Vaginal Delivery Is Safer Than Cesarean for Future Conception/ Pregnancy
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Sometimes a C-section is safer for mother or baby than is a vaginal delivery. Your health care provider may recommend a C-section.Caesarean delivery on maternal request (CDMR), also called an elective caesarean section, is the conduct of a delivery via a caesarean section (CS, or c-section) not by medical necessity or indication but on request of the pregnant patient.
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Surgery is usually done while the woman is awake but anesthetized from the chest to the legs by epidural or spinal anesthesia. An incision is made across the abdomen just above the pubic area. The uterus is opened, the amniotic fluid is drained, and the baby is delivered.
If you have previously had a Caesarean section and become pregnant again, you may need to decide if you wish to have a routinely scheduled repeat C- section for delivery or whether you wish to have a trial of labor. Surgery encompasses more risks than a vaginal delivery but with a trial of labor, there is also the chance (quite small) that the previous uterine incision at time of C-section may rupture and cause complications for both mother and baby.
Doctors used to say that "once a C-section, always a C-section." Then, because of increased surgical complications compared with vaginal deliveries, they began to recommend a trial of labor because about 2/3's of women can deliver vaginally even though they had a previous C-section. Recently the pendulum has flipped and the risk of uterine rupture with a trial of vaginal birth after C- section (VBAC) has become of greater concern.
Recovery from a C-section takes longer than recovery from a vaginal birth. Caesarean delivery also carries a higher risk of complications, just as with other types of major surgery.
Complications that may affect the baby include:
- Breathing problems.
- Fetal injury.
Complications for the mother may include:
- Inflammation and infection of the membrane lining the uterus.
- Increased bleeding.
- Urinary tract infection.
- Decreased bowel function.
- Reactions to anesthesia.
- Wound infection.
- Additional surgeries. Although rare, surgical injuries to nearby organs can occur during a C-section. If this happens, additional operations may be needed.
Adverse outcomes in the next birth are more common among women who deliver their first child by cesarean section than those who deliver their first child vaginally, according to a new report.
"Women who request elective caesarean section for no medical indication should be aware of these potential increased risks for themselves and their babies in their next and future births," Robyn Kennare, a midwife with the Department of Health, Adelaide, South Australia, told Reuters Health.
Kennare and colleagues estimated the association between cesarean delivery of a first child and adverse outcomes in the birth of a second child using data collected between 1998 and 2003 for the second pregnancies of 8,725 women who previously underwent cesarean section and 27,313 women who previously delivered vaginally.
They found that the risks of a whole host of problems including bleeding, prolonged labor, malpresentation, ruptured uterus, and emergency cesarean, were significantly higher among women who delivered by cesarean section in their first pregnancy than among women who first delivered vaginally.
Infants in the cesarean group were also more likely to be preterm (before 37 weeks' gestation) or very preterm (before 32 weeks' gestation), small for gestational age, low birth weight or stillborn, compared with infants in the vaginal group.
However, previous cesarean delivery was not associated with increased risk of death of the newborn, the report indicates.
"Although the absolute risks of many of the outcomes are not high, some of the outcomes are very serious ones or may have very serious consequences," Kennare said.
Getting the unexpected news that you need a C-section can be stressful, both for you and your partner. In an instant, your expectations about giving birth abruptly change. In case of emergency, your health care provider may not have time to explain the procedure and answer your questions.
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