Written by Tara McLellan
We see the statistics continue to rise. Moms in the United States are having more births by cesarean section than ever before. In fact, preliminary reports from the National Center for Health Statistics state rates rose again in 2006 to 31 percent of all births, an all time high for c-section rates. So why is this surgical option growing for moms-to-be? The answer is…well, there is no one answer.
changing times, changing sizes
One reason for a big push for c-sections might be simply a natural swing in medical opinion, according to Dr. Ellen Kruger, an obstetrician at Ochsner Hospital. “When I was trained at the beginning of my career at Columbia, there was a big push for doctors to encourage vaginal births and vaginal births after c-sections, or VBAC, for additional babies,” says Dr. Kruger. “Now the opposite is true. Many doctors are encouraged to present the c-section option, especially if it is a repeat section rather than face the risks involved with a VBAC. It’s a constant swing of opinion.”
It used to be that when you heard of a bouncing baby boy or girl, most little ones came into the world topping out at seven pounds. These days babies are arriving bigger, and bringing a few more complications at birth for some moms. Our grandparents’ and even our parents’ generations were encouraged to gain only 15 pounds during pregnancy, and social mores did not place the same restrictions on smoking and drinking during those nine months. Consequently, babies arrived smaller. And while babies now often have the advantage of good prenatal care, vitamins, smoke-free and alcohol-free moms, their mom’s bodies are still the same as previous generations. The short of it is, sometimes these babies just get stuck.
In addition to baby’s size being a factor, there are other times an obstetrician might recommend a c-section: if your baby is breech and it is your first delivery; if your baby shows any signs of fetal distress during delivery; or for maternal health reasons, such as pre-ecclampsia or infections. The best option is to always discuss with your doctor his or her philosophy on when they might recommend this option for your own unique case. Eagen Knight of Slidell, mom to two-year-old Riggs, was advised to have a c-section after laboring for 24 hours.
“My baby was never in distress, and there was never a time that I was upset or panicking, but my labor never progressed,” says Knight. “Everything went fine and my eight pound, 14 ounce boy came out perfect. Even my recovery went better than I expected. I was up and walking on the second day.”
the lowdown
Having a c-section might seem to some a little overwhelming and frightening, while to some others a happy, and less painful alternative to a vaginal birth. The truth is that while it is major surgery, it is very safe for both the mother and the baby. Vaginal birth is still the most natural and usually the safest way to deliver a baby, but the c-section can also be a healthy, and even pleasant alternative.
The basics are pretty simple, considering, according to Dr. Katherine Williams, an obstetrician with St. Tammany Parish Hospital. “I advise my patients to whom I recommend a c-section, either before the actual delivery or during, not to worry. Although it is surgery, it’s really not that big of a deal. You won’t feel anything during the procedure, you can be awake to see your baby, and the whole process takes only 30 to 40 minutes.”
If you haven’t already had an epidural, you will meet with your anesthesiologist who will go over what he or she thinks is the best option for your case. Often—as was my case—they’ll do a combination epidural and spinal block. The process is pain free. Your husband or birthing partner will be suited up in some scrubs, a little paper hat and some paper shoes and can stay throughout the entire process. Your doctor will be there, along with a partnering physician assisting.
You can talk, but you can’t feel or see anything of the yucky stuff. Soon your doctor will hold up your baby for you to get a glimpse of that tiny little face. A neonatal nurse will wrap him or her up and take him to the nursery to be warmed while your doctor stitches you up. You’ll be wheeled back to your room where you can get a little rest and hold your new baby. C-sections do not impede with your ability to nurse or feed your infant, so you can get started right away if you want.
Recovery time does take a little longer. “I advise my patients that the first day of recovery is the hardest,” says Dr. Williams. “But once you are able to get up and walk around a little bit, usually on the second or third day, patients usually recover quickly.”
You’ll be in the hospital about three or four days. You can use the time to take advantage of any lactation consultants in the hospital if you choose to breast feed and get tips from the expert nurses on baby care. Your doctor will advise you on after care, which usually just requires a little more rest and some slow return to exercise.
no medal for method
Perhaps the most important thing to keep in mind about delivering a baby via c-section is that your baby come into the world happy, safe and healthy. “As we learn more about obstetrics, have access to more accurate tests, and are able to more closely monitor the baby in utero, the decision to perform a c-section to ensure a healthy baby is easy,” says Dr. Williams. “And in the end, it’s not how we deliver the baby that counts, it’s that the mom and the baby are healthy.”