Having a baby
Having the baby on your schedule or theirs: The argument against electiveC-sections
Jessica is 29 years old and pregnant with her first child. She was due to deliver on January 6, but she and her husband thought it would be nice to have that tax deduction for the current year so she “scheduled” a cesarean-section (c-section) delivery for the week after Christmas. Although this would make the delivery before the 39 weeks of gestation recommended by the American College of Obstetrics and Gynecologists, when fetal development is complete, her doctor assured her that her baby would be fine.
Jessica, like many women, elected to give birth early, at a time that is convenient for her, other family members or their doctors (after all we don’t want to inconvenience our doctor). I’m only talking about healthy normal pregnancies that are deliberately scheduled to end early, not the c-section deliveries that are medically necessary. Although most cesarean deliveries result in healthy babies, you are, after all, having major surgery and as such it carries risks. To-be moms must be aware of the possible dangers that exist to them and their babies before electing to deliberately have their babies early, because in my opinion, it's just crazy.
“If there are no complications, the healthiest outcome for mother and infant is delivery at 40 weeks.”
Even though complications from cesarean births have decreased in the past 20 years, the risks to the mother still include infection, blood loss, blood clots, a longer recovery period, rehospitalization, and the possibility of damage to internal organs such as the bladder. Also, the incision site causes longer-term trouble for some women. It may not heal properly and need to be reopened.
Now, here’s what can happen to your baby. With each decreasing week below the normal gestation time of 39 to 40 weeks when fetal development is complete, there is an increased risk of complications like respiratory distress, jaundice, infection, low blood sugar, extra days in the hospital (sometimes in the neonatal ICU), and even deaths — U.S. babies born to women with low-risk pregnancies who opted for c-section delivery were more than twice as likely to die as an infant as babies born vaginally.
A study published last year demonstrated that babies delivered at 36 to 38 weeks had 2.5 times the number of complications when compared to those delivered at 39 to 40 weeks. Despite this, many women are still electing to have c-section deliveries even as early as 34 to 36 weeks.
Plus, Moms, be aware that your “calculated” due date can be off by as much as two weeks; you could be mistaken about when you got pregnant or the “dating ultrasound” could be wrong. Many women mistakenly think that weight gain is all that happens during the last weeks of pregnancy, but vital organs like the brain, lungs and liver are still developing, further there are fewer vision and hearing problems among babies born at full term.
Given the risks involved and the increasing numbers of planned deliveries in the USA — estimated at 1 in 3 births — the March of Dimes began a campaign to curb them. The campaign is called, “Healthy babies are worth the weight.”
If you're considering an elective c-section, here are some questions to ask yourself:
- Why do I want an elective c-section delivery? Are any of my reasons solvable? For example, could hypnosis reduce my anxiety about childbirth, or could an agreement on an early epidural alleviate my fear of pain?
- What's does my doctor think about elective c-section deliveries? Is she willing to work with me to help me make a choice, and does she respect my decision as long as it's medically safe?
- Is my doctor recommending a c-section for medical reasons — am I overdue, or at higher risk for complications during vaginal birth? Should I get a second opinion to determine just how at risk I am, and how likely it is I'll end up having an emergency c-section.
- Am I aware of the potential positives and negatives of both elective cesareans and vaginal deliveries so that I can make an educated decision?
Please consider that anytime you have a medical procedure there is a certain amount of risk. As the chief of maternal and infant health at the CDC, Dr. Eve Lackritz, puts it, “if there are no complications, the healthiest outcome for mother and infant is delivery at 40 weeks.”