Pros and cons of caesarean section. Are there often negative consequences? Natural birth or caesarean? Caesarean cons

According to the information that has come down to this moment, cesarean section is one of the earliest operations carried out, leading from ancient Greece and Rome. However, in the modern sense, this operation began to be carried out only from the 19th century and is popular to this day. A caesarean section is an operation in which the newborn is removed through an incision in the uterus.

When is a planned caesarean section necessary?

In what cases do planned caesarean section? Indications for caesarean section are:

• Wishes of the future mother;
• Disproportionate size of the pelvis of a woman and the size of the fetus;
• Placenta previa - the placenta is located above the cervix, blocking the exit route for the baby;
• Mechanical obstacles that interfere with natural childbirth, for example, fibroids in the cervical region;
• Threatening uterine rupture (a scar on the uterus from a previous birth);

• Diseases that are not associated with pregnancy, but in which natural childbirth poses a threat to the health of the mother (diseases of the cardiovascular system, kidneys; history of retinal detachment);
• Complications of pregnancy that threaten the life of the mother during childbirth;
• Breech presentation or transverse position of the fetus;
• Multiple pregnancy;
• Genital herpes at the end of pregnancy (the need to avoid contact of the child with the genital tract).

When is an emergency caesarean?

In some cases it happens emergency caesarean section when complications that pose a possible threat to the health and life of the mother and child arise directly during natural childbirth. Such cases include:

• Sluggish childbirth or their complete cessation;
• Premature detachment of a normally located placenta (the supply of oxygen to the fetus is cut off and potentially fatal bleeding);
• Possible or already occurred uterine rupture;
• Acute hypoxia (lack of oxygen in a child).

There are many supporters and opponents of caesarean section, and disputes among specialists and even in forums dedicated to motherhood do not stop to this day. That is why we decided to understand and present the main pros and cons of a caesarean section.

Benefits of a caesarean section

To unconditional pluses maternal caesarean sections include:

• The ability to plan the appearance of the baby up to the day;
• Childbirth is relatively quick and not as painful;
• This is a relatively safe delivery in women with a clinically narrow pelvis;
• In cases where natural childbirth threatens the health or even the life of the mother or child, the harm from a caesarean section is much less than from possible complications during natural childbirth;
• After a caesarean section, there are no problems with sexual activity, since the vagina does not stretch, there are no stitches on the perineum from episiotomy;
• Caesarean section helps to avoid hemorrhoids and prolapse of the pelvic organs.

Risks of a caesarean section

However, in carrying out a caesarean section, there are some minuses:

• Some chance of infection in the woman's abdomen;
• In some cases, the likelihood of serious, including fatal complications for the mother is about 10 times higher than during childbirth through the natural birth canal, so you should first consult a doctor who monitors the pregnancy;
• In some cases, there is difficulty in the beginning of lactation;
• A woman will feel pain for some time in that part of the abdomen where the stitches are applied;
• A scar on the uterus after a cesarean section causes a long break between the occurred and the next birth (if you are planning two or more pregnancies), since during contractions at the next birth, the contractions of the muscular layer of the uterus are so strong that the scar in some cases (according to statistics 1-2 %) does not withstand and breaks. This problem can be solved if the doctor immediately after the caesarean section begins the necessary therapy for the rapid healing of the site of the uterine incision, that is, you need to take care of the next pregnancy already in the first hours after the birth;
• Sometimes, after such an operation, the mother experiences stress with the development of psychosis due to the so-called “incompletion” of the physiological process of natural childbirth.

Dangers of a caesarean section for a child

To the main cons of a caesarean section for a child doctors include:

• Experts note that in newborn girls there is no transfer of the mother's vaginal microflora, which subsequently reduces the likelihood of developing vulvovaginitis;
• It is believed that children born by caesarean section have an increased risk of asthma, type 2 diabetes, and a different intestinal microflora.
• According to one medical study, it was found that caesarean section can reduce the protective function of the child's body (immunity) due to the fact that during childbirth there is no contact with intestinal bacteria from the mother's body in the same amount as in the case of a natural birth.

Advantages of a caesarean section for a child

But there is also benefits for the child during caesarean section:

• The newborn is not subjected to oxygen starvation, which so often occurs during natural childbirth;
• There is no risk of deformation of the baby's head when passing through the birth canal;
• With a caesarean section, the baby is insured against various injuries that can be obtained when passing through the birth canal. In some cases, such birth injuries can become irreparable or even lead to disability;
• With such childbirth, the child can be born "in a shirt." Many parents consider this a good sign and hope that good luck will accompany the child throughout his life.

With the approach of childbirth, all expectant mothers are overcome by fears. Someone is afraid of pain or worries about the health of the baby, someone thinks about how long the recovery will take. Panic often comes from lack of information. What are the benefits and risks of conventional labor and caesarean section? Why do some women need to give birth on their own, while others should opt for surgery?

