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Choosing a C-Section: A Modern Controversy

Is it a matter of sticking to tradition, or do those against elective C-sections really have an argument worth listening to?
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More and more women are choosing to plan their child's birth ahead of time with elective C-sections. In fact, the number of C-sections in the U.S. has doubled in the last decade, accounting for over 1.3 million births. Proponents of elective C-sections favor the control it gives them over the birthing process, with pregnant mothers now able to know weeks ahead of time when they will give birth and for about how long -- among other benefits. Some doctors aren't sold on the concept, however. Is it a matter of sticking to tradition, or do those against elective C-sections really have an argument worth listening to?

Why Elective C-Sections?

One of the biggest benefits of deciding on a cesarean birth is, quite plainly, not to have to give birth vaginally. A C-section is a serious surgery with a longer recovery time, but there's no getting around the fact that you avoid the pushing, stretching, and potential tearing of your birth canal. Not only is the natural childbirth process painful, but it can take hours.

This isn't the case for C-sections. According to Dr. Jay Goldberg, OBGYN, MD, the actual delivery process only takes about an hour.

"The procedure takes about 5-10 minutes to get the baby out, and about 30-45 minutes to patch you back up," says Goldberg, a Fellow of the American College of Obstetrics and Gynecology.

For mothers having nightmares of an 18-hour labor, an elective C-section seems like a dream come true.

Choosing a C-section ahead of time can lower your risk of postpartum incontinence and sexual dysfunction, which can happen after vaginal birth if the head damages nerves and muscles when passing through the birth canal. Choosing a C-section is about the wellbeing of the baby, too.

Some mothers worry about the risk of head injury to their child during natural childbirth, particularly if forceps end up being required to assist in the delivery.

Sounds good, right?

Despite rapidly increasing numbers, many mothers, doctors, and health organizations still say no -- American College of Obstetricians and Gynecologists (ACOG) included. The official committee opinion of the ACOG on elective C-sections, or those requested by the mother with no health necessity indicated by mother or baby, states that, based on the balance of risks and benefits, a vaginal delivery should be the recommended choice.

Their statement cites the following reasons for the judgment:

  • Longer maternal hospital stay
  • Increased risk of respiratory problems for the infant
  • Greater complications in subsequent pregnancies, including uterine rupture, placental implantation problems, need for hysterectomy

OBGYN and MD Dr. Shamsah Amersi advises women to remember that a C-section is surgery, and surgery is not without risks.

"The risks of a Cesarean section include bleeding, infection, organ injury, an increased risk of blood clots, wound infection, a longer hospital stay, and a longer recovery. Also, anesthesia risks are there. Furthermore, if you're planning to have more than one baby, you would need a second C-section as most doctors are not amenable to having a vaginal birth after a C-section. The more C-sections you have, the more risks you have," says Amersi.

Kids in the House supports your decision to choose what is best for you and your family. Do the research to find a doctor who will discuss your concerns and desires in order to reach a safe, healthy conclusion to your pregnancy.

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