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Understanding Cesarean Section

What you need to know.

Pregnancy & Postpartum

The rate of cesarean section in this country has never been higher. Reasons for the drastic increase (50 percent in the past decade) are: greater monitoring in the delivery room (which increased the cesarean rate 40 percent with no significant drop in delivery-rated problems); higher medical malpractice premiums and higher rates of obesity. It seems that physicians are quicker to suggest and perform a cesarean, particularly in fist-time mothers. Since the trend these days is for women who have had one cesarean to deliver all subsequent babies the same way, the rate will likely continue climbing.

Overall estimates are that up to 18 percent of cesarean deliveries in the United States are elective—that is, performed without a clear medical need. It's important to know the facts about elective cesareans: Women and their babies are more likely to have birth-related complications than women who have vaginal births. They are also more likely to deliver babies too early. Regardless, there are times when a cesarean is necessary for women experiencing complications that make a vaginal birth unlikely or dangerous.

During a cesarean, the baby is delivered through an incision in the abdominal wall and uterus. Other things you should know:

  1. Anesthesia. Unless there is no time, you are usually given an epidural or spinal as anesthesia for a cesarean. That means you can stay awake for the delivery, although the doctor will screen the surgical field from view. If things are going too fast for an epidural, you may need general anesthesia.
  2. Recovery. A cesarean section is major surgery; expect a longer hospital stay and recovery time.
  3. Blood loss. You lose more blood during a cesarean section than with a vaginal delivery. You may require a transfusion, although the risk that you'll need one is approximately 2 percent. At the very least, the blood loss may leave you tireder than if you'd had a vaginal delivery.
  4. Scar tissue. You may have scar tissue form in the pelvic region from the surgery that may affect future pregnancies and deliveries.
  5. The baby. The baby may have some breathing problems because it did not come through the birth canal. It may also have low APGAR scores (a way of evaluating its health right after birth) because of anesthesia or problems during labor and delivery. But don't worry; the delivery room staff will rub the baby to restore color and movement and/or provide some supplemental oxygen to help it pink up.
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