Caesarean deliveries, or C-sections, can either be planned or the result of complications during labour. Either way, experts say women should know what this type of birth entails.
In April 2018, the Canadian Institute for Health Information found that more than 103,000 C-sections were performed in Canada between 2016 and 2017, resulting in a rate of 28.2 per cent of all births in Canada. Experts say today, that rate is about 30 to 33 per cent.
Dr. Michael Sved of the obstetrics and gynecology department at Mount Sinai Hospital in Toronto told Global News there is also a movement around the world of women planning C-sections ahead of time.
In São Paulo, Brazil, for example, the rate of C-sections is about 90 to 98 per cent of all births, and Sved believes this has to do with the “Hollywood” notion of giving birth — many women want to be able to schedule when and how they deliver their child. He added that some celebrities have gone down this route as well, inspiring others to do the same.
While the procedure is common and generally safe, there are still misconceptions, he added.
Below, experts help us break down what women can expect from a C-section. If you have any questions or concerns about C-sections, speak with your doctor.
Sved said the procedure is usually done by an obstetrician who is a surgeon. There are two types of C-sections: one is elective, where women choose to have a planned procedure, and the second is an urgent or emergency C-section, which is often unplanned. Sved added that in some cases, women may need a C-section due to complications with the birth (the baby’s positioning, for example) or if she is giving birth to more than two children.
If a C-section is planned, patients usually arrive two hours before their appointment to get admitted, go through the risks, take medication and sign a consent form.
Next, patients are given anesthesia (generally via the spine) and are taken to the operating room.
“Before we begin the procedure, we get a sterile solution on the abdomen to decrease the risk of infection and then appropriate drapes are put up as well,” said Sved. This way, the patient can’t see the surgery. There are, however, options at some hospitals to set up cameras that allow mothers and their family to see the birth.
“We review the exact nature of why we’re doing the C-section (and) if there any possible complications, verify that she’s gotten the antibiotics that we requested,” Sved continued, adding that at other times, some patients have stem cells collected as well.
During the procedure, hospitals often allow one or two people to be present during the surgery.
The incision is made in the abdomen, and doctors go into the uterus to deliver the child.
“We stitch everything back up, which takes about 20 minutes… the whole thing probably takes about 40 to 45 minutes,” he said.
Sved said one of the benefits of having a C-section is protecting the perineum (the area between the anus and the vulva). He added that there is a decreased risk of any trauma to the vagina and vulva as well.
What are the risks?
Dr. Robert Gagnon of the McGill University Health Centre’s Department of Obstetrics and Gynecology told Global News that C-sections are major surgeries and that, like any surgery, there are potential risks. Before a woman gets the procedure, she is told about all the risks.
Some of these risks include post-partum hemorrhage, infection (in the uterus or around the wound) and a possible risk of requiring a blood transfusion.
WATCH: C-section deliveries rising in Canada, birth rate declining
According to the Mayo Clinic, a C-section can also increase the risk of developing a blood clot inside a deep vein — specifically in the legs or pelvic organs.
“If a blood clot travels to your lungs and blocks blood flow (pulmonary embolism), the damage can be life-threatening,” the site noted.
But even with risks, Sved added, there are very few complications with C-sections, and for the most part, they are safe.
While this may not be included as medical risk, one thing Gagnon noted is skin-to-skin contact after the baby is born is not done right away when you have a C-section.
“That is delayed by five to 10 minutes and sometimes more,” he said.
The recovery period
Gagnon said the recovery period is between four and six weeks, but this can vary depending on the woman. This is typically a longer recovery period than a vaginal birth.
Women are often told to rest, avoid lifting heavy objects and take over-the-counter medication for pain relief. Doctors will also keep an eye out for infections.
The Mayo Clinic added that vaginal discharge, contractions and tender breasts can also be expected after the procedure. Post-partum depression can happen as well.
“If you experience severe mood swings, loss of appetite, overwhelming fatigue and lack of joy in life shortly after childbirth, you might have post-partum depression,” the site noted.
“Contact your health-care provider if you think you might be depressed, especially if your signs and symptoms don’t fade on their own, you have trouble caring for your baby or completing daily tasks or you have thoughts of harming yourself or your baby.”
What are the misconceptions?
Sved added that many women believe C-sections are “invasive” operations. He said that in the past, obstetricians would have to get a second opinion from another obstetrician before performing the procedure, adding more stress and fear to the women giving birth. These rules are no longer required, and patients can have elective C-sections.
Self magazine previously pointed out that some women may believe if they have a C-section with their first child, they will not be able to have a vaginal birth with the second. Both experts added that this is not the case.
“If you tried the first time around and found out after hours of labour that giving birth vaginally was just not in the cards for you, that’s something to discuss with your OB-GYN. He or she should ultimately respect your wishes,” the magazine noted.
Yes, a C-section is still a “real birth”
Similar to breastfeeding, experts pointed out that some women may feel pressure to give vaginal birth. Vaginal births are often seen as more “natural,” but Sved said you should never feel pressured to give birth this way.
“Everything comes down to information and education,” he said. “There is a segment of people that are fanatical about labour and delivery and their impression around what labour and delivery is. For me, the most important outcome is healthy babies and a healthy mom with the least interventions.”
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