Traditionally, vaginal birth has been the natural outcome of pregnancy and childbirth, with no safe alternative for the baby, but especially for the mother.
It is only in recent decades that the alternative to safe caesarean section has appeared, thanks to the development of technology and medicine.
Now, at the beginning of the 21st century, caesarean section is seen by more and more women as the most common choice.
So is elective caesarean section a right of today's woman?
Caesarean section is an operation that, except in truly urgent situations, takes place in the hospital. It can be programmed and this is a great advantage for the modern lifestyle, where our daily lives are "ruled" by clocks and calendars. However, the exaggerations of choosing a specific date for the baby's birthday are not missing here either. C-section is quick compared to normal delivery and has been associated in the common perception with less pain. It is performed under anesthesia and therefore there are no labor pains that a woman might experience.
Caesarean section avoids the need for the baby to pass through the birth canal. Many women worry about how something as large as a baby could possibly fit through such a small opening. Some even fear that this fact alone will harm the baby.
Caesarean section is clean. The aseptic conditions of the operating theater are very different from those of natural childbirth. The woman does not sweat and the rupture of the membranes does not cause the same "chaos" as what happens in the delivery room. There is a catheter for urine and the baby's outlet is away from the anus. Finally, repeated vaginal examinations are avoided and a woman can maintain her "dignity" more comfortably.
Of course, as fast, clean and comfortable as a caesarean section can be, it also has its disadvantages. The most obvious is the postoperative recovery period which is long (about 6-8 weeks). Contrary to popular belief, it is quite difficult for a woman to fully mobilize and return to her daily activities immediately after a caesarean section. There is, of course, a series of painkillers to help the mother in the first days, but even so she moves with difficulty, personal hygiene and the care of the baby Present their own peculiarities and must be treated with care. Post-operatively, it can also cause discomfort and pain in the abdomen and other parts of the body – even the shoulders – due to air being trapped in the abdomen.
Of course there is also the incision! They are usually horizontal with a length of about 12-15 cm, just below the adolescent's hairline (bikini line). Itching can often be present as it heals. Many household chores may be difficult or impossible to do after a C-section and for a few weeks. These can include anything from cleaning the house to picking up and carrying the baby. It is even more intense if there is already another child at home, since it is difficult for the mother to even hug him.
Driving should be avoided for 6 weeks, as mothers will not be able to control the vehicle in an emergency.
In addition, insurance companies do not cover mothers who had a C-section within six weeks of birth.
Some mothers will suffer post-operative infections (in UK hospitals the rate of new infections is around 20% with the risk increasing significantly after a caesarean section). Depending on the type, severity and response to treatment, these infections can sometimes be quite painful and slow recovery.
Finally, there are the risks. Caesarean section is a serious surgery. Mothers die very rarely these days, but the risk of maternal mortality is greater after caesarean section than vaginal delivery, as is the risk of obstetric hysterectomy. Scar tissue or adhesions can cause pain, intestinal obstruction, infertility or miscarriage and can make a future surgery more difficult.
Also, mothers after caesarean are at increased risk of ectopic pregnancy, placenta previa (placenta praevia) and placenta accreta (placenta accreta) in subsequent pregnancies.
But even for babies, caesarean section is not without risks. Occasionally there may be injury from the surgeon's scalpel. More importantly, babies born by caesarean section have a higher incidence of respiratory problems, both at birth and as adults.
In conclusion, a caesarean section may not be such a practical solution to the problem of childbirth, although it may seem so at first.
However, women who are well informed about the benefits and potential risks of cesarean delivery retain the right to choose. Modern obstetricians should be able to keep women up-to-date with the latest medical knowledge, while respecting and supporting pregnant women's decisions, ensuring the best possible conditions.
Christos Valakostas
Obstetrician gynecologist