Thursday, October 18, 2007

Cesarean section - the way to go?

More and more women are choosing to go the "cesarean route." After all, most plan to have only one or two babies, and they'd rather put up with recovery after major surgery once or twice than "ruin a perfectly good vagina" as one woman put it.

But does cesarean really preserve a woman's body more than vaginal birth?
Is it really less painful?
Are the risks the same?
If I had all the information on risks and benefits, would I choose a C-section for myself?

A doctor friend of mine whose wife recently gave birth by cesarean to her only child, remarked over dinner the other day (as I was discussing natural birth with someone else), "There's nothing quite like a c-section. Slit it open. Take the baby out. Sew it back up and you're done. No sweating, and moaning, and hours of misery. No natural birth for me. I don't find it compelling!"

Is a c-section really akin to just "unzipping," pulling the baby out and sewing the uterus shut again?

Well, not exactly, according to some nursing students who I was visiting with a couple of weeks ago. They were just finishing their eight weeks of Labor and Delivery in their RN training. One of them was lamenting that she had only seen c-sections, during her clinical days, and never witnessed a vaginal birth in the hospital. (She had seen vaginal births in South America, totally unmedicated, and unassisted by any "professional.")

"So," I said, "What do you think of C-sections? Would it scare you to have one, or does it look better than vaginal birth?"

"Oh, my goodness!" she replied. "If women only got a ten second 'behind the scenes' look at c-sections, they would never opt for one. They look awful! The whole uterus, tugged out of the body, lifted up and set on top of the abdomen for repair. The blood loss... it just looks like you tipped over a cup of water and it's pouring out. And then they stuff a rag inside the uterus and..." she shuddered. "I've helped people with severed limbs and stuff, but a c-section was just really gross."

My friend, Jason, and his wife just had an elective cesarean this week. He called to tell me the baby's weight and all the "proud father" news. I asked him if his wife was into recovery yet.
"Oh, yeah, C-sections don't take long. It only took about 10 minutes and we had a baby!" he exclaimed.
"Except that the c-section looked really awful. She didn't feel a thing. But it took the doctor pulling on the baby's head for all he was worth and three people holding her down on the table to get the little six pound guy out! Afterwards, it all looked... uh, just gross. I tried not to hurl, and couldn't watch the rest of it."

Dr. Deirde Lyell, assistant professor of Maternal-Fetal Medicine at Stanford University in California, has this to say:
"Unless a woman has a compelling reason for needing a C-section, vaginal delivery is still the way to go. A C-section is major abdominal surgery and carries a greater risk of severe bleeding, infection, re-hospitalization and blood clots."

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