The C-Section Risk No One Is Talking About


hospital pregnant delivery roomC-sections are a risky way to birth. This we know. There are facts. It is major surgery. But there are still many women who end up with a cesarean. Too many. The c-section rates have risen to an alarming rate (nearly 30 percent) -- far beyond what even the respected medical community feels appropriate.

We all know the risks, but there is one risk that we don't talk about enough. It's the risk involving your placenta and its ability to kill you. Repeat c-sections increase that risk. 

Chavi Karkowsky, a specialist in maternal fetal medicine, wrote a fantastic day-in-the-life essay of what it's like to be an OBGYN. She details a meeting with the obstetrics team involving everyone from urology ("because the bladder is right next to the uterus") to the neonatal intensive care unit in the event baby needs additional care. Also there are members of the blood bank and anesthesiology "because they’re in charge of keeping the mom and fetus alive during the surgery."

When it's put this way, doesn't a c-section sound scary? People don't like to think about the whole process and instead just think it's a procedure and done -- baby is born. Mama gets stitches and a scar. Life goes on.

But Dr. Karkowsky's concern in this meeting is due to the fact the mother they are preparing to perform a c-section on has placenta accreta, which means the placenta isn't growing as it should and is instead growing too much, spreading through the line of the uterus. The placenta -- the life force feeding our babies when they are in our wombs -- can also be seen as a parasitic organ, and if something goes wrong, it can really go wrong and even kill us. Dr. Karkowsky says:

There’s an obvious metaphor here, of course, about pregnancy and motherhood, and how they can devour a woman from the inside. But the setup for a placenta accreta often starts long ago, with a prior pregnancy. The other metaphor is that we carry some of the choices that we make forever, and some of them we never heal from entirely. 

If you have had a c-section and decide to have another child, your risk of placenta accreta rises. It's due to our c-section scar. Placentas sometimes gravitate toward a prior surgical site. They can become abnormally implanted and as Dr. Karkowsky notes:

... with each cesarean section, the risk becomes higher. There is something about the way that scars heal that means that the delicate boundary between inside and outside the uterus becomes disrupted and lays the foundation for future abnormal placental growth. There’s no risk-free way out of any pregnancy. Some of the risks we see now. Some of them don’t become clear until future pregnancies. Let’s discuss them and make the right decision for your whole reproductive life.

This is one of the many reasons this kind of information needs to be heard by every woman. We cannot let doctors insist on a c-section because not only can that birth become more dangerous, each subsequent birth does as well.

Were you aware of this c-section risk? Have you heard of placenta accreta?


Image via george ruiz/Flickr



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nonmember avatar KIMBERLY

I have had 3 c-sections. Horrible experiences. They caused me great pain and depression. My stomach is in ruins and I am striving with exercising and healthy eating to repair it (probably won't help). So after 3 pregnancies and 3 c-sections....I conquered 2 vaginal births with my 4th and 5th pregnancies. I am so grateful for the joy of knowing that there is nothing wrong with my body. I was meant to have a baby vaginally. So sad that I could only find 1 doctor in Denton, Tx who would even allow me the opportunity to try for a vaginal birth. Dr.Frederick Cummings. All other doctors dropped me as a patient when I stated that I would like to try for a vaginal birth. I have faced the reality of c-sections and I wouldn't wish that method of birth on anyone.

zombi... zombiemommy916

I actually had placenta accreta with my third and final cesarean...the placenta was attaching itself to my bladder...the whole experience was terrifying and I had to see a perinatologist the entire time (my medical bills are sickening) but we came out ok! I had a HUGE surgical team and they were fantastic!

Britt Woods

I plan to have atleast 3 more children after my daughter. I cannot have a natural birth because my pelvic opening is too narrow, my daughter wasn't able to fit through. My OB told me to never attempt a natural birth because it would like result in emergency cesarean anyway. I don't know how this will effect my decision to have more children, but it does sound scary.

mrssu... mrssundin

Hmm I have had five emergency c sections and never had that issue. Birthing a baby vaginally or c section is risky I've done both. I was told on my vag that I was lucky my uterus hadn't abrupted due to the contractions I was having.

nonmember avatar syneya

Maybe not everyones dream birth, but C sections are good at what they do, getting baby out quickly. There are risks with everything. I personally did have a C section with a hysterectomy after. Recovery was very easy and I would never claim that my body was "destroyed". Its hard for any mom to get back into shape, not just c section moms. Some people are so set on vaginal and natural births that they are quite butthurt when they are forced to have a csection (even if it is for their health of baby's health) We must look at the bigger picture here, live, learn, and grow forward. Not continually rag on procedures that are done for our babies!

jessi... jessica_mars

I have actually had placental accreta with my second child, James. I almost died because of this, I lost over have my blood before being wheeled into the OR to do a D&C because it was thought that there was placenta still stuck inside and that was what was causing the bleeding. The accreta wasn't diagnosed till afterward. I've never had any c-sections and had had a D&C 5 years prior for a miscarriage that wasn't completing on it's own. When I surprising found out I was pregnant with my third child, Liam, 6 months after the birth of James, I was sent to UCSF Medical Center every 6 weeks for level 2 ultrasounds to keep a watch on my placenta so we would know if it was doing it again. I even had to be delivered at UCSF Medical Center, which means I had to be induced a week early because of how far away it is for me. I had a huge team of doctors, who were all very interested in what had happened prior because they said it was very uncommon for accretas to happen without a prior scar on the uterus. The birth of my third child went without any problems, but I'm not sure if the level 2's are a permanent part of my care whenever I get pregnant.

nonmember avatar Rachel

With my son was told a c-section was necessary. Come to find out later that it could have been avoided. It was the doctors action and hesitation that left me with no choice. I was heart broken, it felt like I'd lost something vital........a part of me I will never get back.When they gave me the saddle block they damaged the nerves in my back. I also wasnt completely numb when they stared cutting. It was a horrific experience. Iwas in the hospital 2 days, the doctor wanted to remove my staples the day I left the hospital. I refused. I left on a sat he took them out the following monday. That night I split open, went to the emergency room and it was discovered I had cellulitis. Iwent to his office the next day he ripped open the rest of the way (hip to hip). It was extremely painful. It took 4 months to heal.

ginge... gingermommy86

I've had 2 and got my tubes tied this Last time.. I was really scared this last time going into the operating room. . I kept playing what if something goes wrong... but luckily everything went fine except after baby and they were doing the tubal ligation I got nauseous and puked a little which was the weirdest thing ever!! I ended up with A LOT more gas pain than with my first... it was worse than the actual section cut... I also had to have my second vertical cut which has left my stomach pretty much with a butt in the front... but I have two healthy babies and I don't have to worry about having another thank goodness!! :)

sweet... sweet_bumblbee

I will be having my 7th c section In June. Thankfully I have not experienced that and they all were smooth. It just really depends on the woman's body and that pregnancy.

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