Our Summary

This research studied factors that might be linked to the choice of having a voluntary cesarean section (C-section) for childbirth. The study looked at data from 1,295 births in São Paulo, Brazil, in the first half of 2012. The researchers compared women who had normal vaginal births with those who chose to have a C-section without a medical reason.

The study found that women who were at least 18 years old, had a high school education or higher, had a paid job, and lived with a partner were more likely to choose a C-section. Even when considering these factors, the study found that choice of prenatal care and place of birth also mattered. Women who used a private health network for their care were more likely to have a C-section.

In simpler terms, women with better socio-economic conditions were more likely to opt for a C-section. The researchers suggest that changes are needed in the private health network to bring the rate of C-sections closer to international recommendations.

FAQs

  1. What factors were found to be linked to the choice of having a voluntary cesarean section?
  2. How does the choice of prenatal care and place of birth affect the likelihood of opting for a C-section?
  3. What changes do the researchers suggest to bring the rate of C-sections closer to international recommendations?

Doctor’s Tip

A doctor may advise a patient that a cesarean section is a surgical procedure that involves risks and a longer recovery time compared to a vaginal birth. It is important to discuss the reasons for considering a C-section and weigh the benefits and risks with your healthcare provider before making a decision. It is also important to follow proper prenatal care and consider the potential impact of socio-economic factors on the choice of delivery method.

Suitable For

Overall, patients who are recommended a cesarean section typically fall into the following categories:

  1. Women with previous cesarean deliveries: Women who have had a previous cesarean section may be recommended to have a repeat cesarean section for subsequent pregnancies due to the increased risk of uterine rupture during a vaginal birth after cesarean (VBAC).

  2. Multiple pregnancies: Women carrying twins, triplets, or other multiple pregnancies are often recommended to have a cesarean section due to the increased risk of complications during vaginal birth.

  3. Fetal distress: If a baby shows signs of distress during labor, such as an abnormal heart rate or lack of oxygen, a cesarean section may be recommended to deliver the baby quickly and safely.

  4. Placenta previa: If the placenta is covering the cervix, a condition known as placenta previa, a vaginal delivery may not be safe and a cesarean section may be recommended.

  5. Breech presentation: When a baby is positioned feet or buttocks first in the womb, known as breech presentation, a cesarean section may be recommended as it can be difficult to safely deliver the baby vaginally.

  6. Maternal health conditions: Women with certain health conditions, such as high blood pressure, diabetes, or heart disease, may be recommended to have a cesarean section to reduce the risk of complications during labor and delivery.

  7. Infection: If a woman has an active genital herpes infection at the time of delivery, a cesarean section may be recommended to reduce the risk of passing the infection to the baby during birth.

Ultimately, the decision to have a cesarean section should be made in consultation with a healthcare provider based on individual circumstances and medical considerations.

Timeline

Before a cesarean section, a patient may experience prenatal care, discussions with their healthcare provider about the birth plan, and possibly complications or concerns that lead to the decision for a C-section. The patient may also go through pre-operative preparations, such as fasting and receiving instructions for the procedure.

After a cesarean section, the patient will typically undergo post-operative care and monitoring in the hospital, including pain management, wound care, and monitoring for any complications. The patient will also need to rest and recover at home, follow any post-operative instructions given by their healthcare provider, and attend follow-up appointments to ensure proper healing and recovery.

What to Ask Your Doctor

  1. What are the risks and benefits of having a cesarean section compared to a vaginal birth for me and my baby?
  2. How will a cesarean section impact my recovery time and ability to care for my baby after birth?
  3. What are the potential long-term effects of having a cesarean section on future pregnancies?
  4. Are there any specific medical reasons why I might need a cesarean section, or is it purely a personal choice?
  5. Can I discuss my preferences for the birth process with you and create a birth plan that includes my wishes regarding a cesarean section?
  6. What are the potential complications or side effects associated with having a cesarean section?
  7. How does the hospital or birthing center where I plan to give birth handle cesarean sections, and what is their success rate with this procedure?
  8. Are there any alternative options to consider before deciding to have a cesarean section?
  9. How will my partner or support person be involved in the cesarean section process, and what can they expect during the procedure?
  10. Are there any specific guidelines or recommendations for post-operative care after a cesarean section that I should be aware of?

Reference

Authors: Ferrari AP, Carvalhaes MA, Parada CM. Journal: Rev Bras Epidemiol. 2016 Mar;19(1):75-88. doi: 10.1590/1980-5497201600010007. PMID: 27167650