Why a C-Section?

Specialties Ob/Gyn

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Hi everyone, I was just wondering why so many women are choosing to undergo ceasarean delivery without even a trial of labor? Don't they realize it is a major abdominal surgery and they will be in severe pain for several weeks? I know that it is a very necessary procedure sometimes, but it just seems so overdone and unnecessary sometimes. I'd love to hear from you!

I will not say these are "ridiculous" to those who hold these concerns. They are VERY valid. I have seen women suffer stress incontinence and even in severe cases, fecal incontinence, and other nasty complications from difficult lady partsl deliveries. As a GYN surgical nurse, I have seen many, many women undergo bladder suspensions and A/P repairs, it became so unliveable for them. I also know of cases where poorly-healed 4th-degree laceration repairs (extending into the anal sphincters) had to be actually surgically re-done years later. it's no walk in the park for these women----so, No, I would NEVER blow off such concerns; they are valid.

BUT----- those electing to have what they want when they want it---yea, they are in for a shock as parents, but then, aren't we all as new parents????

Good point!! The whole lady parts tearing part never scared me until I realized that we can tear upwards too (privy parts and urethra!). No thank you! I like having one hole to pee out of :rotfl:

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When I was referring to "elective", I meant a person who has been planning a C-section from day 1 of the pregnancy. Obviously if the baby is under any kind of stress, it should be an option. But, I think there should be medical reason for it. So, in my instance, the oposite of elective c/s would be lady partsl delivery. I think fear of child birth is a completely assinine reason for a c/s (i.e Britney Spears). :twocents:

Suzi

Ok. I didn't have a fear of childbirth, we thought we'd have him lady partslly all along. I went into the hospital for an NST at noon and was scheduled for a c/s at 330!! Talk about a shocker! I was going to go grocery shopping after the NST and I even had my dog waiting to be picked up at the groomers!! :rotfl:

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Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

Yep yours appears a clear-cut case, Tweety. A different matter altogether than purely elective csection in healthy primips with no known medical problems whatsoever.

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Specializes in NICU.

I must be crazy. My idea of the perfect birth is laboring in a jacuzzi until it's time to push, and then using my pain as motivation to push the kid out ASAP. (Heck, it's exactly how I "delivered" my last kidney stone!) A tad unrealistic, maybe. But I'm a true Pisces and I'm never as relaxed as I am in the water. A hot bath does something magical to me, it's like a cure-all for anything that ails me.

I just can't imagine WANTING to go through major abdominal surgery.

Then again, I might think this way because of one little tiny thing...

...epidurals absolutely scare the bejesus out of me.

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Some I would rather not get into too much detail on here, like the loss of a uterus, severe peritonitis due to light nicking of a bowel , or women going home with a leg bag due to nicked and infected bladder. These things can happen at the hands of a very skilled and experienced surgeon, as I have seen them. Yep, these things do happen.

deb

Must agree. OK, I've only been in postpartum for almost a year now but the recovery is infinitely easier for lady partsl deliveries, handsdown. As far as complications, we've readmitted quite a few people. lady partsl deliveries are almost always for hemorrhage but c-sections have become septic from the incision, nicked bladder (with leg bag as you said), ruptured uterus/bladder and yes, also hemorrhage. So it seems the complications are worse too.

One huge benefit I can see from c-section (aside from healthy baby and quick delivery) is if you want to get a tubal ligation at the same time :)

Melissa

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Having experienced both, for me personally the c-section recovery was significantly more painful. Immediately afterwards I was shaking for what seemed like several hours, and there was some sort of ridiculous delay in getting adequate pain control. I am extremely thankful that c-sections exist for emergencies, and with my son the OB clearly made the right choice to section. But I am even more grateful to the dr. who delivered my daughter and was patient and supportive throughout the 3 1/2 hrs. of pushing, who did *not* pressure me to agree to a c-section. My daughter's birth is one of my most treasured memories, and I am certain that with a different OB I would have ended up in the OR. In a future pg. I will do an elective c-section, the risk of uterine rupture scares me too much to try a VBAC.

I think it is all about informed, educated choice. And a c-section for convenience or vanity is just absurd.

Shannon

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Also...I don't know what it is, but the energy and the atmosphere in the delivery room of a lady partsl delivery simply cannot be replicated in the OR, or in the recovery room of the OR. If you have not felt that same energy, than I can see why maybe a nice convenient c/s seems desirable. You will be missing out on an experience you can never get back though.

Thanks!

I think this is a very sore subject with women who have delivered via a csection because of course they don't want to feel, in any way, that they are missing out on anything. But that said, I agree with your statement above. I think the reason they do feel like they missed out on something is because they did. In my mind, when I hear that a women delivered a baby via csection I think, "Dr. X delivered that baby, not the mother" because that is the truth. In a lady partsl delivery, the mother (and her uterus) pushes that baby out and she is empowered by this feeling of accomplishment and contribution to the process of birth. For the duration of labor, the focus is on the mother and how she is progressing, if she is ready and encouraging her to push, breathe, etc. In a csection birth, the focus switches to the end product - getting the baby out and the mother becomes a passive partner in this process.

That said, of COURSE a csection is vastly preferably to a poor outcome or a sick or dead baby. I am glad csections are available for those that need them.

