What is a C-section?
A C-section, also known as a caesarean section, is the surgical delivery of a baby through an incision made through the abdomen and the uterus. There are many indications for performing a C-section. Commonly, it is done in an emergency- when it is the safest mode of delivery for both the mother and the baby.
The most common indications for an emergency C-section are:
Fetal distress ─ If the baby is not receiving enough oxygen or the heart rate is increasing;
Non-progress of labour ─ Prolonged labour is the most common reason for a C-section being performed. The labour may be prolonged because the cervix is not dilating sufficiently despite contractions, or because the baby’s head is simply too big to pass through the birth canal;
Infection ─ A C-section may also be recommended in cases where the mother is known to have an infection that could pass onto the baby during delivery, such as HIV or genital herpes;
Abnormal position of the baby ─ In a vaginal birth, the baby is usually positioned head-down in the womb and the head comes out before the rest of the baby’s body. If the buttocks moved into the birth canal first (breech position), or the baby is positioned on its side (transverse position), then a C-section may be advised.
However, a C-section may be planned by you and your doctor- this is known as an elective C-section. An elective C-section occurs when there are no medical indications.
Common Myths
There are a lot of misconceptions surrounding C-sections. Below are some common myths and facts.
1. Myth: C-sections make birth easier
Fact: A C -section is a major abdominal surgery which has some medical risks associated with it such as heavy bleeding, blood clots, possible infection, and injury to other organs. For this reason, obstetricians advise pregnant women to avoid C-sections if possible. Additionally, once the baby is born, recovering from the procedure may be more difficult than recovering from vaginal birth.
2. Myth: You cannot deliver vaginally after a C-section
Fact: You may give birth vaginally after a C-section (this is known as VBAC). There is a criterion for who qualifies for a VBAC.
A woman must have had;
one previous low-transverse caesarean delivery; and
no other uterine scars, previous rupture, or previous uterine surgeries;.
A physician must be immediately available throughout active labour to monitor labour and perform an emergency caesarean delivery (if needed); and
Anesthesia personnel must be available for an emergency caesarean delivery.
Note: You will need to discuss your options with an obstetrician to assess whether you are a candidate for VBAC.
3. Myth: Skin-to-skin is not possible after a C-section
Fact: If the procedure has no complications and the baby is healthy, there is no reason to suggest that your baby cannot be placed straight on you once he or she is born. Skin-to-skin has a lot of benefits and is often encouraged if circumstances permit.
4. Myth: You won't feel anything during your C-section
Fact: The doctors will give you anesthesia (medication to numb the pain during the operation), but you might sense some tugging and pressure on your abdomen. Once the operation is done and the anesthesia has worn off, you may fee pain around the surgical site and may need to take pain medication until the surgical wound has healed.
5. Myth: The recovery period for both vaginal births and C-sections are the same
Fact: C-sections usually take a relatively longer period compared to the vaginal births. A woman who gave birth vaginally is discharged from the hospital after 2 to 3 days, whereas a woman who gave birth via C-section is examined in the hospital for up to 5 to 7 days. The scars must heal and there is a higher risk of infection.
Take home message
A C-section is an alternative method of delivery. It is often indicated in emergency situations although some mothers may electively opt for it. A C-section is not an easier route. In fact, it requires more healing time compared to that of a vaginal birth. Medical experts advise that mothers only choose this option in emergency situations.
This article is written by Dr. Itumeleng Buti (MBChB)
References:
1. Neff M. ACOG Releases guidelines for vaginal birth after cesarean delivery. American family physician. 2004 Oct 1;70(7):1397.
2. What To Expect. Having a C-section (Cesarean Section) Available from: https://www.whattoexpect.com/pregnancy/c-section/. [Accessed 11 March 2022]
3. Tommy’s Pregnancy Hub. C-sections- Everything you need to know. Available from: https://www.tommys.org/pregnancy-information/giving-birth/caesarean-section/c-sections-everything-you-need-know [ Accessed 11 March 2022]
4. Briana Pastorino. Five Common Myths about C section. Available from: https://news.llu.edu/patient-care/five-common-myths-about-c-sections[ Accessed 11 March 2022]
5. MacArthur Medical Center. C-Sections: Truths, Myths, Facts, And Fiction. Available from: https://macarthurmc.com/c-sections-truths-myths-facts-fiction/ [ Accessed 12 March 2022]
6. Solace Women’s Care. Myths and Facts About Cesarean Delivery. Available from: https://www.solacewomenscare.com/blog/myths-and-facts-about-cesarean-delivery. [ Accessed 11 March 2022]
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