Caesarean section - what is it?

A caesarean section (CS) is an operation that allows you to remove a child through an incision in the peritoneum and uterus (for more details, see the article: caesarean section: how long does the operation take and what kind of anesthesia is used?). Currently, this manipulation is performed in 20% of patients. The operation can be:

• planned, when it is prescribed during gestation, if indicated;
• emergency, carried out during childbirth in the event of various complications.

The surgical intervention lasts about 40 minutes. It includes several stages:

• insertion of a catheter into the bladder to drain urine;
• use of spinal anesthesia or general anesthesia;
• fixing arms, legs, installing a screen at chest level and lubricating the abdomen with an antiseptic;
• making an incision in the skin and subcutaneous fat, spreading the abdominal muscles, performing an incision in the uterus;
• opening the fetal bladder, removing the baby and placenta (this stage lasts a maximum of 8 minutes);
• suturing.

Despite the fact that the operation has been practiced for a long time and is routine, it is considered quite difficult. However, thanks to the constant improvement of surgery and the emergence of new antibiotics, it does not pose a danger to the life of the baby or mother. The scar heals in about a week.

Indications for surgery

Sometimes a woman does not have the opportunity to give birth naturally, and she is prescribed a CS. A planned operation involves hospitalization for a period of 37 weeks - this allows doctors to additionally examine the expectant mother and fetus. Indications for operative delivery are:

• narrow pelvis (in the case when it is pathologically narrowed and does not allow giving birth naturally);
• myopia with a high risk of retinal detachment;
• genital herpes;
• a large fetus with an estimated weight of more than 4.5 kg;
• the age of the woman in labor is more than 35 years (especially if the birth is the first);
• past operations on the cervix;
• 2 or more scars on the uterus;
• ovarian tumors or uterine fibroids;
• delayed pregnancy;
• poor history (stillbirth, repeated miscarriages, etc.);
• the location of the fetus across the uterus;
• twins with a breech presentation of one baby;
• varicose veins of the vagina.

Indications for an emergency caesarean section are:

• acute oxygen starvation of the baby;
• early outflow of amniotic fluid;
• anomalies of labor activity that cannot be corrected with medications;
• placental abruption;
• threat or beginning uterine rupture;
• preeclampsia or eclampsia;
• weak generic activity;
• sudden bleeding;
• prolapse of umbilical cord loops;
• a sharp deterioration in the condition of the woman in labor due to disruption of the cardiovascular, respiratory systems, etc.

Pros and cons for baby and mom

The passage of the child through the birth canal is provided by nature. With the right behavior of a woman, delivery will take place with minimal discomfort for her and the child. Its advantages:

• from 38 to 40 weeks, the fetus is considered full-term - the baby will be born when all the systems of his body are ready for this;
• when the waters break, the baby instinctively begins to prepare for the difficulties that await him at birth, so this process does not become a shock for him;
• when moving along the birth canal, the intestines, skin and mucous membranes of the child are populated with beneficial mother bacteria;
• during childbirth, the female body secretes hormones that stimulate lactation and uterine contraction;
• attachment to the breast allows the baby to receive colostrum, and the woman to start the process of milk production;
• although natural childbirth is more painful, they are better - this is the logical end of the process of bearing a fetus, followed by the appearance of maternal instinct;
• mother starts caring for the child immediately after birth.

Disadvantages of childbirth:

• severe pain during contractions;
• the likelihood of perineal ruptures;
• birth trauma of the baby.

The tactics of performing a caesarean section is constantly being improved - this is an operation that has saved millions of lives in complicated births. The advantages of this type of delivery:

• in some conditions and diseases, caesarean section is the only way to extract the child;
• the risk of birth trauma in the infant is minimal;
• no pain during contractions;
• the operation lasts 45 minutes, natural childbirth can last up to a day;
• childbirth for a woman will take place without ruptures of the perineum or the formation of hemorrhoids.

Cons of a caesarean section:

• long recovery period;
• severe bleeding, often leading to anemia;
• the negative impact of anesthesia on the body of the woman in labor and the baby;
• pain in the area of ​​the postoperative scar;
• bed rest, interfering with the care of the child;
• a long ban on sports, which complicates the process of returning to physical fitness;
• difficulties with feeding due to the impossibility of early attachment of the baby to the breast;
• the risk of pathogenic microbes entering the body of a newborn, which leads to diseases, digestive problems, etc.;
• refusal of pregnancy in the next 2 years.

Risk of complications

With conventional childbirth, as with caesarean section, a woman may experience complications. If she has to give birth herself, she must be ready to breathe properly and follow the recommendations of doctors, otherwise there will be ruptures of soft tissues or there will be a need to dissect them to facilitate labor. Also, a perineotomy may be needed in case of rapid labor or improper advancement of the fetus, for example, with a prolapsed limb.

With unstable contractions, the baby can get stuck in the birth canal. This threatens with hypoxia and neurological disorders in the future, as well as injuries due to the need to apply radical techniques to save the child's life.

