10 More Reasons C-Sections Are a Big Deal

First, we talked about 16 reasons c-sections are a big deal. Here are ten more reasons that OBs should work to decrease the 1 in 3 statistic.

  1. Because of these additional mental and emotional challenges, bonding is going to be harder. It’s hard to feel safe, warm and loving when all you feel is jittery, looming fear.
  2. Virtually no follow-up care or resources. Speaking of your OB potentially not knowing how to help you with PTSD or PPD (seriously,  PPD has been recognized publicly for years) your OB might also fail to give you resources on taking care of your body post surgery. Did you know that postpartum you only get one follow-up visit with your doctor at six weeks post birth? That’s whether you delivered vaginally or via surgery. Honestly, either way it sounds like way too little care, but can you imagine having any other kind of huge surgery and your doctor seeing you only once, six weeks later, to check the outermost incision? That appointment will last about seven minutes, and includes your doctor pulling down your pants to press their hands up against your incision and say, looks good to me! They might tell you not to exercise for a while, and then only to start with light exercise, they might not. If pressed for specifics, that’s about all you’ll get. But when, and what exactly can you do? Again, they won’t offer specifics because they don’t really know and they don’t want to get sued if you hurt yourself, so you’re kind of on your own. They won’t refer you to physical therapy unless you ask about it, and they won’t really think it’s necessary. They won’t tell you that in order to deliver vaginally next time that they will want you to wait 18 months before you get pregnant again. They won’t ask if you plan on becoming pregnant again. They will tell you that you are cleared to have ravaging sex. They won’t tell you how long to expect lochia (vaginal bleeding). They probably won’t tell you anything to look out for in terms of potential infection or other life-threatening problems post-csection. They won’t check for any kind of prolapse because that’s not their expertise (I still don’t understand why it wouldn’t be) and perhaps because you didn’t deliver vaginally, even though many prolapse cases happen after pregnancy in a variety of birth positions and situations – vaginal and surgical. (Although, I hear many OBs don’t check for prolapse regardless of how someone births – it’s just not part of their well-woman care… Ahem.) I have a whole post coming on what to expect at that 6 week appointment, in addition to another one on prolapse after csection.
  3. You might feel ashamed and feel that you didn’t really give birth. Of course you did, but there’s something to be said about having a baby pulled from your womb by strangers instead of you pushing her out. The power really is in someone else’s hands. Something that could feel thrilling, alive, extremely personal, miraculous and powerful, can instead feel completely impersonal and sterile… like a surgery an OB has done hundreds of times. Not always, but that could be your experience. It’s a very different experience than a vaginal birth, and it brings up a lot of feelings that people don’t usually talk about other than at ICAN meetings. Unfortunately, some people will use this as excuse to look at you smugly and say, but you didn’t have to give birth. Those people don’t know what they’re talking about.
  4. Isolation. You might feel a lot of things that you feel unable to talk about. Two out of three mothers will have had a vaginal birth, and you are outside of this group. You might have feelings of being an outsider or not truly being part of the “mom club.”
  5. You’re even more financially strapped. Csections cost more for insurance companies and more out-of-pocket than vaginal births. My csection, for instance, was about $4000 out of pocket. For vaginal birth I was told I would owe nothing out of pocket. Doctors, and especially hospitals, pharmaceutical companies, and medical device companies do make more money off of c-sections and your body.
  6. You might end up with another surgical birth, particularly if you go to the hospital for that birth. And then you’ll have a newborn and toddler to take care of post-surgery. VBACs (vaginal birth after cesarean) are becoming more common, thanks to wider access to research statistics on uterine rupture (it’s about a .4% chance – that’s right, less than a 1% chance of happening.) Of those .4%, many moms and babies are alive and healthy. OBs are still very fond of making this risk seem astronomical and will even use the phrase “extremely dangerous” when talking about VBACs. That’s not actually at all accurate, given the statistics. They wouldn’t talk about any other one percent risk as extremely dangerous, would they? For instance, did you know during the first few weeks of pregnancy you have almost a 20% risk of miscarriage? Yes, almost one in four pregnancies will miscarry. Doesn’t that sound much more likely and “dangerous” for your baby? Do you know what OBs do to mitigate that risk? Most do nothing. Why? Because they probably won’t get sued for it. That’s why some practices won’t even see women until after the first trimester, when