Elective Cesarean Delivery – Causes, Risks & More

Elective C-Section – Reasons, How to Prepare & More

Many of you may have heard of mothers who have chosen to go in for a C-section for a myriad of reasons. Sometimes, you or your child might have a health concern that necessitates a C-section. While both natural birth and C-sections have their pros and cons, it is best that you understand the full implications of one or the other.

Video : Should You Have an Elective C-Section?

What Is an Elective or Planned C-Section?

A C-section is where the baby is delivered through surgical means. An incision is made on the stomach and uterus and the baby is then removed. An elective or scheduled C-section is where the mother chooses to have her baby delivered for multiple reasons that could be medical or otherwise.

Why Do Women Choose to Have an Elective C-Section?

There are many reasons for choosing to have an elective or planned C-section. These broadly fall into two classifications – medical and non-medical reasons.

Medical Reasons

Some medical reason will manifest early enough in the pregnancy for a C-section by choice by both the mother and her doctor. Others might crop up just before or during labour where the benefits of elective C-section far outweigh the risks of complications.

  • Prolonged labour: If the labour extends beyond 20 hours for a woman with her first delivery or more than 14 hours in case of a previous delivery, then it is classified as stalled labour. In such a case, the doctor might advise having a C-section in order to minimize further risks.
  • Positioning: Babies are supposed to be delivered head first. However, some babies will be in the reverse direction or in breech. In such a case, a C-section will be the best option to deliver the baby safely.
  • Foetal distress: Your doctor might call for emergency C-section if the foetus’ oxygen supply is becoming too low.
  • Congenital defects: In case the foetus has been observed to have birth defects like excess fluid in the brain or heart conditions, then your doctor will recommend a C-section to minimise any trauma during birth.
  • Previous C-section: Most mothers can give birth vaginally after having a C-section. However, this might not be true for all women. A discussion with your doctor will tell you more about if you can give birth vaginally.
  • Mother’s health: In case the mother has some chronic condition such as a heart condition, or gestational diabetes, then a vaginal birth could be harmful to her. If the mother has HIV or genital herpes, or any other disease that could transfer to the baby during vaginal birth, the doctor will opt for a C-section.
  • Cord prolapse: When the cord slips out before the baby, then the condition is known as cord prolapse. This can be dangerous to the baby’s health as the blood flow to the baby can be seriously compromised.
  • CPD: Cephalopelvic disproportion is when the mother’s pelvis is too small to push out the baby or the baby’s head is too big for the birth canal.
  • Problems with the placenta: In some cases, the placenta might entirely cover the cervix or become detached from the uterine wall which causes the baby to lose its oxygen supply.
  • Multiple births: Most cases of multiple births come with a host of other complications like prolonged labour or abnormal foetal position. In such cases, a C-section will be the safest way to deliver.

Doctor doing Blood tests for Pregnant women to check her health

Other Reasons

There are many other non-medical reasons why a woman would get a C-section by choice.

  • One of the main factors is the worry that the pain of a vaginal birth would be unbearable to the mother.
  • A previous history of UTI might cause concern over incontinence issues after vaginal birthing.
  • The woman might choose to get a planned C-section if her partner is not going to be present around the due date.
  • An important event or function might be at the time of the due date.
  • A C-section will ensure that their own doctor and not a duty doctor will deliver their child.
  • A woman might be embarrassed to let others see her give birth.

Possible Risks of Planned Caesarean Delivery

While opting for a C-section might seem to be a simple decision on paper, in reality, there are many risks associated with the surgery to both the mother and the foetus.

Risks for Mother

  • A C-section is a major surgery that must be done under anaesthesia.
  • Excessive bleeding is a common complication.
  • The chances of contracting an infection during a C-section is much higher than in a vaginal birth.
  • The recovery period for a C-section is much longer than vaginal birth. The former takes weeks to recover from with difficulty in moving while most mother report being on their feet within a day of vaginal birth.

Risks for Baby

  • In some rare cases, the baby might be born with serious respiratory distress. This usually happens when the C-section is planned for earlier than 39 weeks due to incorrect calculation of the due date.
  • Some practitioners have stated that it could affect the bond between the mother and baby as they will be separated during recovery. However, there haven’t been enough studies to corroborate this.