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Then again, I might think this way because of one little tiny thing......epidurals absolutely scare the bejesus out of me.

OMG me too. When I say that, people look at me like I'm mad. I had my first two smaller babies totally natural but when I got around to my son (9 pounder) I caved in and asked for the epidural. Sure, it took the pain away but the room got dark and my BP dropped and I felt like I was dying. I could barely move my arms and legs, it was so scary. When the anesthesiologist came back to give me a bolus, I said, "No thanks!" and let it wear off!

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I am sure this varies widely due to different hospital's protocols. Our standards of care and order sets for csections say catheters stay in for 18 hrs, up (at least at bedside within 12 hrs), progress to regular diet as tolerated (but some doctors specify only when bowel sounds or flatus is present). Our spinal orders generally specify no PO meds for first 18-24 hrs.

I can tell you the acuity for fresh csections is higher and the charge nurses take that into account when making patient assignments. The CNAs don't like it because they have to do frequent vital signs (q30 min then q1h for the first 4 hrs I believe). Sometimes they just sleep, whicih is actually easier since I just pop in to check on them until it's time to get them up, but sometimes they are miserable, itchy, nauseous and hurting :(

Glad your baby had no feeding issues, generally the big full term babies are good feeders in general. The only trouble they have is the typical csection spittiness which sometimes interferes with feeding as nobody likes to eat when they are gagging, babies included!

Shoot, maybe i was one of the lucky ones! My urinary catheter was only in for about 8 hrs and they had me walking around after they pulled it out. I was having nausea, but no vomiting, no gas pains. Was able to progress to a reg diet after I "passed gas" which was about a day after surgery. The only pain I was having were those afterpains...I requested a heating pad for my back. I barely got any IV Narcotic. I was using their Vicodin.

Our baby was very healthy apgars were 9 and 9. He was (and is) definitely not a poor feeder! He's a little chunker! :)

I was only in the hospital less than 3 days. Admitted around 2 pm on Friday, went home Monday around 10am. The only complication I ended up with...the incision dehisced about 2 inches thanks to my dog jumping up on me as I got home from the hospital :(...Also ended up with PPD...but that could happen to anyone, not just c/s.

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I think this is a very sore subject with women who have delivered via a csection because of course they don't want to feel, in any way, that they are missing out on anything. But that said, I agree with your statement above. I think the reason they do feel like they missed out on something is because they did. In my mind, when I hear that a women delivered a baby via csection I think, "Dr. X delivered that baby, not the mother" because that is the truth. In a lady partsl delivery, the mother (and her uterus) pushes that baby out and she is empowered by this feeling of accomplishment and contribution to the process of birth. For the duration of labor, the focus is on the mother and how she is progressing, if she is ready and encouraging her to push, breathe, etc. In a csection birth, the focus switches to the end product - getting the baby out and the mother becomes a passive partner in this process.

That said, of COURSE a csection is vastly preferably to a poor outcome or a sick or dead baby. I am glad csections are available for those that need them.

Again, maybe my c-section experience is in the minority! Because I truly and honestly don't feel like I missed out on any of the excitement/emotional aspects of the birth. I was on cloud 9!! It was the most exciting day of my entire life!! :) I don't feel like less of a woman/mother. I feel so lucky to be able to even get pregnant and carry a child in my womb and bring life into the world. There are women in this world who can't do that and pay tons of money to get pregnant or to adopt. I don't define myself by how my child was brought into the world and I don't think others should either. Some things are definitely out of one's hands.

I'm sure that women who are coerced into a c-section, or ones who were really gung-ho to have a lady partsl must feel like they really missed out on something. I think the main reason why I never had that negative outlook on it, was because I left all the choices up to God.

My baby was breech for awhile towards the end of the pregnancy. I was told then I may need a c/s, but I refused to schedule it with the doc and refused to have a version performed. I didn't want to "screw with nature or tempt fate". Then the little guy turned when I was about 38 weeks. So I was thinking "Ok lady partsl birth". Then as I became overdue and then later learned that the little guy was stressed...that also (to me) felt like God intervening and that is why I felt comfortable consenting to the c/s. I knew that the outcome was not going to be good If I tried to labor.

That being said, I do think women who have elective c-sections (just because someone doesn't WANT to have a lady partsl and they have no real medical reason or risks to having lady partsl birth) need to really consider the risks and the recovery too.

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Specializes in Pediatrics.

I've had three kids all lady partsl and all non-medicated. Epidurals scare the crap out of me, and I liked being able to feel my legs even if I felt all the pain as well. I was able to walk to the bathroom immediately following birth. I felt great after, and was able to bond with my babies right away. I just don't understand the need to have a c-section for a first baby without even trying labor. :chair: Help me to understand.

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I've had three kids all lady partsl and all non-medicated. Epidurals scare the crap out of me, and I liked being able to feel my legs even if I felt all the pain as well. I was able to walk to the bathroom immediately following birth. I felt great after, and was able to bond with my babies right away. I just don't understand the need to have a c-section for a first baby without even trying labor. :chair: Help me to understand.

Karry, In my instance I had my first baby in July this yr via C-section. There was no point to letting me try labor since I was determined to have a very small pelvic outlet and my baby was also under alot stress, his amniotic fluid was also low.

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