The Truth About C-Sections
Pregnant and thinking about having a C-section? Learn about the risks, benefits, and recovery.
Pros and Cons of C-sections continued...
"Because we do so many so often, people are lulled into a false sense of security," Hoskins says. "While the process usually works very well, we are cutting into abdomen, adjusting the organs, and making incisions near the bladder and bowel."
As a result, there could be damage to the surrounding organs, excessive bleeding, or an infection, Hoskins says.
For women who have three or more C-sections, the risk rises even further.
"The placenta could be deeply attached to the uterus because of scarring from previous C-sections, and it could be difficult to get out, which means heavy bleeding, therefore a higher chance of needing a blood transfusion, or needing hysterectomy just to save the mother's life," Hoskins says.
He says that 40% or more of women having three or more C-sections will experience these complications, so keeping the procedure limited to those that are medically necessary could be life-saving.
Despite the risks, the number of C-sections being performed in the U.S. continues to climb, for several reasons.
"Physician training and willingness to use instruments like forceps and vacuum has decreased," says Katherine Economy, MD, MPH, a maternal fetal medicine specialist in the department of OB/GYN at Brigham and Women's Hospital/Harvard Medical School. "And if you haven't been trained on how to properly use these tools when the situation warrants it, then you're more likely to turn to a C-section."
Also, as the number of primary C-sections rises, so does the number of subsequent C-sections.
"Women are not being educated on vaginal birth after C-section, or VBAC," Kriebs says. "And in fact, many institutions will simply not even allow this procedure after a woman as already had a C-section."
As a result, births that could have occurred "naturally" are being performed as C-sections, pushing the number even higher. In March 2010, an NIH advisory panel recommended that hospitals end bans on VBAC.
Risk also comes into play -- medical and legal, Kriebs says. More health care providers are turning to C-sections at the slightest hint of a complication during childbirth. "When a situation turns complicated during a delivery, today there is a greater tendency to perform a C-section to minimize the risk to the child," Kriebs says.
The number is also creeping upward because women are tapping into C-sections as a childbirth "option" more frequently.
"Women are worried that something will happen to their baby during labor, so maybe they opt for a C-section upfront," Economy says. "Or, they don't want to go through labor pain, because it is painful, and think they can handle the pain of surgery better because it's a controlled setting."
Age also plays into the expanding number of U.S. C-sections. Hoskins says that more women are delaying childbirth until they're older, and, as a result, are more likely to need a C-section; especially if they're over 40, because of the increased risk of complications in older moms.
Waiting until later in life to have children may also mean more need for fertility treatment, which could increase the chance of having twins. And that, in turn, makes a C-section more likely.