Pros and cons of cesarean section. Are there often negative consequences?

A cesarean section is one of the birthing topics that frequently generates a lot of conversation. While some may view it as an essential medical procedure, others may question whether it’s always the best choice. Expectant parents can make more informed decisions about their birth plans if they are aware of the benefits and drawbacks of having a C-section.

Having a cesarean section has obvious advantages, particularly when complications develop. For both mother and child, this procedure may save their lives. Like any surgery, there are risks involved, though, and they shouldn’t be disregarded. Individual differences exist in recovery times, possible complications, and long-term effects.

It’s critical to consider the advantages and disadvantages of a C-section and to be mindful of any potential repercussions. In this manner, parents can feel more confident in their choices and better prepare for the possible outcomes.

To whom the operation is shown?

An alternative delivery technique called a Caesarean section involves making incisions in the uterus and anterior abdominal wall to deliver the baby instead of the conventional manner. Even though the procedure is widely performed and seems straightforward, it falls under the category of intricate surgical abdominal interventions. As a result, at least in state clinics, perinatal centers, and maternity hospitals in Russia, it is not performed upon request. The option to perform an elective caesarean section (an operation the woman requests) is available at very few private clinics. Such a service costs approximately half a million rubles in these clinics.

The Russian Ministry of Health has established and approved a list of circumstances in which giving birth surgically is both safer and more rational (see Ministry of Health of Russia letter No. 15-4/10/2-3190 from 2014). Therefore, in the following circumstances, a planned caesarean section is advised.

• low location of the placenta with complete overlap of the internal os or incomplete overlap, as well as presentation with signs of detachment and bleeding;
• premature detachment of the "baby"s place" from the uterine wall, while the location of the placenta does not matter;
• two births performed by caesarean section in the past, as well as any operations on the uterus if scars remain after them;
• the weight of the fetus is more than 3.6 kg with an incorrect position of the child in the uterine cavity (sitting, located transversely);
• incorrect positioning of one baby from twins;
• multiple (often singleton) pregnancy that occurs after IVF;
• post-term pregnancy (at 41-42 weeks of gestation), if other methods of labor stimulation have not had an effect;
• any mechanical obstacles to passing the child along the birth canal – tumors, large groups of polyps, scars after ruptures of the cervix;
• the condition of the severe form of gestosis (with edema, a large weight gain, signs of increasing blood pressure);
• The ban on attempts (with myopia, some diseases of the cardiovascular system, transplanted donor kidney and t. D.);
• the condition of acute oxygen starvation of the fetus (any origin);
• falling of the umbilical cord;
• Genital herpes of the primary type;
• HIV infection in the mother, if during pregnancy, a woman for some reason did not receive supportive treatment;
• a narrow pelvis, in which independent childbirth will be difficult;
• impaired blood coagulation of the mother, fetus;
• malfunctions of the baby – omfalocele, gastroshizis, etc.

There are more signs that an emergency operation is necessary. A woman in labor will undergo an emergency unplanned operation in which she experiences unexpected weakness in her fights during childbirth, cervix not opening, secondary weakness of attempts noted, placenta exfoliation, and opening of the bleeding. The purpose of this procedure is to preserve the mother’s life and that of her eagerly anticipated child.

Technique

Anesthesia is used during the procedure. The patient is fully entitled to choose general anesthesia, which will put her to sleep through all surgical procedures. However, the majority of surgical births performed in Russia today take place under spinal or epidural anesthesia, a procedure in which a lumbar puncture is used to inject anesthetic medications into the subarachnoid or epidural space of the spine. Since there are very few contraindications to general anesthesia and it induces unconsciousness more quickly, it is typically administered during an emergency cesarean section, when every minute counts.

The surgical team starts the procedure after administering general anesthesia or anesthesia to the woman. In a planned intervention, they attempt to make a lower uterine segment horizontal incision in the abdomen, just above the pubis. If the child is in critical condition during an emergency procedure, a vertical incision through the navel can be made in the center of the abdomen.

The physician opens the abdominal cavity, making room for additional "maneuvers" by pushing the bladder and muscle tissue aside. Next, they puncture the amniotic sac, make an incision in the uterus, and remove the amniotic fluid. The baby’s head is then cautiously removed by the surgeon through the created incision.

After the baby’s umbilical cord is severed, neonatologists are given custody of them. The woman’s uterus is progressively repaired, starting with the internal organs and moving on to the abdominal cavity, muscles, and bladder, finishing with the external skin being sutured or stapled back into place.

A mother will be able to see her child right away if she is not under general anesthesia. The meeting will be rescheduled to occur just a few hours after the birth if she is sound asleep.

After the procedure, a new mother spends a few hours in the intensive care unit before being moved to a regular ward’s postpartum department, where she can start to sit, stand, and walk eight to ten hours later.

When a natural birth presents risks, a cesarean section, or C-section, can be a safe and effective procedure that saves both the mother and the baby’s lives. Like any surgery, there are advantages and disadvantages to it. On the plus side, it can avoid difficult labor and delivery; however, it can also result in more recovery time, infections, and other health problems. Even though many women have C-sections without any serious complications, being aware of any potential drawbacks is crucial to helping you make an informed choice.

Advantages

One comparatively predictable result of the intervention is the undeniable benefit of a cesarean section. There is very little chance that the mother or the child will sustain birth injuries. Since the child does not have to fit through a narrow birth canal, there is almost no possibility that he will suffer a head or neck injury during the surgical delivery. In contrast, a natural birth would be much more likely to result in injuries to both the mother and the newborn if the mother had a narrow pelvis or if the baby was large and presented breech.