they can get out of that messy, high miscarriage-potential window. The thing is, even though VBACs are actually considered safer than a repeat csection by ACOG, hospitals have interpreted prior ACOG suggestions to warrant a full surgical staff ready, round the clock, in L&D departments ready to receive VBAC patients. Some hospitals argue that that’s too much to spend. (Strangely, they don’t argue having to put down money to keep their trauma centers open.) So they don’t spend the money on staff, and say they don’t do VBACs. I have a whole other article about this here. To me, this makes this an inherently not female-friendly decision, besides being a pretty transparent excuse. They do not care how that baby comes out. Hospitals also care A LOT about making money. Even those non profit hospitals. I’ve worked in hospitals and so has my family, and trust me, most of their meetings are about their bottom line. They’re a business first, after all. And you know what makes a ton more money than women birthing vaginally? Surgery. Csections.
  7. Your next pregnancy will be full of red tape. And the more csections you have, the more “high risk” (read: high litigation risk) you will be in the eyes of the hospital system. You basically now have a big black mark on your chart that screams “potential liability.” Expect your next doctor to find just about any reason to convince you to have another c-section so they can feel safer in reducing their liability.
  8. You actually do have a higher risk of having future pregnancy and delivery complications now, thanks to your c-section. Your doctor might not have explained this to you at all, because OBs like to make c-sections sound like a breeze, (so fun for them!) but in illegally foregoing informed consent, they’ve illegally failed to tell you the medical risks involved in having a primary csection – and there are a few. For instance, a much higher risk of maternal mortality undergoing a c-section vs a vaginal birth. (Likely, they didn’t tell you that before your first c-section.) Read my article here on c-section risks/consequences your provider might not have told you about. In addition, for your next pregnancies, a slightly higher risk of uterine rupture (yes, your uterus can rupture even if you’ve never had a c-section… bet your OB has never mentioned that), and a much higher risk of placenta previa, which is a situation where the placenta covers the cervix. This is a situation that requires a c-section. You now likely have adhesions – painful fibrous bands that form between tissues and organs, sticking them together. Adhesions are caused by surgical injury and according to the National Institutes of Health, over 90% of patients who have abdominal surgery develop them, and abdominal pain is the most common symptom. Your OB probably doesn’t know this and so won’t tell you, but I will: physical therapy will help with this, as they will massage your incision. Make an appointment and tell them you are having abdominal pain post c-section. This was hardest for me personally to come to terms with. In one fell swoop, the careless locum on-call doc not only dashed my hopes for my current delivery, but made my future ones much more difficult as well. It was truly a selfish decision that she made without my consent.
  9. You were 7 times more likely to die during your birth than your friends giving birth vaginally. Yep, your birth was much more dangerous, although easier for your doc to handle. Additional risks you open yourself up to (Get it? Okay, sorry.) with having a c-section, first time, or any time, around include: Infection, surgical injury to you or baby, hemorrhage (much higher risk with surgery than vaginal birth), problems with anesthesia – such as it not working and you being able to feel the surgery or partially feel it, or adverse other affects, including death. The risk of death from a c-section is 3 to 7 times greater than from a vaginal birth. Seven times greater. And they make a risk of uterine rupture of about .4% seem extremely dangerous.  What is most dangerous to whom? We have to ask ourselves. Your baby is also at a higher risk of developing an upper respiratory infection and breathing problems post-birth if delivered by c-section. Yes, your baby is also at a higher risk of problems. Not to mention all the drugs that your baby will also be exposed to before, during and after your c-section. A common drug to stick in your IV with your epidural cocktail (you get an epidural or spinal before your c-section for numbing) is Fentanyl. Fentanyl is four times more potent than Heroin.
  10. And, likely the very least of your concerns, a scar. This will probably be the least of your concerns, but you will have a 5-inch long red or purple scar across your abdomen forever, and you either won’t be able to feel parts of it, or will still have stabbing pain in parts of it. Or, both. It might be higher than your pubic hair line, and your bathing suit may or may not cover it. You will probably always think of it at some point every time you get undressed, dressed, bathe and have sex. Even though this will likely be the least of your concerns, it will probably be the focus of your OB and postpatum care.

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