What to Expect if You Have a Cesarean Delivery
A cesarean section involves delivering a baby through an incision in a
woman's abdomen and uterus. Approximately 15% to 20% of U.S. babies are born by
cesarean section -- a significant increase from the 3% to 5% rate of 25 years
ago. Although the media like to put a negative spin on this increase by
focusing on the number of unnecessary cesareans, what often gets left out of
the discussion is the number of babies whose lives have been saved or improved
because of this increase in the cesarean rate.
This isn't to say that the 25% or higher cesarean rate at some institutions
is something to cheer about, however. Cesareans continue to be four times
riskier than vaginal deliveries (at least according to oft-quoted studies; in
some patient populations, however, the difference in risk appears to be
significantly smaller). Potential complications include
infections (particularly of the uterus, the
nearby pelvic organs, and the incision)
excessive blood loss
complications from the anesthesia
blood clots due to decreased mobility after
bowel and bladder injuries
You may have heard a common myth about cesareans: that the baby misses out
on the squeezing motion of a vaginal delivery -- a process that helps clear
amniotic fluid from the lungs and stimulate the circulation. There's no
evidence showing that babies delivered through cesarean section are at a
disadvantage because of this so-called lack of squeezing. In truth, a fair bit
of squeezing does occur as the doctor guides your baby out through the incision
he or she has made in your uterus.
Still, most caregivers agree that cesareans should be planned only when
there's a solid medical reason for avoiding a vaginal delivery. Here are some
The baby is predicted to be too large to pass
through your pelvis.
The baby is in a breech or transverse
You have placenta previa.
You have an active genital herpes
You have previously had a cesarean
Note: Not all women who have previously had a cesarean section are
candidates for a repeat cesarean. The cause of your previous cesarean (for
example, a one-time emergency versus a chronic problem), the type of uterine
incision used, and your obstetrical status during your subsequent pregnancy
will determine whether another cesarean will be necessary. We'll be discussing
this issue further on in this chapter.