With surgical extraction of the fetus, the risk of postpartum complications is 12 times higher. These include:

• the impossibility of predicting the outcome of the operation - complications are possible up to a lethal outcome;
• a long recovery period (up to six months) with the risk of skin folds forming over the seam;
• abrupt termination of pregnancy - stress for the body, which causes hormonal failure, disruption of the lactation process and the menstrual cycle;
• possible development of inflammation, leading to chronic pain, the appearance of adhesions in the abdominal cavity and infertility;
• divergence of the postoperative suture;
• the risk of a fistula due to incomplete dissolution of the catgut applied to the muscles - a second operation is required to remove necrotic tissues.

Caesarean section or natural childbirth - which one is better?

The question of what to choose - caesarean or natural childbirth, appears when there are deviations in the course of pregnancy. Doctors analyze the patient's condition and may suggest giving birth on her own or performing surgery. It is impossible to say which option will be better or worse, since the choice depends on many factors. Comparative characteristics of delivery methods for some problems:

The choice between a caesarean section and a conventional birth is up to the woman, but the doctor must explain in detail all the benefits and risks. If necessary, a planned operation is carried out at 39 weeks.

Breastfeeding after caesarean section

Colostrum and breast milk contain many nutrients and antibodies - breastfeeding reduces the risk of colic in an infant and supports its immunity. A caesarean section involves anesthesia and subsequent antibiotics to prevent inflammation of the wound, so the first few days the mother will not be able to feed the baby. In addition, after such childbirth, milk comes later. How many days will he have to wait? Lactation after a planned CS begins on day 5-10, after an emergency - on day 2-3, but sometimes milk does not appear at all.

While the woman is taking medication, the child is fed formula milk. If she does not try to maintain lactation by pumping, she simply will have nothing to feed the baby, and the baby himself may refuse to make efforts to extract milk from the breast, as he will get used to the silicone nipple.

Expert opinion

In Russia, about 10 women in labor out of 100 insist on a caesarean section. However, the opinion of experts is unequivocal - they are against the operation if there is no evidence for it. This position is supported by a number of facts:

• surgery is always a risk;
• CS does not make the birth of the baby more comfortable for the mother;
• the next pregnancy should be no later than 10 years;
• milk is poorly produced, the child cannot immediately begin to feed, and then it is more difficult to teach to suckle;
• there is a hormonal failure, later the maternal instinct wakes up.

If the patient had a caesarean section, the next pregnancy will also end with an operation. A woman will be able to give birth herself if she finds an experienced doctor, and he does not see contraindications for this and will be able to monitor the state of the seam.

is an abdominal operation to remove a baby from the womb, which is performed for medical reasons or urgently. The reason for surgical intervention may be various pathologies that pose a threat to the life of a child or a woman in labor. Many women who are afraid of childbirth believe that this way they can avoid the pain and risks associated with the natural process of childbirth. But is it? Caesarean section, the pros and cons of this operation is the main topic of our article.

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When is a caesarean section performed?

The famous commander and ruler of the Roman Empire Gaius Julius Caesar is considered the first child born in the process of abdominal surgery.

His mother was dying from a difficult childbirth, and in order to save the baby, doctors decided to extract it through the stomach.

The process of natural childbirth is the normal state of a woman, provided by nature. If the woman and the child are healthy, nothing threatens them.

Childbirth is accompanied by contractions and severe pain, but there are no fatal risks. It is a completely different matter when pathologies are detected in the body of the mother or child.

There are two types of caesarean section:

1. Planned - the operation is performed for medical reasons that arose even before pregnancy or during the period of gestation.
2. Emergency - is carried out in cases where during childbirth there are serious complications that threaten the life of a woman or child.

Among the indications for caesarean section, absolute and relative are distinguished. Be that as it may, it should be remembered that only the doctor decides how a woman will give birth. He is fully responsible for the outcome of childbirth and the consequences of caesarean section for the child.

Absolute indications for surgery

Absolute indications for operative delivery are factors that pose a serious threat to the mother and child, or pathologies in which the natural process of childbirth is impossible. These include:

• gynecological operations previously performed on the cervix;
• the impossibility of the baby passing through the birth canal due to the anatomical features of the pelvic bones or acquired deformities due to injuries or neoplasms;
• large size of the fetus and weight exceeding 4.5 kg;
• the presence of uterine scars as a result of previous abdominal operations;
• prematurely and wrong presentation;
• neoplasms of the pelvic organs of a benign or malignant nature - uterine fibroids, polyps, cysts, etc .;
• arising as a result of pathological childbirth, threatening the life of the child;
• convulsions and loss of consciousness during labor;
• the child in the uterus is located across, in the process of contractions, the location has not changed;
• the fetus lies with its buttocks towards the exit, and its weight exceeds 3.6 kg.

