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What You Need To Know About C-Sections

What is a C-Section

Cesarean delivery (C-section) is a surgical procedure used to deliver a baby through incisions in the abdomen and uterus. A C-section might be planned ahead of time if you develop pregnancy complications or you've had a previous C-section and aren't considering a vaginal birth after cesarean (VBAC). Often, however, the need for a first-time C-section doesn't become obvious until labor is underway.

If you're pregnant, knowing what to expect during a C-section — both during the procedure and afterward — can help you prepare.

Why it's done

Sometimes a C-section is safer for you or your baby than is a vaginal delivery. Your health care provider might recommend a C-section if:

  • Your labor isn't progressing. Stalled labor is one of the most common reasons for a C-section. Stalled labor might occur if your cervix isn't opening enough despite strong contractions over several hours.

  • Your baby is in distress. If your health care provider is concerned about changes in your baby's heartbeat, a C-section might be the best option.

  • Your baby or babies are in an abnormal position. A C-section might be the safest way to deliver the baby if his or her feet or buttocks enter the birth canal first (breech) or the baby is positioned side or shoulder first (transverse).

  • You're carrying multiples. A C-section might be needed if you're carrying twins and the leading baby is in an abnormal position or if you have triplets or more babies.

  • There's a problem with your placenta. If the placenta covers the opening of your cervix (placenta previa), a C-section is recommended for delivery.

  • Prolapsed umbilical cord. A C-section might be recommended if a loop of umbilical cord slips through your cervix ahead of your baby.

  • You have a health concern. A C-section might be recommended if you have a severe health problem, such as a heart or brain condition. A C-section is also recommended if you have an active genital herpes infection at the time of labor.

  • Mechanical obstruction. You might need a C-section if you have a large fibroid obstructing the birth canal, a severely displaced pelvic fracture or your baby has a condition that can cause the head to be unusually large (severe hydrocephalus).

  • You've had a previous C-section. Depending on the type of uterine incision and other factors, it's often possible to attempt a VBAC. In some cases, however, your health care provider might recommend a repeat C-section.

Some women request C-sections with their first babies — to avoid labor or the possible complications of vaginal birth or to take advantage of the convenience of a planned delivery. However, this is discouraged if you plan on having several children. Women who have multiple C-sections are at increased risk of placental problems as well as heavy bleeding, which might require surgical removal of the uterus (hysterectomy). If you're considering a planned C-section for your first delivery, work with your health care provider to make the best decision for you and your baby.

For many women, C-sections are seen as the ‘safer’ option, however, research shows that C-sections pose a much greater risk to the mother than vaginal deliveries, with potential problems including damage to the bladder, infection, heart attack or kidney failure. Women are twice as likely to experience a severe hemorrhage following a C-section compared with a vaginal birth. Bleeding out after giving birth is one of the leading causes of childbearing related death.

Possible cesarean delivery complications:

Some possible complications of cesarean deliveries are as follows:

  • post-surgery infection or fever

  • too much blood loss

  • injury to organs

  • emergency hysterectomy

  • blood clot

  • reaction to medication or anesthesia

  • emotional difficulties

  • scar tissue and difficulty with future deliveries

  • death of the mother

  • harm to the baby

Harsh Impacts On The African American CommunityDespite these risks – and despite what the Centers for Disease Control and Prevention (CDC), the US health protection agency, calls a “complex national problem” of Black maternal deaths – the evidence is clear. Black mothers consistently undergo caesareans more than white mothers, even in low-risk situations. And as a result, we’re more likely to suffer for longer after birth, to struggle to fully recover, or to die.

One factor driving these disparities is the extensive use of C-sections in the US. In 1970, the rate was a mere 5%. By 2019, it had risen to more than 30%. The increase hasn’t led to an improvement in outcomes. And the overall figure hides a racial disparity: the rate of C-sections for Black women is higher (35.9%) than for white women (30.7%).

African American women are significantly more likely to have a cesarean delivery than other women. This has been documented in single-hospital studies,1–3 in large cities, in regional systems, and in large state-wide or national data sets. These findings extend from data gathered in the early 1990s to more recent periods, and the disparities in cesarean use show no sign of reduction.

The care received by African American women may differ because of differences in the interaction between patients and providers or hospitals. In such a mechanism, African American women may face obstacles in communicating their preferences for maternity care to their providers, or those providers are less likely to act on communicated preferences. Third, patient preferences may play a role in producing observed differences in the care received by different racial/ethnic groups.

Advocating For Yourself

Having a baby is arguably the most vulnerable yet empowering time of your life. Which means it’s extremely important to know how to advocate for yourself and have true confidence in your abilities.

Remember: you are powerful, confident, and you know you and your body better than anyone. And you can advocate for yourself and use your voice at every opportunity throughout your pregnancy.

But sometimes, it’s not that easy. So for anyone wondering how, here are five simple ways you can advocate for yourself during pregnancy and postpartum.

Do your research

Not kidding, look up everything you can about having a healthy pregnancy, labor, delivery and postpartum experience.

Next, check out the reviews online about your doctor and the hospital you will be delivering at. Investigate anything that concerns you - reach out to other women who have delivered there, and ask lots of questions. The key here is to feel extremely confident and comfortable with your provider and the hospital.

Ask a million questions

If you have questions do not be afraid to ask them. Start by making a list of a minimum of three different questions to ask at each and every prenatal visit. Then, create a separate question list for labor and delivery that focuses on your birthing experience, what to expect, and how you would like it to look.

Don’t forget to make a birth plan, too. This will let your medical team know your labor and delivery preferences when it comes to things like pain management, postpartum care, and newborn procedures. Although we all know things don’t always go as planned, it’s great to have a guideline.

Own your health and listen to your body

You know your body better than anyone else, so listen to it! If something does not feel right, speak up. If you are concerned, seek a second opinion. If you receive inadequate care, make a formal complaint.

Pay close attention to your body, your baby, and how you feel at all times - especially during postpartum. After birth, most women are sent home and told to return in six weeks. During this time, it’s especially important to advocate for yourself by calling your doctor immediately if something doesn’t feel right.

Feel free to breakup at anytime

Breakups are never fun, but making sure you’re getting the experience and care that you want and deserve is far more important. If your medical team is not making you feel heard, if you don’t trust their abilities, or if the chemistry is not there, it is more than okay to find someone else.

Remember: you should never have to settle when it comes to medical care.

These ways to advocate for yourself during pregnancy and postpartum will help you prioritize the experience you want. The goal is for you to feel empowered, confident, and ready to advocate for yourself and baby if faced with tough decisions.

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Hi, thanks for stopping by!

Nicole Grant-Williams is a Wife, Mother of two, Certified Doula, Founder of The New Jersey Doula Association, and Co-Founder of the Great Preparations Program.

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