Often, patients ask "why not just do a cesarian section?". When a patient is in labor and they are frightened, it often seems like the quick way to have the baby and not have to worry about pain. This is not a good time to be asking about a cesarian section.
While you are pregnant and feeling well and happy, you are in a better frame of mind to understand the controversial issues that are being discussed today.
Fear of pain is the biggest factor in a women's asking for a cesarian section. The reality is, epidural anesthesia, widely used today, will give excellent pain relief. Once you are comfortable, you will be in a better frame of mind to let your body labor naturally. It is also important to remember that after the operation, you will have pain. Recovery from a cesarean section is not as easy as a vaginal birth.
Most families will have more than one child. To have a surgical procedure with each child is not easy on the mother or the family. In general, after the first vaginal birth, the others come much easier. On the contrary, multiple cesarean sections pose increasing risks for the mother. Due to scar tissue formation, damage of the bladder and bowel become more common. The placenta may become adherent to the uterus, leading to excess blood loss and the need for a hysterectomy.
Recently, there has been some discussion about elective cesarean section to prevent damage to the pelvic floor which can result in urinary incontinence. This is still very controversial. It is well known that women who have never labored and had primary cesareans for other reasons may also have urinary leakage later on in life. There are also women who were never pregnant that developed these problems. Therefore, it is not safe to assume that an elective cesarean section will prevent incontinence. Again, mutiple cesarean births lead to increasing risk of organ injury, hemorrhage and hysterectomy.
Vaginal delivery is still the safest delivery method.
Denise E. Lester MD