Multiple pregnancies are also an indication for a caesarean section, but the doctor's decision depends on many individual characteristics of the woman in labor and the course of pregnancy.

Relative readings

Relative indications are considered in which a woman is allowed to have a natural birth, but there is always the risk of complications, which pose a serious threat to both herself and the baby.

Therefore, in such cases, the operating room should always be prepared for emergency surgery.

Relative indications are:

• chronic diseases of a woman in labor, not related to her condition, but capable of causing serious complications in the process of labor, - diseases of the cardiovascular system, diabetes mellitus, kidney failure, genital herpes infection, respiratory diseases;
• the first birth after 35 years or when the interval between births is too long;
• protracted course of pregnancy;
• varicose veins of the small pelvis (the danger lies in the potential bleeding, which is difficult to stop);
• sexually transmitted diseases of the mother, which the child can become infected with when passing through the birth canal;
• pathologies that can be attributed to negative obstetric history: repeated spontaneous, stillbirth, infertility for many years.

Important! No obstetrician would risk the life of a patient and her unborn child.

As a result of a thorough examination, an adequate decision will be made on the method of safe delivery.

Pros and cons of a caesarean section

With absolute indications for surgical delivery, the very possibility of the birth of a baby in the conditions of a pathological state of the mother can already be considered a miracle of medicine. After all, with natural childbirth, he could not appear at all. Every woman planning to become a mother would like to know what are the pros and cons of having a caesarean section.

Advantages of the operation

For a child, the main plus is the absence of stress, which he will definitely receive if he passes through the birth canal.

Advantages of a caesarean section for mother and child:

• the absence of gynecological injuries, ruptures of the vagina or perineum, which usually accompany the natural process of childbirth;
• the ability to avoid exacerbation of hemorrhoids, which is inevitable as a result of attempts;
• a woman who has had a caesarean section is unlikely to face prolapse of the organs of the genitourinary system, as can happen after childbirth;
• the child does not pass through the natural birth canal of the mother, which means that he insured against suffocation as a result of entanglement with the umbilical cord or oxygen starvation;
• almost zero risks of birth injuries to the baby;
• caesarean section lasts no more than 40 minutes, and childbirth can drag on for a day;
• a woman does not feel any pain at the time of the birth of a child;
• there are no problems associated with sexual life in the postpartum period, since there are no injuries and ruptures, then there is no discomfort.

Cons of a caesarean section

Any abdominal operation is a serious intervention in the body and can lead to a number of serious complications.

The main disadvantages of operative childbirth:

• The recovery period after surgery is much longer than after natural childbirth, although this is an individual indicator. It all depends on the indications for the operation, the age of the woman in labor, the outcome of the caesarean section and the woman's compliance with all the necessary recommendations.
• What is bad about caesarean section for women is possible development of endometritis and impaired uterine contractility. These pathologies entail inflammatory processes, most often acquiring a chronic form.
• The development of an adhesive process, which in the future can cause the formation of tumors and nodular fibroids on the uterus. As well as the development of postoperative intestinal dyskinesia.
• The first days after the operation, the seam hurts a lot, the woman is given painkillers, against this background, lactation may disappear or not appear at all. For a woman, this is an undesirable scenario; a tumor in the mammary gland may develop in the future.
• The disadvantage of a caesarean section for a child is that it is not immediately brought to the mother and applied to the breast. Its not yet perfect, and mother's milk has a bactericidal property.
• The natural decrease in the immunity of women as a result of surgery can cause the development of infectious diseases of the genitourinary system.
• Circulatory failure, which is inevitable with any abdominal surgery, can cause blood clots. The postoperative period requires constant monitoring of women's health.
• Not every woman understands that the pregnancy is over, the child has been born and requires the attention of the mother. The absence of a natural birth process can become psychological trauma for a young mother.
• The disadvantages of a caesarean section for a child is that he immediately enters the outside world and has difficulty adapting to pressure, environment, and various microorganisms. Even the temperature and humidity of the air are unusual for a newborn. Often, caesarean children are placed for the first time in a special chamber with an optimal microclimate.
• The next birth is likely to be performed surgically. And you can get pregnant no earlier than two years after a caesarean section.
• In our country, there are few clinics whose specialists are able to deliver without complications. And in some localities there are no operating rooms with the appropriate equipment for emergency operations.

Important! The negative consequences of a caesarean section for a child is that if the operation is planned, then it is performed at 38 weeks of pregnancy, ahead of schedule. The fetus by this time may not fully develop, or its organs may work in the future with deviations.

Video: pros and cons of a caesarean section

Conclusion

It can be concluded that with a caesarean section, the pros and cons are individual, and equal risks are possible for both the mother and the child. An indisputable plus for the baby is that for his health, and even more so for life, a caesarean section does not pose a danger. On the contrary, the baby is insured against birth injuries and the development of cerebral palsy. The woman risks the most, but this is a justified sacrifice in order to know the joy of motherhood.