Elective Caesarean Section vs. Natural Birth

There are many pros and cons of both a C-section and vaginal birth.

Vaginal Birth: Pros

  • Lesser time spent at the hospital
  • Lesser chances of complications
  • She can immediately nurse her baby
  • Lesser chances of the baby having respiratory issues

Vaginal Birth: Pros: Can immediately nurse her baby

Vaginal Birth: Cons

  • Some cases of vaginal birth have tearing that require stitches
  • Higher chances of incontinence and loss of control of the bowel
  • Lingering pain in the area between the vagina and anus.

C-Section: Pros

  • A scheduled birth with time to prepare for the birthing
  • No prolonged labour
  • No chances of injury to the birthing canal

C-Section: Cons

  • Longer recovery period
  • Chances of complications are higher
  • Chances of vaginal birthing later might be reduced
  • Higher chances of asthma or other breathing issues with the baby.
  • Higher chances of the baby being stillborn.

What About the Pain of Labour of Childbirth?

If you are concerned about the pain that will accompany the labour of vaginal birth, then you must discuss the same with your OB/GYN. She will be in a position to discuss your various pain management options including an epidural. You could also inform the birthing staff to give you the pain medications as soon as it is safe to do so.

Pregnant women consulting with Gynaecologist

You could also talk to other women who have had a C-section and talk to them about the pain of recovery post the surgery.

What About Tearing?

Far fewer women suffer from vaginal tearing during natural birth than you think! While most women do experience some form of tearing, it is usually of a small nature that will heal well either by itself or with a few stitches. More than 97% of mothers who have had natural births have had vaginal tears that have healed perfectly. In case you are still worried, make sure you choose an OB/GYN who does not use forceps or cuts the episiotomies which increase the chances of vaginal tearing.

How to Prepare for Planned C-Section?

Planning for an elective C-section will remove much of the stress and will allow you to be discharged early. You will most likely have an appointment at the hospital of your choice the day before the planned C-section.

The Day Before Surgery

  • Your doctor will explain the surgery to you such that you understand the entire procedure.
  • You can have a large meal that is high in carbohydrates.
  • Your last snack should be at 10 pm after which you must have your pre-medications.

Some doctors will ask that you get admitted to the hospital the day before your scheduled C-section. This is to ensure that all routine work is done ahead of time such as blood tests.

The Day of the Surgery

  • You must not consume any food for up to eight hours before your scheduled surgery. This means no biscuits or toffees.
  • You must not consume water for up to two hours before surgery.
  • Two hours before surgery, you will be asked to drink water and your pre-medications.
  • An anaesthetist will see you in the ward to determine the dosage required.

After the Surgery

  • You will be given something to eat and drink in the recovery area where you will stay for at least one hour.
  • The urinary catheter will be removed after a few hours.
  • You will be encouraged to be mobile within six hours after returning to the ward. This will help you heal faster.
  • You will be given and shown how to administer your pain medications.

Things to Remember

You must remember to carry certain things with you to the hospital to ensure a comfortable stay and quick recovery. Either you or your partner can be responsible for this task.

  • A set of warm clothes is very important as it will decrease your chances of any post-surgery infections. This includes slippers that are warm.
  • Maternity pads can be bought at the hospital pharmacy. However, it is best to be prepared beforehand as the pharmacy might run out of its supply.
  • Formula for your baby if you are choosing to bottle feed. Discuss this with your doctor and choose a brand that is best suited for your baby.
  • Baby clothes to keep your little one warm.
  • You might want to carry nappies for your little one as some pharmacies do not stock these.

Elective C-sections have many pros and cons and you must make a responsible decision after discussing the various options with your doctor. You must weigh-in the benefits and risks not only for your health but also your baby’s. Talk to mothers who have had vaginal births as well as mothers who have had C-sections and ask them questions to make a more informed decision. Your doctor will be able to help you get in touch with other mothers who may be able to share their experiences with you.

Also Read: C-Section Scars – An Overview

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