Tuesday, February 13, 2007

Thoughts on labour and c-sections

When I was pregnant, I remember thinking that I was in no way going to go through labour. I wanted, and was determined to get, a c-section to delivery my child. I didn't want to go through what I thought at time was going to be a painful labour, to have to suffer with stitches, pain, and more. Plus, my mom had 2 c-sections by choice and she was up and about within days of both of them. She loved them, had no complications, barely a scar, and told me it was a great decision on her part. As I neared my delivery date, I spoke to my Ob/Gyn about this, and she asked me why I'd want to have a c-section, how it was a major surgery, and I'd be better off just trying to go through natural labour. She said the decision, in the end, was up to me - to go to the hospital and if I changed my mind, she's authorize a c-section. I was induced, so that she could delivery my baby before she left for Greece. (Just days before my real due date). Anyway, to make a long story short, labour was everything I didn't think it woud be - it was absolutely a wonderful, beautiful experience, and I can't believe I even entertained the idea of having a c-section! I was in barely any pain - I made it to 7 cm before asking for my epidural. Yes, that part was yucky but in a few minutes, I was numb and therefore, very happy. Then it was time for my baby to make his entrance into the world! With my husband and sister (who were both in the room with me) laughing and joking with me, my baby came out, eyes open, cute as can be, and I was like, "Wow... that was not bad at all!" To put things in perspective - it hurts way more to get a brazilian. I recovered very quickly. I breastfed easily, thank God - I can only hope it's easy for my next baby, too. I ate chicken fingers and fries that night, while my baby slept beside my husband and I. I was a happy camper! (Not aware of the fact that I wouldn't sleep for days, and weeks due to my 'new mommy worry' and constant feeding, but that's another story altogether!) And so... I thought I'd share this article with you all, in case any of you were thinking of avoiding labour and getting a c-section. I don't recommend it! However, the decision is yours to make.

Caesarean births triple risks for mothers
The Ottawa Citizen
Published: Tuesday, February 13, 2007

Women who have a planned caesarean section suffer more than three times the number of cardiac arrests, blood clots and major infections as those who deliver vaginally, new Canadian research reveals.
The study, based on nearly 2.4 million deliveries over a 14-year period, comes as more women are demanding, and getting, a C-section without a clear medical reason to justify one.
Part of the reason is "the widespread perception that the procedure is of little or no risk to healthy women," a cross-Canada team of researchers reports today in the country's top medical journal.
"Indeed, a belief has become widespread that the risks of caesarean delivery for healthy women are so low as to make it a reasonable elective option for childbirth."
Yet, the new study in the Canadian Medical Association Journal found women who had a planned caesarean were five times more likely to have a postpartum cardiac arrest.
Their rates of wound infections were also five times higher. The C-section group also had three times the number of major post-delivery infections and they were twice as likely to have anesthetic complications, blood clots or a hemorrhage requiring hysterectomy. They also stayed in hospital an average 1.5 days longer.
In absolute numbers, the risks were low. For example, the risk of cardiac arrest in the caesarean group was 1.9 per cent, versus 0.4 per cent in the vaginal delivery group.
There was no significant difference in the rates of in-hospital maternal deaths.
"Regardless of how people give birth, childbirth in Canada is a very safe enterprise," said Dr. Robert Liston, professor and head of the department of obstetrics and gynecology at the University of British Columbia.
"This information tell us, yes, caesarean section is safe, but it's not as safe as a planned vaginal delivery. The likelihood of death or something really horrible happening is very small, but it's more likely to happen if you have a caesarean section than if you go for planned vaginal delivery."
In 1969, Canada's C-section rate was 5.2 per cent of all pregnancies. In 2003, nearly 26 per cent of babies entered the world through an incision in their mother's bellies.
The surgical birth rate has been climbing despite no evidence of any increase in obstetric emergencies that would warrant a C-section, according to researchers.
"Doctors hear, 'I'm healthy, I know the pregnancy is entirely normal but I'm worried about labour, I'm scared about labour, I'm scared for my baby, therefore I want a caesarean section," Dr. Liston, who was one of the authors of the new study, says.
"I think the majority of women still focus on normal labour and birth as the ideal, but I think practitioners would agree with me that in Canada there is an increase in the number of people who are requesting a C-section just on the basis of choice."
The safety of caesareans has improved so dramatically that "many people believe it's just like having your toenails cut," Dr. Liston said.
"The message I would like to get across is that it's not like having your toenails cut. It does carry a risk. The risk may be small, but it's still there."
The study looked at all deliveries that took place in an acute care hospital from April 1, 1991, through to March 31, 2005 (complete information was not available for Manitoba or Quebec.) Complication rates were compared between 46,766 healthy women who had a non-urgent C-section for a breech baby and 2,292,420 women planning a vaginal birth.
Because there's no code for an elective C-section "on demand," the team used caesareans performed for breech, or feet-first births as a "surrogate" for low-risk caesareans.


Dal said...

Personally, I would never opt for a C-Section unless I had to for medical reasons. And even at that, I would be sad that I would not be bale to give birth naturally. Giving birth is a miracle and it is an extremely special moment. I would not give that up for anything.

Loukia said...

Well said.. it was the most amazing thing I have ever done in my entire life... of course if circumstances arise where medically I'd need one to safe my life or my baby's life, no questions asked! But yeah, why bother having surgery when you don't need to? We were made to give birth!

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