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Pregnancy is not only a pleasant time, but also an exciting period full of various questions. With an increase in the term, expectant mothers begin to worry about childbirth. Many women hesitate to have a caesarean section. This article will tell you about the pros and cons of this manipulation. You will also find out the possible complications of a caesarean section. You should definitely draw a parallel and decide for yourself which births are still better.

Conception and pregnancy

Surely every expectant mother knows how conception occurs. Due to the established hormonal background, a woman ovulates once a month. In this case, the dominant follicle is torn, and the egg is released into the abdominal space. Within a few hours, she can meet with the spermatozoon and merge with it together. This is how an oocyte is formed, which continues to divide and moves through the fallopian tubes into the cavity of the reproductive organ. It is there that the reliable attachment of the fetal egg takes place, which will transform and grow every day.

The average pregnancy lasts from 38 to 42 weeks. If the baby is born earlier, then we can talk about premature birth.

natural childbirth

This procedure is completely normal. Such childbirth lasts from three hours to several days. At the same time, doctors divide the whole process into several stages:

• stage one: the time from the beginning of the first contraction to the complete opening of the cervical canal and smoothing of the cervix;
• stage two: the time from the first attempt to the birth of the child and cutting off the connecting umbilical cord;
• stage three: the birth of the placenta (the time from cutting off the umbilical cord to the end of the cleansing manipulations).

The first part of the process is the longest and most painful, but nulliparous women are more afraid of the second period.

Cesarean section

This manipulation is not natural. Even in ancient times, the dissection of the peritoneum and the removal of the baby was performed only in the event of the death of the mother. Only a few centuries ago, doctors learned how to do a caesarean section correctly.

Previously, women in labor who underwent such an operation died. This was due to the fact that doctors simply did not sew the uterus. The woman was dying due to banal internal bleeding. Later, doctors began to remove the reproductive organ after removing the child. At the same time, the woman's life was saved. However, such a patient could no longer have children.

Today, medicine has come a long way. Doctors may perform a caesarean section on a woman several times. Some women in labor even practice natural childbirth after this operation.

How is the manipulation going?

Before you find out what the pros and cons of a caesarean section are, you need to learn a little about the procedure itself. The operation is performed at about 36-38 weeks. The only exceptions are preterm birth or sudden complications. During the manipulation, the woman is given an anesthetic drug. Anesthesia for caesarean section can be general or epidural. In the first case, the woman is asleep and does not feel anything. In the second type of anesthesia, the woman in labor sees and understands everything, but the lower part of her body is completely immobilized and has no sensitivity.

During the procedure, the doctor cuts the peritoneum in layers in the lower abdomen. After that, the uterus opens with the hands and the baby is removed. Next comes the classic cutting of the umbilical cord and removal of the placenta. After thorough cleaning, the layers are stitched in reverse order.

Advantages of the operation

Like any other medical manipulation, a caesarean section has pros and cons. If you are scheduled for a planned operation, then you do not have to choose. However, many women consciously and voluntarily sign consent to such a procedure. This group of women in labor is sure that the operation has only advantages, while natural childbirth is very dangerous and can be painful. Let us consider in detail what advantages this medical manipulation has.

No pain

All mothers-to-be know that childbirth is painful. After listening to their experienced girlfriends, frightened women beg the doctor to operate on them. Anesthesia for caesarean section is always used. The expectant mother does not experience any discomfort and contractions. She simply sits on the operating table and waits for the doctor to do his job.

Quick delivery

This manipulation is very fast. The surgeon skillfully performs all movements and removes the baby from the mother's reproductive organ. From the beginning of the action of the anesthetic drug to this period, only a few minutes pass. About another quarter of an hour is required for the doctor to cleanse the uterine cavity and stitch all layers together. On average, such an operation lasts about half an hour, while natural childbirth can drag on for a day.

Perineum Integrity

What other cesarean section pros and cons does it have? Women during natural childbirth often have to go through an uncomfortable procedure called an episiotomy. It is done to make it easier for the baby to go through the birth canal and be born. Newly made mothers are very worried about the seams in an intimate place. That is why preference is given to childbirth occurring by caesarean section.

During the operation, the child does not have time to descend into the small pelvis and start expanding the cervical canal. That is why with this manipulation it is possible to avoid ruptures and episiotomy.

Keeping the elasticity of the vagina

This manipulation allows you to maintain the integrity of the vagina, because during it the tissues do not stretch. It is this stretching that women in labor often fear. Women believe that after natural childbirth they will no longer be able to get sexual pleasure and satisfy a man. A caesarean section is carried out in such a way that the child does not even begin to make his way "to the exit."

Child safety

During natural childbirth, the baby is forced to squeeze through the narrow birth canal of the mother. In this case, there may be a complication in the form of entanglement with the umbilical cord. With the operation "caesarean section" this can be avoided. Even if the child is wrapped around the umbilical cord, the doctor will quickly and accurately unravel the loops and release the baby.

