Cesarean Section - Benefits and Risks

Cesarean section, also called c-section or C-section, is a form of birth made through surgery. A C-section is still the most common route of delivery in Brazil, despite the normal delivery (vaginal delivery) is considered by the World Health Organization (WHO) and various entities medical the best way the baby is born. According to WHO recommendations, only about 15% of deliveries have indication for cesarean section, should the remaining 85% being made by vaginally.

In this article we will discuss the pros and cons of cesarean delivery, emphasizing its indications and its risks.

Scar after cesarean section
Scar after cesarean section
 


What is cesarean section


Cesarean section is a form of labor performed by a surgical procedure in which an incision is made in the abdomen and another in the womb to get the baby. A hard cesarean birth on average 45 minutes to an hour. The birth of the baby usually occurs within the first 15 minutes of surgery, but the obstetrician still need at least another 30 minutes to perform all the sutures, including uterus, muscles and skin.

Except in cases of emergency surgical delivery, the cesarean incision is made horizontally in a lower region of the abdomen, as at the time of the pubic hair, so as not to be visible in the future when the woman is with belly showing, as at the beach or at the gym.

Like any surgery, cesarean section must be done under anesthesia, usually epidural or spinal. General anesthesia in cesarean section only done in special situations. During cesarean the patient is awake, but can not move the lower body, which still remains anesthetized some time after the end of surgery. There is no type of sedation during delivery.

Choosing the birth form


The preferred form of delivery should always be normal birth vaginally. However, cesarean section may be indicated for medical reasons related to problems in pregnancy, or simply at the request of the pregnant woman.

Exaggerated popularization of cesarean section in recent decades caused the people the false impression that delivery by cesarean section is safer and causes fewer complications for the baby. However, what happens is just the opposite. Some studies show that the risk of complications in cesarean section is up to twice the normal delivery.

The mother has full right to choose the mode of delivery, but it is up to the obstetrician clarify all the benefits of normal birth before accepting performing a cesarean delivery without full medical indication. In general, mothers opting for Caesarean do for fear of labor pains, for psychological trauma due to problems in vaginal birth in family or friends, or family / professional pressures that pregnancy has a previously stipulated expiration date. All these fears and questions can easily be circumvented with proper medical guidance and clarification of the pros and cons of birth by Caesarean section.

Labor advantages by caesarean section


The fact that cesarean delivery is not the election route in most cases does not mean that it does not present some advantages over normal delivery. What should be clear is that, in cases without medical indication, these advantages do not outweigh the risks of subjecting the mother to a surgical procedure.

Among the advantages and amenities that C-section provides, include:
  • Ability to previously choose the exact date of birth.
  • Helps reduce maternal stress during labor by passing the idea of a fully controlled environment, where everything is previously stipulated manner.
  • The labor is short and expected duration.
  • Ensures that the pregnant woman's obstetrician will be available the day of delivery.
  • Prevents the occurrence of post-term births (more than 42 weeks of gestation), which is associated with a higher risk of problems for the newborn.
  • Eliminates the risk of complications related to vaginal delivery work process, such as brachial plexus injury related to shoulder dystocia, bone trauma (clavicle fracture, skull and humerus) or asphyxiation caused by intra partum complications.
  • Reduce the long-term risk prolapsed uterus or bladder and urinary incontinence in the mother.

Risks of cesarean section


When the pregnant woman undergoes a cesarean, it ceases to be simply a patient in labor and passes to be a surgical patient in labor. Therefore, in addition to the potential risks inherent in any delivery, they are added also the risks inherent in any major surgery.

Among the complications that the mother is exposed include:
  • Increased risk of infections.
  • Increased risk of thrombosis of the lower limbs.
  • Increased risk of bleeding.
  • Increased risk of reactions to anesthetics.
  • Longer recovery after childbirth.
  • Increased incidence of postoperative pain.

Regarding the baby, caesarean delivery carries an increased risk of respiratory problems in the postpartum immediately, in as transient tachypnea of the newborn. This risk is minimized if the mother already has at least 39 weeks pregnant and if allowed it enters spontaneously into labor before cesarean section be performed.

In addition to the immediate problems of the C-section, there are also long-term consequences. Every caesarean made, the woman starts to have greater risk of abnormal implantation of the placenta, especially cases of placenta previa in subsequent pregnancies. Another problem is increased risk of uterine rupture in the next pregnancy, parturition if this time is vaginally.

Indications of cesarean section


Despite the risks of cesarean delivery, there are certain medical conditions that make it more dangerous than vaginal delivery cesarean section. In these cases, which occur on average one every 7 pregnant, the doctor should opt for cesarean section to protect the mother and / or baby.

Depending on the reason, the choice of cesarean delivery can be made in advance, or only at the time of birth if something unforeseen arises during normal labor.

Among the medical situations that usually indicate the previous schedule a cesarean section, we include:
  • When the baby is in the wrong position, side or head up.
  • When the baby is too large, there is disproportion between its size and the mother's pelvis, which makes its exit through the birth canal.
  • Pregnancy twin.
  • When the placenta is implanted abnormally, as in cases of placenta previa.
  • Women who have had more than one cesarean section previously.
  • Women who have had caesarean section recently.
  • Mothers infected with diseases that are transmitted during childbirth, as genital herpes or HIV.
  • Suspected genetic baby anomaly.
  • Massive fibroid which may obstruct the passage of the baby.
  • Previous uterine surgery, such as removal of fibroids.

Among the medical conditions that indicate change for cesarean section during a normal labor already begun, include:
  • Labor, which does not develop as it should, despite the contractions have already begun for hours.
  • Fetal distress signs during childbirth, such as reduced heart rate of the baby.
  • Heavy bleeding for placental abruption.
  • Inadequate position baby not recognized before the beginning of labor.
  • protrusion cord out of the uterus before the baby out.

In fact, the conversion of a normal delivery to Cesarean delivery should be done whenever there is a problem during labor that endangers the health of the mother or baby.

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