C-section is another name for caesarean birth, a surgical delivery that removes the baby through an incision in the mother’s abdomen & uterus. Sometimes a C-section is deemed safer than vaginal birth, but they all involve anesthesia, major surgery, & antibiotics.
The number of babies delivered via C-section has alarmingly increased worldwide recently, being dangerously overused in middle & high-income countries for non-medical purposes. This is raising concerns because there are many risks associated for both mother & baby.
Some factors that contribute to the rising use of caesarian delivery are the improvement of surgical & anesthetic techniques, reduction of the postoperative complications, & today’s increasing perception of greater safety with the procedure compared to natural birth.
The World Health Organization (WHO) suggests that a C-section rate between 5% – 10% is justified, but a rate above 15% implies an unnecessary & unjustified use of surgical delivery, & having no improvement in women’s health or reductions in the mortality rate of mother or child.
Some C-Sections are Medically Necessary
There’s a growing list of conditions deemed medically necessary for caesarian delivery:
- Abnormal fetal positioning prior to birth
- Baby’s head is too large for a vaginal birth
- Baby’s health is at risk
- Birth defects such as hydrocephalus
- Complications during labor
- Complications during pregnancy
- Emergency occurs during labor
- Infection like HIV or genital herpes that can be passed onto the baby
- Labor isn’t progressing as fast as “normal”
- Medical condition like diabetes, high blood pressure, or obesity
- Mother’s health is at risk
- Physical condition
- Placenta problems
- Pregnant with twins or more
- Umbilical cord gets pinched or prolapses
C-sections are often medically required & can be life-saving, but critics wonder what the numbers would be if every mother was given complete information regarding the benefits & risks. Today, the majority are performed when there is no medical need, & the WHO found that more than 60 percent of countries overuse caesarian surgery.
Caesarian Rates as High as 83%
In countries such as America, Britain, & Australia, roughly a third of all births are from C-section. Worldwide, rates have exploded from 7% of all births in 1990, to 21% in 2015. The fact that more than 1 in 5 of all babies are born via major surgery has profound consequences that go far beyond just the financial cost.
Our place of birth matters, as across the U.S. there’s a 10-fold variation in hospital-level caesarean rates, from 7% to 70%. The variation is even more extreme in patients with lower risk births, varying by 15-fold.
In developing & low to middle income countries, wealthy women have more than five times the number of caesarians than poor women; a social trend that has many dangerous long-term implications.
In private hospitals in Kashmir & Brazil the C-section rate is 82%, & in West Bengal 83%. However, when looking countrywide, Latin America & the Caribbean have more than 4 in 10 of all births as C-sections; & in five countries they now outnumber vaginal deliveries: Dominican Republic, Brazil, Cyprus, Egypt, & Turkey.
Other Reasons for Worldwide C-Section Increase
Many factors are feeding the explosive growth. Generally, there’s a lack of midwives to prevent & detect problems, medical litigation issues, & pressure from doctors & facilities to have birth to be completed on a timetable, rather than have to contend with nature’s unpredictable schedule. Also, these days C-sections are viewed as more advanced than natural delivery.
Our declining health plays a major role, as the caesarian trend tracks the increase of obesity & diabetes; diseases that often result in the need for a C-section delivery. The number of women giving birth later in life & increased vitro fertilization boosting the number of multiple births are also two big factors.
At least some of the rise is cultural. For example, many Asian religions have strong incentives to give birth according to lucky & unlucky days & years. To get their child a preferred zodiac sign, Chinese parents often schedule births to land on one side or the other of auspicious dates, while American culture avoids planning births on weekends & holidays.
Some medical professionals & facilities can have strong profit motives to encourage C-section, plus they’re much less likely to be sued after an elective surgical birth. Also, many women find it more convenient & worth the money.
In other areas, the trend is system-driven, like Brazil, where pregnant mothers who can’t afford private healthcare are offered the procedure to help clear patients more quickly through their underfunded, overburdened free public health care system.
C-Sections Pose Risks to Baby
C-sections have been linked to dozens of health issues for children, including the risk of developing autism, attention deficit disorder, or even schizophrenia. This increased risk is present for both planned & unplanned surgical deliveries, & includes:
- Type I Diabetes
- Hearing impairment is 3x more likely
- Metabolic disorders
- Lower APGAR scores are 50% more likely (tests of immediate physical health)
- Fetal lacerations
- Childhood leukemia
- Persistent pulmonary hypertension is 4x higher
- Respiratory problems since the protective inner coating of the lung is made in our final womb days, so much more likely to suffer from respiratory distress syndrome
- Wet Lung (aka. transient tachypnea) vaginal delivery causes baby’s lungs to naturally expel fluid, whereas if C-section is performed before labor begins, they could still have fluid in their lungs.