Possibility to choose the date of birth of the child

So, you already know a lot about the operation "caesarean section" (for how long the procedure is carried out, its positive aspects). Based on this, you can independently choose the appropriate date when your baby will be born. With a planned operation, you can even specify the time at which you would like to give birth.

Cons of the operation

After studying all the positive aspects of this procedure, it is worth mentioning the disadvantages. The disadvantages of the operation include many factors, for example: long recovery, the need for antibiotic therapy, and so on. Let us consider in detail what disadvantages this type of childbirth has.

Aesthetic side

Such childbirth (caesarean section) reviews are negative for the reason that an ugly scar remains after the manipulation. Many mothers after such a procedure are embarrassed by their own bodies and are forced to resort to cosmetic surgery. It is worth noting that sometimes doctors make very sloppy incisions that leave a woman with a psychological complex for life.

Long Recovery

After the procedure, a woman needs a long time for rehabilitation. If, after a natural birth, a newly-made mother comes to her senses in about a month and a half, then a caesarean section forces her to recover twice as long. This fact is confirmed by the legislation. Sick leave after such an operation is given for a longer time.

Possibility of infection

Like any other operation, caesarean section has the risk of inflammation. Since a scar remains on the uterus, it cannot contract normally and secrete postpartum residues. Retention of blood in the genital organ is fraught with infection. In this case, the newly-made mother notes a deterioration in well-being, weakness and fever.

The occurrence of adhesions

After this operation, as after any other, adhesions may appear. With extensive damage to the pelvic organs, pain and discomfort regularly occur. Also, in women, the functioning of the ovaries and the functionality of the fallopian tubes may be disrupted. It is worth noting that with each subsequent operation, the situation only gets worse.

Inability to have a natural birth

Most women who have undergone a caesarean section will never want to give birth on their own. Also, the failure of the suture can prevent the natural expulsion of the fetus from the uterus. Many doctors do not risk allowing a woman to give birth herself due to the fact that the uterus can simply disperse. In subsequent pregnancies, a caesarean section has to be repeated.

Consequences of anesthesia

If epidural anesthesia is chosen for caesarean section, then complications often appear after it. These consequences include headache in the first month, heaviness in the legs, cramps, and so on.

When general anesthesia is used, things can get even worse. Often, new mothers experience memory problems, deterioration of the hair and skin of the face, as well as many other unpleasant symptoms.

Cons for a child

How does a naturally born baby and a baby after a caesarean section behave? The first thing that both do is inhale. The lungs of a naturally born baby are completely dry and ready to fill with air. The crumb, which was forcibly removed from the cavity of the genital organ, has lungs with a moist inner membrane. As a result, there may be difficulty with the first breath and problems in the future.

A child after a caesarean section often suffers from headaches and reacts strongly to changes in the weather. Such children, according to statistics, have more neurological diagnoses, and they often have to undergo treatment.

Inability to breastfeed

Surely everyone knows that the best food for a baby is mother's milk. However, most women after a caesarean section cannot give this to their baby. At first, anesthesia simply interferes with them. It is mandatory for caesarean section. Later, doctors forbid feeding the baby due to the need for antibiotic therapy. Further, the baby himself refuses to grab the nipple and prefers the silicone nipple.

Natural birth or caesarean section?

So, you know what the pros and cons of a caesarean section are. If you are still undecided on the choice, then visit your gynecologist and ask to tell you even more. In the absence of clear indications for surgery, any sane doctor will convince you. Remember that after a natural birth, you will be able to pick up your baby on the same day, hug him and put him on your chest. All this will not get a woman who had to go through a caesarean section.

Make the right choice!

The share of abdominal delivery has grown, and today one in five pregnancies ends with a caesarean section, rather than a natural birth. The operation has its definite pluses and minuses. We will talk about the advantages and disadvantages of surgical childbirth, how likely it is to develop complications after them, in this article.

To whom is the operation indicated?

A caesarean section is an alternative method of delivery in which the baby is born not in the traditional way, but through incisions in the anterior abdominal wall and uterus. The operation, despite its apparent simplicity and wide distribution, belongs to the category of complex surgical abdominal interventions. That is why in Russia it is not carried out at will, in any case, in state maternity hospitals, perinatal centers and clinics. Only a few private clinics provide for the possibility of an elective caesarean (surgery at the woman's own request). In these clinics, such a service costs about half a million rubles.

The list of situations in which it is safer and more reasonable to give birth surgically is specified and approved by the Ministry of Health of Russia (Letter of the Ministry of Health of 2014 No. 15-4/10/2-3190). So, a caesarean section is scheduled in a planned manner in the following situations.

