The Pros and Cons of Elective Cesarean Birth

Valerie was a client of mine six months ago, but it became clear within the first few minutes of our initial interview that she would probably prefer an obstetrician as her care provider. "I want to have a cesarean," she stated in a matter-of-fact manner. "I want to 'stay tight,' and I don't want to be incontinent when I'm 40."

The very same week, another woman, at 37 weeks, declared that instead of submitting to intravenous antibiotics during labor for a positive group B strep culture, she would request a cesarean birth. "I've been doing some reading," she commented. "I don't want my baby exposed to antibiotics. I understand that if I have a cesarean, I won't need them."

The Risks of Cesarean
Cesarean birth can save the life of mother and baby, but it can also present significant risks both at the time of surgery and in the future. For the mother, in comparison to vaginal birth, cesarean increases risk of:
-- Prolonged recovery
-- Pain
-- Breastfeeding problems
-- Urinary, wound and uterine infection
-- Hemorrhage
-- Clotting disorders and blood clots
-- Bowel obstruction

Feelings of failure, depression, infant attachment disorders and marital and family dysfunction accompany cesarean birth to a greater extent. Long-term consequences of cesarean birth include:
-- Chronic depression
-- Emotional distress
-- Sexual dysfunction
-- Chronic pelvic pain
-- Infertility
-- Ectopic pregnancy
-- Premature separation of the placenta in a subsequent pregnancy (abruption)
-- Low-lying placenta (placenta previa)
-- Uterine rupture, whether spontaneously or in labor or in a subsequent pregnancy, with its related risks of hemorrhage, emergency surgery and fetal and maternal death

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