- Infant Death – 3x more likely to die in the first month
- Separation issues. Many mothers report a struggle to connect with their surgically deliveries newborns.
- More likely to spend time in the neonatal intensive care unit
- Much less likely to be breastfed after both emergency & planned C-sections, breastfeeding & skin to skin contact can be uncomfortable or pained
- Much more likely to experience more stress & shock
- Immune system defects are 40% more likely
- Rheumatoid juvenile arthritis is 10% more likely
- Stillbirths up to 7x higher
- Delayed brain function, due to lower ability to concentrate & voluntarily focus their attention.
C-Sections May Harm Mom
At a minimum, C-sections increase the likelihood of urinary tract infections, constipation, bladder infections & lifelong incontinence for the new mother, while leave scarring of the womb that may cause abnormal bleeding, blood clots, fever, muscular pain, headaches.
Many of these new mothers leave the hospitals with prescriptions for painkillers, & need a lot of assistance once home. They’re unable to drive or lift anything heavier than their baby for a few weeks.
There are several immediate maternal risks associated with a caesarean delivery:
- Bladder Issues
- Bowel Issues
- Reaction to anesthesia
- Surgical injury to nearby organs, like bladder or intestines
- Inflammation of the uterus
- Amniotic fluid embolism (fluid or fetal material enters maternal bloodstream)
There is also the added risk of additional surgeries such as hysterectomy, bladder repair, or another caesarean. The vast majority of women that have one have to have multiple, since most hospitals & doctors offering maternity services do not permit women with a previous C-section to give birth vaginally at their facility, due to the chance the uterus could tear along the previous scar line.
Plus, caesarians are associated with future subfertility & infertility, increasing the risk of serious complications in the next pregnancy, such as placenta praevia (attaches too close to cervical opening), uterine rupture, irregular placental development, ectopic pregnancy (embryo attaches outside of the uterus), preterm birth & stillbirth.
These are the only surgical patients that have repeated cuts done on the same scar, over & over again. This makes surgery more difficult each time, causing the internal tissue to fuse together, looking like “a box of melted crayons”.
Every Face Squashed into a Vaginal Canal is Essential
There’s a strong link between birth method & a child’s future health, as babies born via C-section have different hormonal, physical, medical, & bacterial exposures during birth, altering their health trajectories.
Caesarian babies are not exposed to the vital microbes they acquire during a vaginal birth. Human gut microbiome is made up of the trillions of microorganisms & their genetic material that live in our intestinal tract.
Prior to birth, the mother’s vaginal microbiome changes significantly towards matching that of her gut, just so that the baby can get a faceful & begin their final stages of immune development which are done outside of the womb.
The human placenta is not sterile as recently believed, but we’re born with very low microbial diversity & numbers. The diversity increases dramatically during our first months, but in babies born by C-section, the levels of harmful bacteria are often quite high.
A healthy microbiota in newborns derives from a vaginal delivery, immediate skin to skin contact, delivery at term, breastfeeding, exposure to a variety of microorganisms, & the food choices of our first two years.
Industrialized countries require antibiotics for all women prior to undergoing a caesarian, to protect against infection. But these drugs are indiscriminate & kill both the good & bad microbes, leaving both mother & newborn with a disturbed & unbalanced internal ecosystem, our gatekeeper of the exterior world.
Serious Birth Defect is Only Fixed Easily Early
The best cure is prevention, so some current interventions include having midwives working more closely with physicians, addressing women’s fears of labor pain & vaginal delivery concerns, & promoting prenatal nutrition & maternal health.
C-sections are growingly considered by doctors to be repairable birth defects due to the immense, chronic damage that they can have on our health. As caesarian deliveries continue to become more prevalent, & happening suddenly to many expecting mothers, having the antidote on hand before the baby arrives may be critical.
The window of opportunity to completely transform an infant’s developing gut microbiome occurs in the first weeks of life; a pivotal moment when the foundation of their immune system is established, when we’re able to powerfully influence a newborn’s lifetime ratio of helpful bacteria supressing opportunistic pathogens, or to re-establish the mother’s gut, after the antibiotics that she just had to consume.
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