• low location of the placenta with complete overlap of the internal os or incomplete overlap, as well as presentation with signs of detachment and bleeding;
• premature detachment of the "children's place" from the uterine wall, while the location of the placenta does not play a role;
• two births carried out by caesarean section in the past, as well as any operations on the uterus, if scars remain after them;
• the weight of the fetus is more than 3.6 kg with an incorrect position of the child in the uterine cavity (sitting, located across);
• incorrect location of one baby from twins;
• multiple (often singleton) pregnancy after IVF;
• post-term pregnancy (at 41-42 weeks of gestation), if other methods of inducing labor have not had an effect;
• any mechanical obstacles to the passage of the child through the birth canal - tumors, large groups of polyps, scars after cervical ruptures;
• the state of a severe form of preeclampsia (with edema, large weight gain, signs of increased blood pressure);
• a ban on attempts (for myopia, some diseases of the cardiovascular system, a transplanted donor kidney, etc.);
• the state of acute oxygen starvation of the fetus (of any origin);
• prolapse of the umbilical cord;
• genital herpes of the primary type;
• HIV infection in the mother, if during pregnancy the woman for some reason did not receive supportive treatment;
• narrow pelvis, in which independent childbirth will be difficult;
• blood clotting disorders of the mother, fetus;
• malformations of the baby - omphalocele, gastroschisis, etc.

As for emergency surgery, there are other indications for it. An unplanned operation will be urgently performed on a woman in labor, whose contractions suddenly weakened during childbirth, the cervix does not open, secondary weakness of attempts is observed, the placenta exfoliated, and bleeding began. It will be an operation to save the lives of the mother and her long-awaited baby.

Technique

The operation is performed under anesthesia. The patient has every right to choose general anesthesia, in which she will sleep soundly during all surgical procedures. But most of the surgical births in Russia today are performed under epidural or spinal anesthesia, in which anesthetic drugs are injected into the epidural or subarachnoid space of the spine using a lumbar puncture. With an emergency caesarean section, when every minute counts, they usually give general anesthesia, since there are practically no contraindications to it, and the state of unconsciousness comes faster.

After the woman is given anesthesia or general anesthesia, the surgical team proceeds with the operation. With a planned intervention, they try to make a horizontal incision in the abdomen just above the pubis in the lower uterine segment. During an emergency operation, if the child is in danger of death, a vertical incision can be made in the center of the abdomen through the navel.

After opening the abdominal cavity, the doctor frees up space for himself for further "maneuvers" - he takes the muscle tissue and the bladder aside. After that, an incision is made on the uterus, the fetal sac is pierced and the amniotic fluid is drained. Then the surgeon gently head forward removes the baby through the incision made.

The umbilical cord is cut and the baby is transferred to neonatologists. The woman is gradually restored, first, the uterus, applying internal sutures, then the abdominal cavity, returning the muscles and the bladder to their anatomical initial state and applying sutures or staples to the skin from the outside.

A woman, if she is not under general anesthesia, will be able to see her child immediately. If she is fast asleep, then the meeting will be postponed and will take place only a few hours after the birth.

The newly-made mother stays in the intensive care unit for several hours after the operation, after which she is transferred to the postpartum ward in a regular ward, where already 8-10 hours after the intervention she can begin to sit down, get up, walk.

Advantages

The undoubted advantage of caesarean section can be considered a relatively predictable outcome of the intervention. The likelihood of birth injuries for both the child and his mother is minimal. The child does not need to pass through the narrow birth canal, and therefore he also has practically no chance of getting a neck or head injury during surgical delivery. Whereas with a narrow pelvis or a large baby in a breech presentation, injuries to the newborn and his mother during natural childbirth would be much more likely.

Caesarean section makes it possible to become mothers to women who are contraindicated in natural childbirth. And today, the quality of materials for suturing tissues and surgical techniques make it possible to give birth promptly to not one or even two children, but as many as a woman wants.

During a caesarean section, a woman does not feel labor pain, which scares pregnant women the most and the memories of which are never erased from memory. Parturient women have some fear of what is happening when using epidural anesthesia, but it is more psychological.

If general anesthesia is used, then the woman simply falls asleep and wakes up already in the status of a mother.

The use of spinal or epidural anesthesia allows you to correct a disadvantage that has been unremovable for many years - a woman gets the right to see the baby immediately after it is removed from the womb, and it also becomes possible to attach the baby to the breast, which is very important for the early development of lactation and full subsequent breastfeeding.

A caesarean section, if done in a planned manner, does not leave gross disfiguring scars on the patient's abdomen. Doctors do their best to ensure that the suture is neat, unobtrusive, cosmetic, located in an area that is usually well covered by shorts or swimming trunks. Each subsequent operation, if the woman decided not to be limited to one child, is carried out on the previous scar, no new scars appear on the abdomen and uterus.

A caesarean section makes it possible to carry out additional surgical procedures. If there is a need to provide lifelong contraception, then tubal ligation is performed at the same time, tumors in the uterine cavity can be removed.

