A c-section can save the life of a baby or mother. If health problems come up before or during labor and delivery, a c-section can get the baby out very quickly. Most c-sections result in a healthy mother and baby.
Still, a c-section is major surgery. And all surgeries have risks. These include infection, dangerous bleeding, blood transfusions and blood clots. Women who have c-sections stay at the hospital for longer than women who have vaginal births. Plus, recovery from this surgery takes longer and is often more painful than that after a vaginal birth. So, c-sections should only be done when the health or the mother of baby is in danger. Doctors recommend c-sections when the health of the baby or mother is in danger. Even so, there are risks of delivering by c-sections. Limited studies show that the benefits of having a c-section may outweigh the risks when:
- the mother is carrying more than one baby (twins, triplets, etc.)
- the mother has health problems including HIV infection, herpes infection, and heart disease
- the mother has dangerously high blood pressure
- the mother has problems with the shape of her pelvis
- there are problems with the placenta.
- there are problems with the umbilical cord
- there are problems with the position of the baby (e.g. breech presentation)
- the baby shows signs of distress (e.g. slowed heart rate)
- the mother has had a previous c-section
A growing number of women are asking their doctors for c-sections when there is no medical reason. Some women want a c-section because they fear the pain of childbirth. Others like the convenience of being able to decide when and how to deliver their baby. Still others fear the risks of vaginal delivery including tearing and sexual problems.
But is it safe and ethical for doctors to allow women to make medical decisions? The answer is unclear. Only more research on both types of deliveries will provide the answer. In the meantime, many obstetricians feel it is their ethical obligation to talk women out of elective c-sections. Others believe that women should be able to choose a c-section if they understand the risks and benefits.
Experts who believe c-sections should only be performed for medical reasons point to the risks. C-sections can be dangerous for the mother and baby. This major surgery increases the risk of infection, bleeding and pain in the mother. C-sections also increase the risk of problems in future pregnancies. Women who have had c-sections have a higher risk of uterine rupture. If the uterus ruptures, the life of the baby and mother is in danger. Babies born by c-section have more breathing problems right after birth and are very rarely cut during the surgery.
Supporters of elective c-sections say that this surgery may protect a woman's pelvic organs, reduces the risk of bowel and bladder problems, and is as safe for the baby as vaginal delivery. The American College of Obstetricians (ACOG) is not opposed to elective c-sections. ACOG states that "if the physician believes that (cesarean) delivery promotes the overall health and welfare of the woman and her fetus more than vaginal birth, he or she is ethically justified in performing" a c-section.
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