Nationwide, according to CesareanRates.org, cesarean births makeup statistically 31.7% of all births in 2019. In Nevada, 26.8% of births were by cesarean. The Healthy People 2020 Initiative is to have births in all states have a cesarean rate of 23.9 and below. Known as belly birth, c-section, surgical delivery, and cesarean section, a cesarean delivery of a baby doesn’t come without big emotions, thoughts, biases, and even misinformation.
What is a Cesarean
A cesarean birth is the birth of the baby through the abdomen and uterus by surgical incision. There are elective cesareans. These are situations where the birthing person decides to have a cesarean for reasons that they choose. For some, the idea of knowing when a baby will be born can provide mental, emotional, and or physical comforts.
In some instances, an emergency cesarean is conducted. These situations occur when there is imminent danger to the gestation carrier and/or the baby. This is most often determined and defined by the provider. Maternal exhaustion, fetal distress, excessive cervical swelling, and prolonged pushing, are some examples where an emergency cesarean may occur.
Reasons a Cesarean May Be Done
There are a variety of reasons that a Cesarean may be performed for a baby to safely enter the world. A decrease in or lack of progress in an active labor pattern. In this instance, a prolonged stint engaged in the pelvis may be stress triggering for the baby. Maybe contraction patterns have not picked up in strength or consistency. More commonly, multiple pregnancies are often known to have elective cesareans for the health of babies and the gestational carrier.
Dealings with the placenta, such as: placenta previa (part or all of the placenta covering the cervix), placenta accreta (part of the placenta deeply embedded into the uterus), or a placenta abruption (premature release of placenta from the uterine wall). A breech presentation can be a reason for a necessary cesarean delivery. This is where the baby is in a position other than head down before or in delivery. Umbilical cord being compressed, short, or wrapped around the baby more than the average once is also a cause.
The actions or inactions of the baby or body are not the only deciding factors for a cesarean birth. The birthing person may make the decision for a cesarean for emotional reasons, physical exhaustion, or mental exhaustion. If the gestational carrier is HIV positive or is in a Herpes outbreak, a cesarean birth is the method of delivery safest for the baby. While previous cesareans can heighten the chance of repeat surgical births, it is not always the case or requirement. If one is desiring a VBAC (vaginal delivery after cesarean), they should discuss this option with their provider, and seek out the providers that confidently provide this service.
What to Expect During Birth
During a Cesarean birth, there are particular protocols that come into play to ensure the safety of the birther and the baby. The birthing person is prepped with anesthesia to desensitize the body from chest to feet. The anesthesia methods can be general, epidural block, or spinal block. In the operating room, a sheet is set to divide the birther from the operating area, and keep the area sterile. The support person can support the birthing individual and provide affirmations while at the head of the birther.
The process of a cesarean birth typically can take 30-45 minutes. An incision is made right about the pubic bone in a line or “U-shape”. The incision is made through the layers of skin, tissue, muscle, and uterine lining. Upon the birth of the baby, monitoring is conducted and then the baby is presented to the family. If there is a support person with the birther, they may attend the side of the pediatric nurses while the baby is being assessed. This is a good opportunity to take photos (as permitted). A support person may also stay by the side of the birther while the surgery continues.
As the anesthesia wears off, the birthing person may feel disorientated, nauseous, anxious and with heightened emotions. The recovery of a cesarean delivery comes with an extended watch stay of on average 48-hours to 96-hours. During this time bonding with baby by skin-to-skin and putting baby to the breast to feed are ways to experience an adapted golden hour with baby.
Recovery from Birth
Because a cesarean section is an intervention to birth in the form of surgery, complications can arise. There are precautions that the birth team will adhere to to ensure a safe delivery and recovery of the individual and the baby. Complications that may occur during or after a cesarean delivery can include:
- Blood loss
- Reaction to medications
- Residual nerve effects from surgery
Recovery from a cesarean birth can be straining on the body. Because of the surgery that has occurred, it is important to take note of any infections, redness, fevers, nauseas that arises. Due to the muscle and nerve reactions after a cesarean, it is advised to not operate a motor vehicle for 6-8 weeks, lift anything heavier than the weight of the baby, to limit the usage of stairs. Enlisting support from a partner, postpartum doula, family and friends can aid in a healthy recovery. Both mentally and physically. Follow the providers guidelines on red flags in the postpartum recovery realm. Fevers, nausea, puss, itchiness, foul odors, etc can be an indication of an issue with the surgery.
Birth is filled with emotions, decisions, and options. Understanding that every birth is special. That every birth is unique. And that every birth tells a story helps to dispel the stigma of how birth is “supposed” to be. And instead will allow for unity in parenthood, as opposed to a division in how one gave birth.