Should I Get a C-section?
When you're having a baby, one of the first decisions you have to make as a parent happens before the baby is even born: Should you have a Cesarean section or a vaginal birth?
The answer to that question used to be simple: 50 years ago, having a vaginal birth was not just the norm, but the option with the least risk. Now, with several decades of surgical advancements later, C-sections are super common - in fact, they account for about a third of all deliveries, according to the Centers for Disease Control and Prevention. Still, that doesn't stop people - mothers, friends, social media trolls, you name it - from having some serious opinions about the best way to give birth. Whether you're of the camp that believes natural or home births are for hippies or you think that wanting a C-section makes you "too posh to push," the reality is that both birthing options have their own set of risks and stigmas. So what should you do?
The Truth About Vaginal Births
While there's a lot of talk about the risks associated with the invasive surgery that is a C-section (such as infection, blood clots, hemorrhaging, and painful scarring), a lot of women are uninformed about the risks the come with opting for a vaginal birth. First there's the stretching and tearing - in a long or complicated vaginal delivery, this can get pretty bad. Which leads to another big risk: urinary and fecal incontinence, which in some cases can mean a lifetime of peeing your pants every time you laugh, sneeze or cough. Yikes. There's also the risk that the baby could be injured during a difficult vaginal delivery - not something to take lightly.
"I always tell people is that an easy C-section is better than a hard vaginal delivery," Lauren Streicher, M.D., associate clinical professor of obstetrics and gynecology at Northwestern University's Feinberg School of Medicine, says. "You haven't done a woman any favors if she spends two hours getting stitched up and can't walk for a month [after a difficult vaginal delivery]."
The Truth About C-sections
Thanks to those complications, the C-section has earned a reputation of being the easy way out, hence the whole "too posh to push" thing. But that's totally not the case for many women - like Jessica L., 29, from Washington D.C. While she'd originally wanted a vaginal birth, Jessica was informed by her gyno that her baby was in breech position, meaning the baby would come out either butt or feet first, which could lead to a difficult and dangerous delivery). After trying all the old wives' tales to get the baby to turn around, Jessica had to change plans and scheduled a C-Section.
And it was a tough experience. "The recovery was unexpectedly miserable. People talk about C-sections as if they're the 'easy way out,' so I think I assumed that I'd be able to recover pretty quickly," she says. "In reality, I was in terrible, searing, indescribable pain. I hardly got out of bed for four weeks, with the exception of the occasional walk around the block. It was so overwhelming to try to heal at the same time as I was trying to take care of a tiny new human."
So anyone throwing shade at women who have C-sections for not being "tough" enough should that recovery from this major surgery can be a b*tch, too. Though it varies from woman to woman, recovery tends to take about four to six weeks.
So When Should You Consider a C-section?
Whatever your opinion on different birth options, all women can likely agree that they want to to do what's best for your health and the baby's health. While doctors stress that there's no one-size-fits-all answer, there are some common signs that point to scheduling a C-section.
1. When the baby is breech. If you're in a situation like Jessica, you may have no choice but to schedule a C-section. Doctors start paying close attention to the baby's position in the seventh month of pregnancy, which is when babies start to move into the proper position for delivery. While numbers are hard to pin down, it's estimated that about 1 in 25 full-term babies end up breech. In this case, a C-section isn't just the best option, it might be your only option.
2. You have a small pelvis and/or a big baby. Having narrow hips and a nine-pound baby (ouch) is not a good combination. The baby's size relative to mom's birth canal is a totally legit factor to weigh when you consider the best birthing option, according to Streicher. "There's a very big difference between someone who's having a six-pound baby and someone who's having a 10-pound baby in terms of what their risk is of developing problems," she says.
3. You want a small family. How many kids you plan on having is an essential part of the C-section equation, says Mary Jane Minkin, M.D., assistant clinical professor of obstetrics and gynecology at Yale University School of Medicine. If you have a C-section, any subsequent deliveries will probably have to be C-sections, too. And with that comes increasing risks. "With each C-section you have, you increase your chances in the next pregnancy of having a placenta that is stuck to the wall of the uterus, which can cause major hemorrhage," Minkin says. It's best to avoid a C-section if at all possible if you want a large family.
4. You're worried about protecting your pelvic floor. Many women simply worry about the pain of a vaginal birth as well as the number it can do on your lady bits, which is totally valid, says Streicher. "You can make a case that, if you do a C-section rather than allow someone to labor and deliver vaginally, you are going to protect the pelvic floor and lessen the risk of having problems down the road," she says. "Certainly we're seeing that request more than we did 20 years ago." There's nothing wrong with wanting to lower your risk of a lifetime of incontinence or prevent pelvic organ prolapse, which is when your bladder falls from it's usual spot and starts pushing against your vagina.
How to Figure Out the Best Option for You
When you are making your birth plan, both delivery options have equally valid arguments -which one is ultimately better depends on the individual pregnancy. The crucial thing, though, is that it's time to ditch the idea that choosing one option over the other somehow makes you a "better" woman or mom.
"Some things are really straightforward," says Streicher. "This is not."
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