory distress syndrome, both of which are associated with multiple complications, intensive care and burdensome financial cost. Even with mature babies, the absence of labor increases the risk of breathing problems and other complications. Far from doing better, even premature and at risk babies born by cesarean fare worse than those born vaginally.
In my next post, I'll explore the facts about VBAC and why it's an important choice.
