In just the past 14 years, the rate of cesarean sections done on low-risk women has jumped a whopping 5.4 percent, according to a new investigation by Consumer Reports. And C-sections represent 31.8 percent of all births in the U.S. annually. Whether the trend is for better or worse, one thing's for sure: Women are often faced with a lot of misinformation about the procedure. So many myths about C-sections -- when it comes to what the surgical procedure entails, who the best candidates are, what recovery is really like, and much more -- often overshadow the truths.
That's why it seems imperative to set the record straight. Here, the truth about all the aspects of going under the knife in the delivery room.
Myth: Having an obstetrician with a higher rate of C-sections automatically means you'll end up on the operating table.
Reality: The number of C-sections a doctor has performed doesn't show you the whole picture. It also pays to look at the doctor's patient population. Many doctors with a higher C-section rate are actually go-to physicians for high-risk or multiple birth pregnancies that have a greater chance of surgical delivery.
Myth: You can schedule an early, elective C-section to deliver at a more convenient time for you and your doctor. Celebs do this all the time!
Reality: While elective C-sections are an option, doctors warn against having the procedure more than a week before your due date. The reason is illustrated by a study published in the New England Journal of Medicine, which looked 13,258 pregnant women who had had a prior C-section. 36 percent decided to schedule their next C-section delivery before 39 weeks of gestation. The trial found that babies delivered at 37 weeks by elective C-section were twice as likely as those born at 39 weeks to have complications ranging from respiratory problems, heart issues, sepsis and seizures — conditions that typically require resuscitation or ventilator support in a neonatal intensive care unit.
Myth: After one C-section, VBAC (vaginal birth after cesarean) is considered safe. However, after two or more C-sections, you'll need an elective C-section.
Reality: This myth stems from the idea that the risks of C-section scar rupture increases with the number of cesarean operations. However, the Guide to Effective Care in Pregnancy and Childbirth concludes that "the available evidence does not suggest that a woman that has had more than one previous cesarean section should be treated any differently from the woman who has had only one cesarean section." In fact, research has shown success rates of vaginal delivery of 60 to 80 percent for women undergoing a trial of labor (TOLAC) after a C-section, according to Dr. Adam Paxton, M.D., OB/GYN at Newton Medical Center in Newton, NJ. That said, as many as four out of 10 women who have a trial of labor end up needing to have a C-section.
Myth: Complications and risks from C-section aren't that much different from vaginal birth.
Reality: Compared with women giving birth vaginally, healthy, low-risk women undergoing their first C-section were three times more likely to suffer serious complications—such as severe bleeding, blood clots, heart attack, kidney failure, and major infections—according to a 14-year analysis of more than 2 million women in Canada.
Myth: Babies born by C-section will end up on formula, because breastfeeding after the operation is too difficult.
Reality: Although no one would argue that it is more challenging for a mom contending with post-operative pain to breastfeed, it's certainly not out of the question. "Your transition from colostrum to mature milk is slower," explains Paula Fitt, RNC-EFM, BSN, perinatal nurse educator and International Board Certified Lactation Consultant at Newton Medical Center. "Most moms who have a vaginal delivery will experience the onset of mature milk around day 3 after delivery, [whereas those who have had] cesarean deliveries experience an increase in their milk volume around postpartum day 4." That said, there are ways to facilitate breastfeeding after a C-section, like asking for skin-to-skin contact as soon as possible after the birth to decrease the likelihood of the baby being given formula first, and asking a lactation consultant or attending nurse to show you how to breastfeed in the side-lying and clutch-hold positions, which will keep the baby's weight off your incision.
Myth: Having a C-section means you won't be able to have skin-to-skin (which will stabilize baby's temperature, heart rate, and breathing) after the delivery.
Reality: "Some hospitals are really ready to have mom do skin-to-skin in the OR, and some hospitals are not," explains Fitt. "Readiness has to do with the comfort level of the anesthesiologist. A lot of times the nursery nurse is not capable of staying in the OR, so that's one of the challenges, too." But moms-to-be can preempt these possible obstacles by asking about a hospital's protocol before opting to deliver there, speaking up if you can, or having someone on your birth team (your partner or doula, etc.) help you advocate for it.
Myth: Recovery after birth is pretty much the same no matter how you delivered.
Reality: While vaginal delivery recovery averages one to two weeks, post-C-section recovery can take up to six. Typically, recovery protocol requires a catheter after the procedure for the first day, then narcotics for pain and to minimize the risk of blood clots. The typical hospital stay for a C-section is four days, compared to two days after a vaginal birth. And once you go home, you're not allowed to lift anything heavier than the baby or drive for the first two weeks (because of the muscle movements of your core needed to apply pressure on the brakes). However, whether you deliver by C-section or vaginally, most women are advised against exercise or sex for the first 6 weeks postpartum.
Did you believe any of these myths about C-sections? How do you feel now?
Image via Corbis