Women who are not suitable candidates for vaginal birthing can become mothers through a caesarean delivery. Additionally, a woman can now have as many children as she desires thanks to advancements in surgical techniques and the quality of suture materials.

The most terrifying thing for pregnant women is the pain of labor, which is avoided with a caesarean section but leaves lasting memories. Although it’s more psychological in nature, laboring women are somewhat afraid of what happens when they use epidural anesthesia.

When general anesthesia is administered, the woman just goes to sleep and awakens as a mother.

With the help of spinal or epidural anesthesia, it is possible to address a long-standing injustice: a woman now has the opportunity to see her unborn child as soon as it is taken out of the womb and to nurse it to full term, which is crucial for the early onset of lactation and successful breastfeeding.

When performed as planned, a cesarean section does not leave the patient’s abdomen with jagged, deformable scars. Physicians make every effort to guarantee that the suture is small, barely perceptible, cosmetic, and placed in a region that is typically well covered by swimsuits or underwear. If the woman chooses to have more than one child, the same scar is used for every operation; new scars on the uterus and abdomen do not form.

Further surgical maneuvers can be carried out following a cesarean section. Tumors in the uterus can be removed at the same time as the fallopian tubes are tied if lifelong contraception is required.

While natural labor can last up to a day or longer, surgical labor typically lasts no longer than 45 minutes.

Disadvantages

A cesarean section is always a drastic alteration to the way a woman’s body functions; it is not a natural birth. When an operation is planned, the mother’s body is frequently not yet ready for childbirth because contractions have not started. As a result, the mother’s and the baby’s bodies are under a great deal of stress when the baby is extracted via the abdomen.

Even in the case of spinal anesthesia, the medications used by anesthesiologists to alleviate pain during surgical procedures have an impact on both the mother and the unborn child. Since a baby born with surgical assistance is inherently more inhibited and sluggish due to the anesthetics and muscle relaxants given to the mother, it is theoretically impossible for him to score nine points on the Apgar scale. But this effect fades after a few hours.

The infant is denied the chance to follow the path that nature has planned for him; he is unable to overcome the genital tract’s resistance in order to be born, which some experts believe is bad and will undoubtedly have an impact on how his character develops later in life. Accordingly, it is asserted that these kids lack initiative, are fearful of challenges, and are less resilient to stress.

Although there are still many unanswered questions, it is undeniable that a baby that does not pass through the birth canal will not have the chance to gradually adjust to the new environment it will have to live in.

The arguments made by some opponents of cesarean sections that the children have developmental delays as they grow up, require special education, and get sick more frequently are unfounded and cannot be viewed as a drawback.

Due to its complications, caesarean sections are risky and several times more likely than physiologically independent childbirth. After childbirth, the recovery and rehabilitation phase lasts much shorter, and breast milk arrives several days later. If done, fallopian tube bandaging prolongs the duration of the procedure and the period during which a woman’s body is restored.

It is not advised for a woman to become pregnant again for more than two years following a cesarean section, but this is not the case after a natural birth. Lifting weights is dangerous, and taking care of a newborn and regular household chores become extremely challenging when domestic helpers are unavailable.

Of course, the risks associated with the procedure are not greater than the benefits, but even so, you can never be certain that difficulties and unfavorable outcomes won’t arise.

Probability of complications

Any time during and after the procedure, complications could arise. During surgical manipulations, there is a risk of bleeding from the anterior abdominal wall’s vessels, as well as mechanical injury to the bladder, ureters, and intestines if the vascular bundle is damaged. In the event that complications emerge during the procedure, the woman will be admitted to the resuscitation department rather than the intensive care unit, where she will receive the necessary medication, have her condition monitored for several days, and receive blood transfusions if needed. Such complications occur no more frequently than 0.01%.

Hazardous outcomes may also result from postoperative hemorrhage and decreased uterine contractility (hypotension or atony of the reproductive organ). In this situation, medical attention will be necessary, and if the uterus does not shrink or its muscles do not respond to contractile drugs, then surgical intervention may be necessary.

Infectious inflammation is a serious vital complication following cesarean section. The new mother may die as a result of it. Inflammatory infectious complications can manifest as fever, pain in the abdomen, unusual discharge, open wounds, and elevated leukocyte counts in a blood test. Endometriosis, or inflammation of the uterine endometrium, typically arises following surgery, though other circumstances are not unheard of. Peritonitis is the most hazardous of the possibilities. In actuality, these complications occur in only 0.7-9% of cases due to the sterility of contemporary operating rooms and the accuracy of the surgical team.

The short-term effects of anesthetics pose a risk to the child because they can cause respiratory failure in 0.003% of cases. If the intervention was carried out at 36 weeks of pregnancy or earlier, respiratory failure occurs in newborns far more frequently; however, the reason for this is no longer the operation itself, but rather the gestational immaturity of the fetal lung tissue.

A well-structured postoperative period is crucial.

A woman runs the risk of never becoming a mother again if the doctor’s instructions and recommendations are not followed. This is because an insolvent scar will form on her uterus, making it impossible for her to conceive.

When a natural birth is not feasible or presents risks, a cesarean section provides a safe alternative that can save the mother’s and the baby’s lives. Many women value being able to plan their birth, as it eliminates the uncertainty of labor. But it’s crucial to keep in mind that it’s still a significant procedure with risks of its own.

Cons: Compared to a vaginal birth, recovery from a cesarean is typically more difficult and takes longer. Further complications include blood clots, infections, and problems conceiving in the future. Before making any decisions, women should carefully consider these factors and have a thorough discussion with their healthcare providers.

Ultimately, the specific circumstances of the mother and child will determine whether or not a cesarean section is the best option. Knowing the benefits and drawbacks enables families to make well-informed decisions that put their members’ health and safety first.

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