Duration of surgical childbirth usually does not exceed 45 minutes, while natural childbirth can last up to a day or even more.

disadvantages

Caesarean section is not a natural delivery, it is always a gross intervention in the work of the female body. If the operation is carried out in a planned manner, then often the mother’s body is not yet actually ready for childbirth (the contractions have not begun), therefore, removing the child in the abdominal way is a huge stress for both the mother’s body and the baby’s body.

The drugs that anesthesiologists use to anesthetize surgical procedures affect not only the woman, but also the baby, even when it comes to spinal anesthesia. A baby born with the help of a surgeon cannot have an Apgar score of 9 in principle, since he is always more inhibited, lethargic - he is affected by anesthetics and muscle relaxants that were introduced to the mother for anesthesia. However, after a few hours this action passes.

The baby is deprived of the opportunity to go the path prepared for him by nature - he does not overcome the resistance of the genital tract in order to be born, and this, according to some experts, is bad and will certainly affect the formation of his character in the future. Thus, it is argued that such children are less initiative, afraid of difficulties, have less stress resistance.

Many issues have not yet been fully studied, but the fact that a baby without passing through the genital tract is deprived of the opportunity to gently adapt to the new conditions in which he will live is undeniable.

The statements of some opponents of cesarean section that children then grow up with a developmental delay, need correction programs, get sick more often, do not correspond to reality, therefore, they cannot be considered as a disadvantage.

A caesarean section is dangerous due to its complications, and their probability, compared with physiological independent childbirth, increases several tens of times. The period of recovery and rehabilitation lasts much longer than after childbirth, breast milk comes a few days later. Tubal ligation, if performed, lengthens both the time of the operation and the recovery time of the woman's body.

After a caesarean section, a woman for more than 2 years is not recommended to become pregnant again, while after a physiological birth there is no such prohibition. It is harmful to lift weights, and in the absence of au pairs, ordinary household chores and caring for a newborn become a very difficult task.

The harm from the operation, of course, does not exceed the benefits, but still you can never be sure that complications and negative consequences will bypass you.

The likelihood of complications

Complications are possible at any stage of the operation, as well as after it. During surgical procedures, bleeding from the vessels of the anterior abdominal wall may occur; if the vascular bundle is injured, mechanical injury to the bladder, ureters, and intestines may also occur. If complications arose during the operation itself, the woman will not be placed in the intensive care unit, but in intensive care, where her condition will be monitored for several days, if necessary, a blood transfusion will be given, and the necessary drugs will be administered. The frequency of such complications does not exceed 0.01%.

Dangerous consequences can also have postoperative bleeding, as well as a violation of the contractility of the uterus (hypotension or atony of the reproductive organ). In this case, medical assistance will be required and removal of the uterus is possible, if its muscles do not respond to the introduction of reducing drugs, the uterus does not decrease.

Severe vital complication of caesarean section - infectious inflammation. It can lead to the death of a new mother. Symptoms of inflammatory infectious complications are high fever, abdominal pain, discharge of an atypical nature, suppuration of the wound, an increase in leukocytes in the blood test. More often than others, inflammation of the endometrium of the uterus (endometriosis) develops after surgery, but other situations are not excluded. The most dangerous of the possible is considered peritonitis. In practice, given the sterility of modern operating rooms and the sophistication of the actions of the surgical team, such complications are not so common - only in 0.7-1% of cases.

The danger for the child lies in the short-term exposure to anesthetics, which can lead to respiratory failure (0.003% of cases). Much more often, respiratory failure develops in newborns if the intervention was performed at 36 weeks of pregnancy and earlier, but it is no longer associated with the operation itself, but with gestational immaturity of the fetal lung tissue.

Much depends on a properly organized postoperative period.

Problem Prevention

To prevent inflammatory processes, if their likelihood is suspected, doctors prescribe antibiotics to a woman in the early postoperative period. Since complications occur most often in women with obesity, systemic comorbidities, low social status and bad habits, as well as with impaired blood clotting, it is these women who are in the zone of special attention of medical personnel.

To exclude hypotension or atony of the uterus, early attachment of the child to the breast is recommended, as well as the introduction of reducing and analgesic drugs. If a woman has had 3 or 4 such operations, more careful monitoring of the scar area on the uterus during the year is recommended, since it is thinner than in those who have had one or two operations.

A woman should not lift weights, you also need to protect yourself. Sexual life can begin to live only when the discharge from the genital organs stops, not earlier than 2 months after the birth of the baby. It is strongly not recommended to become pregnant within 2 years, the scar on the uterus during this period is in the stage of intensive formation.

During pregnancy 4 months or a year after cesarean, the weak and thin connective tissue in the incision area may not withstand the intensive growth of the uterus, which can lead to rupture of the muscular organ even during gestation.

According to the reviews of women left on thematic forums on the Internet, there were no complications after a caesarean section. Due to the fact that they are not so common, there are almost no reviews describing the negative consequences. Most women note that the recovery went well, the scar on the abdomen healed about 3 weeks after the operation.