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Home › Articles › Labor and Delivery › Elective Cesarean

Elective Cesarean

Physical and Emotional Risks of C-sections

By Sue Poremba

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A growing number of women are deciding to schedule a Cesarean instead of having a vaginal birth. In some respects, it seems a logical decision. Today's mother-to-be is a busy woman. Scheduling a Cesarean means she can plug the date of the baby's birth on her calendar and easily plan around it.

Also, some women believe if a previous birth was by Cesarean, subsequent births are easier done the same way, or they've been told a vaginal birth after a C-section is difficult. Still other women believe a C-section is the safer way to give birth.

However, having a Cesarean is not without risks. It's easy to forget this is major surgery. With a C-section, anesthesia is involved, as is opening up the abdomen and womb. The typical recovery period is eight weeks, which is longer than the recovery for a vaginal birth.

Cesarean Concerns
"There can be long-term, permanent damage from a C-section," says Dr. Robert Atlas, chair, Department of Obstetrics and Gynecology at Mercy Medical Center in Baltimore, Md. "Some women end up with chronic pain, numbness or itching at the incision."

Itching and numbness has been an issue for Sheri Menelli of Carlsbad, Calif. "A few inches below my belly button and all the way down to and past the incision is numb," she says. "It feels strange. As the nerves are growing back, the area itches or feels prickly, but it is mostly numb."

Urinary incontinence is another lasting side effect some women experience after having a Cesarean. Thin, Caucasian women are most susceptible to this problem.

The most serious post-Cesarean risk is a uterine rupture. This can occur in future pregnancies, particularly if the woman tries to have a vaginal birth after a Cesarean. Dr. Atlas advises women who plan to have large families to avoid a Cesarean section if at all possible. "While the risk of a uterine rupture after Cesarean section is relatively low, the risk increases after multiple pregnancies," says Dr. Atlas. Five seems to be the magic number; any pregnancy after her fifth makes the mother more prone to a uterine rupture.

Any woman who has had surgery on her uterus before a pregnancy - this includes surgery for fibroids or to repair a misshaped uterus - has an increased risk of uterine rupture. This happens when the scar from the previous surgery gives way during labor.

While the rupture itself isn't fatal to the mother, and most ruptures go unnoticed, if the tear is bad enough, it can cause hemorrhaging and the mother may end up needing a hysterectomy. There can be some dangers to the fetus as well. It can cause the fetal heart rate to become abnormal, or the baby can end up moving out of the uterus. The rupture can also mean the placenta could separate from the baby, cutting off the fetus' oxygen supply.

Emotional Concerns

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