Having a C-Section?
I have seven children, and five of them were delivered by c-section. According to statistics from the CDC, 30.1% of babies delivered in Iowa (my home state) in 2016 were delivered by c-section (https://www.cdc.gov/nchs/pressroom/sosmap/cesarean_births/cesareans.htm), which is actually lower than the national average. If you’re pregnant, or hoping to become pregnant someday, you may want to take some time now to think about what you’ll do if you have to make a choice between a c-section and a vaginal delivery, because it often is a matter of choice. The consequences may be greater, or at least different, than you might think, and you may have options that your doctor isn’t telling you about. I know that when I scheduled my first c-section, with my second child, in 2004, I didn’t understand all of my options, and I had no idea that I might someday wish I had chosen differently.
I have had a lot of babies, and each delivery was scary, strange, wonderful, and unique. I’ve never had a “bad” birth experience…but I wouldn’t exactly call any of them easy, either. I’m going to share a little about each of them, just to give you an idea of how different each birth can be and how different this list could have been if I had made different choices along the way.
Here’s a short history of each delivery:
- Baby #1: Normal (vaginal) delivery
- Baby #2: Scheduled c-section (baby was breech and couldn’t be turned; my doctor/hospital wouldn’t deliver a breech baby vaginally)
- Baby #3: VBAC (Vaginal Birth After C-section)
- Baby #4: Scheduled c-section (baby was breech – again! What are the odds?); I went into labor early and, because the labor had progressed so far by the time we got into surgery, I had to be put under general anesthesia
- Baby #5: Scheduled c-section (my doctor/hospital wouldn’t allow a VBAC after 2 c-sections); I went into labor early again but was able to have a “normal” c-section
- Baby #6: Scheduled c-section
- Baby #7: Scheduled c-section at a hospital 2 hours from home because our hospital won’t perform a fifth c-section
Why not just have a c-section?
So, what’s the big deal? Why not just have a c-section? There are some very tempting benefits, which I admit were part of why I didn’t protest much with my earlier c-sections. Benefits such as:
- Being able to schedule the delivery in advance
- Delivering up to a week earlier than your due date (which anyone who has been 9 months pregnant knows is a bigger temptation than anyone who has not been 9 months pregnant would think)
- Knowing, to a much greater degree than with a vaginal birth, what to expect during the delivery
- Not dealing with the pain of labor
- Getting extra time off work to stay home with the baby
But there are risks…
I have had very easy c-sections. No complications, quick healing, minimal scarring. However, until my latest delivery (little Fisher, now almost 2 months old), I didn’t realize that there were some real drawbacks. For one thing, I didn’t realize at first that after a certain number of c-sections (one, at my local hospital) you may not be allowed to try to deliver vaginally. As a young mom, I never imagined that I would have seven children, so I wasn’t really concerned with the effects of having multiple c-sections. I had no idea that, with each c-section, you run a greater risk of several complications, such as heavy bleeding, placenta accreta (where your placenta attaches to the uterus), and bladder and bowel injuries. This means that if you want a large family, your ability to create one is put in serious jeopardy by having c-sections. Scar tissue and a thinning uterus – or possibly even an emergency hysterectomy – caused by multiple c-sections can mean far fewer children you may want to have. I was chastised by one of my doctors during my seventh pregnancy for being pregnant again and was told that this HAD to be my last baby. Which is fine with me now, but it may not have been fine 3 babies ago, and it may not be fine with you when you hear it.
There is also a greater risk to the baby during a c-section. Not a huge risk, but is any increased risk really worth it? I think that anyone who has lost a baby would say no. One reason for the risk is that you’re delivering the baby prior to his due date, so the baby’s lungs and other organs may not be fully mature, especially if the due date was miscalculated. With my third baby, who was a VBAC, the due date was way off – she was born 10 days after her due date, but my doctor said that she didn’t look at all like a baby usually does when it’s born after 40 weeks. The due date was incorrect, and if I had scheduled a c-section a week beforehand, she would have been born 2 ½ weeks early. She could very likely have suffered complications because of that.
Another factor is that the expense is significantly greater than with a “normal” vaginal delivery. Close to double, in my experience. That’s another barrier to having a large family that I never anticipated. At over $7,000 per baby, AFTER insurance, a c-section is a major expense for us – well over 10% of our annual income.
And, not least important, many women go through emotional distress after a c-section and have trouble bonding with their baby. I’ve never experienced this, but I’ve read so much about it that I’m convinced it’s a real and serious side effect. Here are a couple of interesting resources on c-sections and post-partum depression:
You can read more general information about c-sections and the risks involved at:
Would I do it differently?
I don’t regret having the c-sections; what I really regret is that I put so little thought into my decisions. If you have decided to have a c-section after considering all possibilities, or if you have had an emergency c-section for reasons beyond your control, I don’t think you have any reason to second-guess yourself or feel bad about your experience.
But many of you may eventually be in my shoes, with real options to consider that will have real consequences for you and your children.
If I could go back to 2004 and give myself some advice, I would say…ask more questions and do some research! Don’t assume that “because my doctor says so” is enough of a reason to choose a c-section. Don’t assume that because your doctor or hospital won’t let you attempt a vaginal delivery (such as when your baby is in breech position, or after you’ve had one or more c-sections), that NO doctor or hospital will, or that it’s overly dangerous to do so. I live in a small town with a “rural” hospital, and there are many procedures that they can’t or won’t perform which are actually very possible at a larger hospital. I could (and should) have looked into giving birth at a bigger hospital, or gone the opposite route and researched delivering at a birthing center or home birth. Home birth? Sounds crazy, right? Well, I watched a documentary on this called The Business of Being Born (https://topdocumentaryfilms.com/business-being-born/), and it makes a compelling argument that giving birth in a hospital is more about money than about health and safety.
The older I get, the more I see that most of the decisions I’ve made regarding my family were a much bigger deal than I realized at the time, including the decision to have – or not have – a c-section.
It’s never too soon to start thinking about your plans for having children, including how and where they will be born. Plans often evolve, and are sometimes radically changed at the last minute, but it’s well worth it to sit down with your husband and do some family planning, of which this issue is an important part. Don’t be afraid to choose what you think is right over what other people think is good or normal. I guarantee you that most of the people who will criticize your choices have put far less thought into their opinions than you have into yours.
Have you had a c-section? We would love to hear about your experience.