Dr Michelle O'Driscoll: C-section – the misunderstood way to give birth
One in three babies in Ireland are being born by C-section. Picture: Stock
BIRTH can be magical, overwhelming and unpredictable. It’s a unique experience for every mum; no two birth stories are the same.
While the traditional textbook birth occurs vaginally, this is not always the case.
A Caesarean section or C-section is a surgical procedure during which an incision is made in the abdomen and the womb, through which baby is delivered.
C-sections are conducted for reasons such as baby’s breech or ‘wrong-way-round’ position (most care providers are not experienced in the vaginal delivery of a breech baby), failure for labour to progress, or baby and/or mum getting into difficulty during labour.
Despite one in three babies being born by C-section in Ireland (a rise of 50% since 2000), it’s a procedure that comes with many misconceptions, some of which are addressed below.
Yes, a C-Section CAN be a positive experience C-sections are traditionally associated with cold operating theatres, a crazy atmosphere, and baby being whisked away immediately, not to be seen for hours. There certainly are cases where the medical team need to get baby out as soon as possible, and the sense of urgency will be palpable (and potentially quite traumatic), leaving parents with a lot to process physically and emotionally.
Thankfully however, this is not always the case. Some C-sections are scheduled, and others, although labelled ‘emergency’ C-section, do not automatically mean panic stations. In these cases there is the potential for a C-section to be a very positive experience, with lots of scope for taking some control over how it all plays out; time to prep you and your partner, talk you through the process, and maintain a calm atmosphere.
Small things like immediate skin to skin being facilitated, the drape being lowered to see baby being born, and breastfeeding being started sooner rather than later if that is mum’s wish can all help contribute to this.
There is no ‘easy way’ to bring a baby into the world. There is recovery involved regardless of the route.
C-section recovery can be painted as a ‘stroll in the park’ compared to a vaginal birth. However, it does not come without its own discomforts and challenges. The seriousness of a C-section procedure should not be underestimated. It is major abdominal surgery, with risks including infection, haemorrhage, or injury to bladder or bowel during surgery, as well as potential respiratory issues for the baby Post-section, you’re unable to leave your bed due to the spinal block that you receive, sometimes until the following morning.
You require a longer stay in hospital, and once you get home you are very restricted in terms of being able to lift anything (including other children). C-sections also lead to a period of six weeks where you’re not allowed to drive, as using the brakes suddenly could cause the wound to split. You don’t escape the post-partum bleeding typically associated with vaginal birth (albeit possibly not as heavy) and pain around the scar can last for weeks or months. Nothing about any of this sounds like ‘the easy way out’ there is no ‘easy way out’ when it comes to childbirth!
No, it is NOT automatically ‘Once a section, always a section’
So for whatever reason, you’ve had to give birth by C-section. What does that mean for future pregnancies? There is a misconception that once you’ve had one C-section, you’re automatically required to birth future babies that way. While this was historically the school of thought, it is certainly no longer the case if you do not wish for it to be so.
Subsequent births after a section require a decision to be made with your care provider about whether to attempt a vaginal birth or not. Your suitability as a candidate for a VBAC (Vaginal Birth After Caesarean) is assessed, and if eligible you are given the choice between attempting a vaginal birth or scheduling a repeat C-section. This decision is an incredibly personal one, and needs to be the one that’s right for you, your baby and your family.
It involves the weighing up of risks and benefits for both options. The expertise and support available to facilitate a VBAC has improved, and it is something that more and more women are now successfully availing of.
C-sections come with lots of emotions to wade through; you spend much of your pregnancy planning how you want your birth to go, and a C-section can often come from left-field.
Women may feel disappointed that they either didn’t get to experience labour at all, or that their labour didn’t end in the vaginal birth that they wished for. They may grieve the birth that they wanted, but didn’t get to experience.
For others who chose C-section due to medical advice and personal circumstances, their decision can feel like one that is judged, or makes their birth story less valid. Common throwaway comments that you were ‘too posh to push’ or that baby ‘came out through the sunroof’ undermine a woman’s birth experience during an incredibly vulnerable time.
A woman who delivered her baby via C-section still carried her baby for up to 42 weeks, single handedly grew that baby by providing the oxygen and nutrients it needed, overcame all of the risks and dealt with the recovery associated with major abdominal surgery while looking after a tiny new human being.
She gave birth with strength and love, just by another route.
This decision is an incredibly personal one, and needs to be the one that’s right for you, your baby and your family.
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