Our Summary
This research paper is about the history, current prevalence, and implications of cesarean delivery, commonly known as C-sections. C-sections are now performed on one in three women in the United States and up to four in five women in some parts of the world. The practice has been around for centuries, but was avoided until the late 19th century due to high death rates. However, in 1926 a safer method was introduced and quickly became the standard.
Since the 1970s, new surgical techniques have become popular due to their benefits during and after surgery. Despite efforts to encourage natural birth after a C-section, the rate of C-sections has increased from 5% to 30-32% over the last decade. This increase is due to the perceived safety of the procedure, short-term benefits after birth, legal concerns, and maternal requests.
The rising rate of C-sections has also led to an increase in complications for mothers and babies, with black women being disproportionately affected. While there is a lot of data on diagnosis and management of C-section-related complications during pregnancy, there is less data on how to improve outcomes of gynecological conditions related to C-sections. The authors of this paper call for more research, education, and changes to health policies to address the impact of C-sections on women’s health.
FAQs
- What is the current prevalence of C-sections in the United States and other parts of the world?
- What are the reasons for the increase in the rate of C-sections over the last decade?
- What are the implications of the rising rate of C-sections on mothers and babies, particularly black women?
Doctor’s Tip
A doctor might advise a patient who has had a cesarean section to take care of their incision site by keeping it clean and dry, avoiding heavy lifting or strenuous activity, and following up with their healthcare provider for any signs of infection or complications. It is also important for patients to follow their doctor’s instructions for post-operative care and attend any follow-up appointments to ensure proper healing and recovery.
Suitable For
Patients who are typically recommended for a cesarean section include:
Women with a previous history of C-section: Women who have previously had a C-section are often recommended to have another C-section for subsequent pregnancies, although some may be candidates for a vaginal birth after cesarean (VBAC) depending on certain factors.
Multiple pregnancies: Women carrying twins, triplets, or other multiples may be recommended for a C-section due to the increased risk of complications during vaginal delivery.
Fetal distress: If the baby is showing signs of distress during labor, such as an abnormal heart rate, a C-section may be recommended to deliver the baby quickly and safely.
Placenta previa: This is a condition where the placenta partially or completely covers the cervix, making vaginal delivery unsafe. In these cases, a C-section is usually recommended.
Breech presentation: If the baby is in a breech position (feet or buttocks first), a C-section may be recommended as delivering a breech baby vaginally can be risky.
Maternal health conditions: Women with certain health conditions such as high blood pressure, diabetes, or heart disease may be recommended for a C-section to reduce the risk of complications during labor and delivery.
Umbilical cord prolapse: If the umbilical cord comes out of the cervix before the baby during labor, cutting off the baby’s oxygen supply, a C-section is usually recommended.
It is important for healthcare providers to carefully assess each individual case and recommend a C-section only when it is necessary for the health and safety of the mother and baby.
Timeline
Before a cesarean section, a patient may experience a variety of symptoms such as prolonged labor, fetal distress, breech presentation, placenta previa, or other complications that make a vaginal delivery unsafe. The decision to have a C-section is typically made by the healthcare provider after considering the risks and benefits.
During a cesarean section, the patient is given anesthesia to numb the lower half of their body, and a surgical team performs the procedure to deliver the baby through an incision in the abdomen and uterus. The baby is then carefully removed and the incisions are closed with stitches or staples.
After a cesarean section, the patient will be monitored closely for any signs of infection or complications. They may experience pain, discomfort, and difficulty moving around due to the surgery. It is important for the patient to follow their healthcare provider’s instructions for recovery, including taking pain medication, avoiding heavy lifting, and caring for the incision site.
In the long term, a patient who has had a C-section may have a higher risk of complications in future pregnancies, such as placenta accreta or uterine rupture. They may also experience emotional and psychological effects from the surgery, such as feelings of disappointment or failure if they had hoped for a vaginal birth. It is important for patients to discuss their feelings and concerns with their healthcare provider and seek support if needed.
What to Ask Your Doctor
What are the risks and benefits of having a cesarean section compared to a vaginal delivery?
How will the cesarean section be performed? Will it be a planned C-section or an emergency C-section?
What type of anesthesia will be used during the procedure?
What are the potential complications that can arise during and after the surgery?
How long is the recovery period after a cesarean section? What can I expect during the recovery process?
Will I be able to breastfeed my baby after a C-section? Are there any additional challenges I may face?
Will I be able to have a vaginal birth in future pregnancies after having a cesarean section?
Are there any long-term effects of having a C-section on my health and the health of my baby?
How can I minimize the risks of complications during and after the surgery?
Are there any alternative options to a cesarean section that I can consider?
Reference
Authors: Antoine C, Young BK. Journal: J Perinat Med. 2020 Sep 4;49(1):5-16. doi: 10.1515/jpm-2020-0305. PMID: 32887190