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To C, or Not to C?

Updated: Jan 25

My doctor recommended a planned cesarian section, but were the risks worth it?

My butthole was destroyed due to HG during pregnancy. (Feel free to punish yourself by reading the previous blog posts on HG and on my resulting rectal prolapse). I wasn't given the decision to opt for a vaginal delivery. My baby was measuring quite large and the concern was that I would again push my rectum out of my body should I try to squeeze out a 9-pounder.

I was terrified of my doctor's orders. Was a highly invasive surgery worth saving my freshly healed bungholio? Would I be exposing the baby to the medications required for this surgery? Could I care for my child while recovering from having been sliced through several layers of anatomy? Would a planned C-section allow my child the time to bake according to her needs? Might the fluids not be effectively squeezed from her lungs and other orifices? Perhaps she wouldn't bond with me as effectively because I wasn't going through the biological ritual. All of these concerns and more flooded me and I tried to convince my beloved OBGYN that the C-section was unnecessary. He was obviously more educated and experienced than I, though, and informed me that he would ask me to change doctors should I try for a vaginal delivery. So, I hit the books to self-educate. What I found really surprised me and validated my decision to go for the C.

Now, of course, any surgery carries risk. I have a good friend whose emergency c-section ended in her receiving life-saving CPR due to the spinal block traveling upwards and paralyzing her heart and lungs. The maternal mortality rate is higher for c-sections: 9.7 per 100,000 by c-section versus 1.8 per 100,000 by vaginal birth. Additionally, there is a greater risk for surgical lacerations and major bleeding in subsequent pregnancies. C-sections require surgically excising the skin, fat, fascia, peritoneum, and the layers of the uterus. They also require the rectus abdominis to be separated at the midpoint. C's require longer hospital stays, incur higher labor and delivery medical bills, are challenging to recover from when caring for a newborn, and do increase the risk of neonatal respiratory distress.

With all that said, it seems that c-sections should be avoided at all costs. But, I must report that even had it not been for a bulging balloon knot of a butthole, I would opt for an elective c-section again.

My Daughter's Birth Story is So Simple and Drama Free

On 11-7-11, four days prior to her official due date, my husband and I casually strolled into the hospital. We spent about an hour registering and prepping and within two hours of my arrival, we welcomed our bouncing baby girl. I was stitched shut, given an extra suturing of my abdominal muscles (a little girdle bonus thrown in by my doc), and was wheeled to my recovery suite. My daughter and I spent the next five days doted on by nurses, lactation consultants, pediatric specialists, food deliverers, and maids. It was the most relaxed and well-taken care of I have been since delivering my babies and I might just have to have another baby in order to assure that type of peace in life once again.

I ain't gonna lie, the recovery wasn't ideal. It was painful, difficult to get around, and limited my mobility. Post-surgical potty time was dreadful and I had to sleep on the lower level of our home for a week. It wasn't all sunshine and rainbows.

Let's consider the alternatives though: vaginal deliveries and emergency C-sections.

Vaginal Deliveries

This beautiful right of passage is enviable. I mourned that I would never wear the badge of honor of having naturally delivered my babies. Growing up, I had this vision of a peaceful, unmedicated, doula-assisted home birth. I donned a flower crown and gauzy long sun dress. My husband massaged my lower back as I rested on my birthing ball. When time came, I effortlessly disregarded the discomfort and ab-crunched my glowing baby into the doula's hands, sans vaginal ripping and fetal distress. I wish I could have proven my fortitude and bravery by going this route.

Truth is, though, not too many women experience the peaceful deliveries they envision and vaginal deliveries are certainly not without complications. According to a literature review, about 1 in every 200 birthing mothers died in their childbeds from the early 1700's to 1935, an indication of how risky a natural delivery can be. During this time, when we see thorough records, more complicated cases saw about 1 in 40 perish.

In current days, deliveries are much safer in large part because of the many interventions employed. We now have forceps, vacuums, pain relief, antibiotics, better attention to hemorrhaging and health monitoring, etc, etc. Statistically, it is likely that you will have one or many interventions like an epidural (67%), IV fluids (62%), Pitocin to speed delivery (31%), membranes artificially ruptured (20%), an episiotomy to widen the birth canal (17%), and even an emergency C-section (18.2%).

Emergency C-Section

It must be mentioned that while C-sections carry the risk of maternal mortality, a majority of this risk involves those c-sections that were performed as an emergency rather than electively. The maternal mortality rate of elective C's are 5.9/100,000 versus the 18.2/100,000 rate of emergency C's.

Emergency C's often come after long hours of laboriously attempting to vaginally deliver, only to find that the task is impossible or far too risky to the mother or child. By the time the procedure is performed, both the mother and child are often inflamed, exhausted, and traumatized.

The Benies of a C

There are actually so many benefits of elective c-sections.

First of all, your baby won't be born with a smooshed cone-head (not that they aren't adorbs). But more than that, they won't experience brain bleeding! Check this out. In a study, MR images showed that 17 (26 percent) of the babies who had been delivered vaginally had intracranial hemorrhages! I mean, the baby's cranium contorts to fit through the canal and that brain is soft like jello. Evolutionarily, the brain is getting bigger but the size of that pelvic opening isn't keeping pace.

There are other benefits to the baby like reduced cases of clinical chorioamnionitis, reduced fetal heart rate abnormalities, and reduced instances of cord prolapse.

Additionally, a C can be nice for mama by reducing the risk of urinary incontinence (peeing your pants), fecal incontinence (pooping yourself), severe labor pain, and fear and anxiety related to labor. And don't forget that a c-section mama doesn't get thrown into the world of the unknown mere hours after delivery.

In Sum

Sure, I will forever be saddled with a sizable surgical scar on my pubic line, but worth it to me. It's a battle scar I wear with pride. It reminds me how fortunate my baby and I were to have experienced a well-planned, safe, and drama-free delivery.

Going in for a Planned C? Here's what to pack:

  • Toothbrush/ toothpaste/ floss

  • Hair brush your personal hair essentials. (NOTE: I don't recommend spray-dry-shampoo because these airborne particles may be harmful to the baby's lungs)

  • Light makeup for those photo ops

  • Our favorite skin kit (The Ordinary Travel Pack)

  • And exit outfit for yourself

  • An exit outfit for your baby

Have These Ready for the Drive Home

What the Hospital Usually Provides

  • Diapers

  • Baby Wipes

  • Breast Pumps and disposable formula bottles and sometimes nipple cream (lanolin)

  • Really cheap toothbrush, toothpaste, and comb

  • Stinky soap

  • Adult diapers for your post-operative care

  • Hospital gown and hospital socks

  • Not-so-cozy blankets for mama

  • Baby swaddles

  • Baby onesies

  • Pacifier

Need More Help? It Does Take a Village!

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