Cesarean Section

Cesarean section involves delivering a baby through an incision in the abdominal wall and uterus instead of through the vagina. The rate of babies delivered by cesarean section (C-section) in the U.S. reached 30 percent in 2007, an increase of over 50 percent since the 1990s. Is this increase medically warranted or are mothers demanding delivery by C-section?

Medical Reasons for Cesarean Delivery

Many valid medical reasons exist for delivering a baby by cesarean section. The most common reason obstetricians deliver by C-section is fetal distress. When the fetal monitoring device indicates the baby is not receiving adequate oxygen, fetal distress occurs and delivery by C-section is indicated. Other reasons physicians choose to deliver surgically include:

• Repeat C-section – In many cases, if the woman’s previous babies were delivered surgically, the physician may opt for C-section rather than attempt vaginal delivery. Vaginal deliveries after C-sections (VBAC) can lead to complications.
• Cord prolapse – With cord prolapse, the umbilical cord slips through the cervix, causing decreased blood flow and oxygen to the baby.
• Breech position – Babies still positioned with their feet first near the time of delivery are considered breech and often delivered surgically.
• Placenta previa – In this condition, the placenta lies low in the uterus and partly or totally covers the cervix.
• Placental abruption – Usually occurring during the third trimester of pregnancy, placental abruption is a separation of the placenta from the uterine lining. This condition may cause bleeding and an emergency C-section is often required.
• Uterine rupture – When the uterus tears during pregnancy, the attending obstetrician often orders delivery by C-section.

These are not the only medical reasons for surgical delivery; talk to your obstetrician about your pregnancy and your concerns about both vaginal birth and delivery by C-section.

C-section on Demand

Oversight authorities do not track C-sections on demand separately from others. By reviewing medical records and counting the deliveries occurring without labor, on low risk pregnancies, or with no documented medical reason, experts can estimate the rate of on-demand C-sections. According to the National Institute of Health, the rate of these on-demand procedures was 2.5 percent in 2004 and steadily rising.

Why Choose a Delivery by C-section?

Women elect to deliver their babies by C-section for a number of reasons – most of which are steeped in vanity or fear. Common reasons include:

• Convenience – Just as more modern parents opt to learn the sex of their baby before birth — so they can begin decorating the nursery — women who elect surgical delivery crave the convenience and control of knowing the exact date and time of birth in advance.
• Less weight gain – Women usually gain the bulk of their baby weight in the third trimester. If they can have a C-section 2 to 3 weeks early, they may avoid the last 5 to 10 pounds of weight gain. Rumors abound in Hollywood about celebrities opting for delivery by C-section for this reason.
• Avoid labor and delivery pain – Those electing to have their babies by C-section may do so to avoid the often protracted labor and delivery pains associated with vaginal delivery.
• Avoid physical effect of vaginal delivery – Women often report urinary incontinence, vaginal stretching, and diminished vaginal contraction strength after vaginal delivery. Some who elect to undergo C-section deliveries without medical indication may hope to avoid these post-delivery complications.

Risks of Elective C-section Procedures

As with any surgery, women who have C-sections have an increased risk of infection of the surgical incision as well as of organs near the uterus. C-section surgery also raises the risk of blood clots and other related complications. While this is true for medically indicated C-sections as well, women should consider their reasons for risking this infection unnecessarily.

Discuss the benefits and drawbacks of both vaginal and cesarean section deliveries with your OB/GYN. Tell him or her about your concerns, if any, regarding weight gain, vaginal stretching, and other physical consequences of pregnancy. Your physician can offer advice and talk to you about procedures to correct complications occurring after delivery.

About the Author

Samantha Gluck is a freelance writer specializing in various topics including pediatric healthcare, OB/GYN healthcare, business and much more.

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