Pregnancy and childbirth are among the most exciting yet nerve-wracking experiences in a woman's life. As the due date approaches, one of the biggest decisions an expectant mother faces is how she will give birth.
While many women hope for a natural delivery, there's a growing number who prefer a Cesarean section (C-section). Some are so committed to their chosen method of delivery that changing their minds can seem impossible, even in situations where a C-section might be necessary to save lives.
Today, we aim to shed light on the many myths surrounding C-sections and provide the facts to help expectant mothers make informed decisions about their birth plans. Understanding the reality of C-sections can help reduce anxiety and empower women to approach childbirth with confidence, knowing they’re prepared for whatever path their journey takes.
Many women are candidates for a vaginal birth after a Cesarean (VBAC), but it depends on factors like the type of uterine incision used previously and the current health of the mother and baby. VBACs can offer a quicker recovery and avoid major surgery, but they also come with potential risks, such as uterine rupture.
Elective repeat Cesareans (ERCS) offer more predictability and eliminate the risk of labour-related complications but involve major surgery and a longer recovery. Ultimately, the choice between VBAC and ERCS should be based on individual medical advice and personal preferences.
Many believe Cesareans are safer for the baby, helping to prevent complications like cerebral palsy or birth asphyxia. However, cerebral palsy has multiple causes beyond the delivery method, and it cannot be solely prevented by choosing a Cesarean. Additionally, birth asphyxia can occur during a straightforward elective Cesarean if unforeseen complications arise.
While Cesareans can be lifesaving in emergencies, they also carry risks such as surgical complications, longer recovery times, and potential issues in future pregnancies. Vaginal births, though not without risks, typically involve a quicker recovery and fewer long-term complications. The safest approach depends on individual medical circumstances and professional advice.
C-sections are an easy way out
Some believe that Cesarean sections offer an easy escape from prolonged labour, intense pain, and the difficulty of pushing. However, Cesareans are major surgeries with significant recovery challenges. They come with risks such as infection, blood loss, and complications from anaesthesia. Recovery from a Cesarean can be longer and more painful compared to vaginal births, often requiring weeks of healing and pain management. Rather than an easy solution, a Cesarean is a complex procedure with its own set of difficulties.
You can’t bond with or breastfeed your baby after a Cesarean
Contrary to this belief, bonding and breastfeeding after a Cesarean is very possible. Many hospitals encourage immediate skin-to-skin contact and early breastfeeding, even after a Cesarean. This helps facilitate bonding between mother and baby. Additionally, lactation consultants and hospital staff offer support to help mothers successfully start and maintain breastfeeding. Although the recovery from a cesarean can present challenges, with appropriate support, mothers can effectively bond with and feed their babies.
C-sections don’t affect future pregnancies
A C- section can indeed impact future pregnancies. Women who have had a cesarean may face increased risks in subsequent pregnancies, such as placenta previa (where the placenta covers the cervix), placenta accrete (where the placenta attaches too deeply into the uterine wall), and uterine rupture (a rare but serious condition where the uterus tears along the scar from the previous cesarean). Additionally, the risk of preterm birth can be higher. These factors can complicate future childbirths and may require careful management and planning with a healthcare provider to ensure the safety of both mother and baby.
With a C-section, you can only have a maximum of 2 or 3 children
The idea that you can only have a limited number of children after a Cesarean section is not entirely accurate. Many women who have had a Cesarean go on to have more children, including multiple Cesareans if needed. While each Cesarean comes with potential risks, such as complications in future pregnancies, many women successfully have larger families with careful monitoring and planning by their healthcare provider. The number of children you can have after a Cesarean depends on individual health factors, the type of incision made, and overall medical advice, rather than a strict limit on the number of births.
C-sections mean you can't have a natural childbirth experience
While a C- section is a surgical procedure, it doesn’t necessarily preclude elements of a natural childbirth experience. Many hospitals and birth centres are equipped to offer a more personalised and supportive environment, even for Cesareans. For example, you can often have your partner present during the surgery, which helps maintain a sense of continuity and emotional support. Immediate skin-to-skin contact with your baby is frequently encouraged, promoting early bonding despite the surgical delivery.
Additionally, you can work with your healthcare provider to create a personalised birth plan that includes your preferences for anaesthesia, timing of the baby's first feed, and other aspects of the birth experience. These measures can help create a more meaningful and connected experience, even within the context of a Cesarean.
Babies born via Cesarean section are less healthy
Some people think that babies born by Cesarean might be less healthy because Cesareans are often done in emergencies when the baby might be in trouble. However, most babies born via Cesarean are healthy. One reason for this belief is that babies born by Cesarean don’t pass through the birth canal, which means they don’t get the natural squeeze that helps push fluid out of their lungs.
This can sometimes lead to minor breathing issues, but these are usually temporary and easily managed. Also, if general anaesthesia is used during the cesarean, babies might be a bit sleepier right after birth, but this is usually short-lived. While there may be some slight differences or minor issues, most babies born via c-section are perfectly healthy.
Cesarean sections are always a sign of medical failure and you can’t have a birth plan or make changes once a Cesarean is decided.
Cesarean sections are not necessarily a sign of medical failure. They are often essential and lifesaving, ensuring the safety of both mother and baby when complications arise during labour. Contrary to the belief that a C- section rules out having a birth plan, you can indeed create one. This can include your preferences for anaesthesia, immediate bonding with your baby, breastfeeding, and who can be present during the birth. Additionally, while some women need a Cesarean for specific medical reasons, many others may choose or be advised to have one for various personal or health-related factors.
C- sections are mostly performed for financial gain, with doctors suggesting they earn more money
Cesarean sections are significant surgeries with their own risks, and doctors generally do not recommend them unless necessary. Most doctors, especially those working in public hospitals or teaching institutions, receive a salary that is not tied to the number of Cesareans they perform, so they do not benefit financially from recommending this procedure. Suggesting a cesarean unnecessarily can lead to complications and potential risks for both mother and baby.
This myth can sometimes cause delays in necessary care, leading to severe outcomes like the death of the baby, the mother, or both, or long-term health issues due to delayed treatment.
While it is true that a few doctors might act inappropriately for personal gain, the majority make decisions based on the best interest of the patient’s health. If you have concerns about the recommendation for a Cesarean, it's important to seek clarification and ask questions rather than risking the health of both mother and baby based on the fear of financial motives.
You will always have a visible scar after a Cesarean section
While a C- section leaves a scar, it’s not always as noticeable as some might think. Advances in surgical techniques aim to make the scar as small and discreet as possible. Surgeons typically place the incision low on the abdomen, often just above the bikini line. This placement helps ensure that the scar is less visible and can be easily covered by underwear or swimwear. Additionally, over time, scars often fade and become less noticeable. So, while there will be a scar, modern methods work to keep it as minimal and unobtrusive as possible.
Dr Okemo is a Consultant Obstetrician Gynaecologist at Aga Khan University Hospital, Nairobi
