Increased Prevalence Of Elective Caesarean Delivery- Pros, Cons & Risks

Across the globe, many women have been opting for ‘elective caesarean’ for the delivery of their child. The rates of C-section deliveries have seen a considerable rise over the years, with China been cited as the country with highest number of C-sections -50% so as to quote. Indian women, specifically urban, and as many as 20%of them (estimate by some senior obstetricians and gynecologists) are also opting for elective caesareans, both to avoid pain and avail convenience. Some Indian statistical experts place the ratio of elective C-section to be as high as 40-50%. Not restricted to India, the rise in C-sections across continents and countries is a concern for all of us, reports the WHO; which officially withdrew its previous recommendation of a 15% C-section rates in June 2010. Their official statement read, “There is no empirical evidence for an optimum percentage. What matters most is that all women who need caesarean sections receive them.” Ref link

Why Women Are Opting For Elective Caesarean?

Until 2010, cesarean—or C-sections—were limited to 8.5% of all deliveries in the country, just under the recommended level of 10-15%, according to a World Health Organization (WHO) report (pdf), and the numbers have been escalating in many parts of the country. So why is it that women are opting for surgical methods and procedures even of they do not have complicated pregnancies? Perhaps, the below points can shed some light:

1. The fear of labor tops the list of women who just want the baby to come out now. The difficult stories and experiences of women who have had vaginal deliveries make women scared of the pains and troubles associated with a vaginal delivery
2. Some women find scheduling a delivery more convenient than waiting for the labor pain to kick in. It also gives them the flexibility of deciding on leaves etc.
3. To be ‘honeymoon fresh’for years to come is another reason that women like to opt for C-sections
4. Protection of pelvic floor muscles
5. The belief that a C-section will minimize the pains and complications like tearing, incontinence and sexual dysfunction associated with a VD
6. The feeling of control over a highly unpredictable experience

Pros And Cons Of Elective C-section

A C-section may be termed as convenient and preferred by many women, but even for a C-section, you need to wait for atleast 39 weeks of gestation. C section is a surgical procedure, and like it is with all surgeries, it will take some time to heal and will surely leave you at risk for some serious complications in case you have future pregnancies. At the end of the day, it involves cutting the woman’s abdomen and womb. It does have repercussions!

Pros Of An Elective C-section

• Convenience of both the doctor and the patient, decreased risk on incontinence
• Decreased risk of sexual dysfunction
• Reduced risk of oxygen deficiency or birth trauma to the baby
• Sense of control, and planning in advance

Cons Of An Elective C-section

• Higher risks of infection, blood clotting, maternal blood loss, and damage to the mother’s bowels and/or bladder
• If pain was all that you were worried about, you are very likely to have abdominal pain and discomfort in your wound for a few weeks atleast
• You are at risk of adhesions – in which there bands of scar tissues can make your organs stick to each other or to the abdominal wall
• Longer hospital stay and longer recovery period
• Possible complications with breastfeeding
• Breathing problems for the baby
• Risk of clinical postpartum depression
• Slightly higher mortality rate for the mother and twice the risk of infant mortality
• Risks of infection to the scars and stitches, difficulty in healing
• Potentially more expensive
• If it was safe, it would have been offered to everyone – there is no evidence stating that a C-section is better than a vaginal delivery

A C-section is not closely safe as vaginal births, in fact, a woman is four times more likely to die in a C-section delivery than in a vaginal birth. The wound and the scar can make it immensely difficult to breastfeed, sit, and mother your new born. You will be advised a lot of rest and resuming your daily routine will also take quite a while.