Cesarean section – Indications, benefits and risks

Caesarean section is the surgery that involves the sectioning of the mother’s abdomen and uterus to bring the baby to the world. Caesarean surgery may be recommended in advance by the doctor or may be required by a complication during labor (emergency).

When is caesarean section indicated? Caesarean section is required when there are conditions of the mother or fetus associated with major risks in the case of a natural birth.

Maternal conditions include:

Placental abnormalities (placenta previa, placenta premature take-off)
Diseases of the uterus (uterine fibroids, malformations, anterior uterine surgery)
Cervical disease (dilation dystonia, antecedent surgery, cervical cancer)
Risk of transmission of infectious diseases (herpes, HIV, hepatitis B or C)
Neurological diseases or post-traumatic disorders of the pelvis or spine
Pre-existing or gestational diabetes
Pre-existing or pre-existing high blood pressure (preeclampsia)
Advanced myopia

Fetal disorders include:

Multiple / twin pregnancy
Fetal abnormalities
Pelvic presentation
Too much weight of the fetus
Fetal suffering requiring emergency birth
Controversial indications

Is natural birth possible after cesarean section? Here’s a frequently asked question. Doctors say that a previous cesarean section is not an absolute indication for a second caesarean section. In other words, if you gave birth by Caesarean section and then want to give birth naturally, this is possible if the doctor finds that there are no medical contraindications.

Pregnant women who are afraid of giving birth vaginally, called tocophobia, may request caesarean section, but after the psychologist and doctor come to the conclusion that this phobia really exists. Caesarean section on request is not acceptable as a medical indication. But it must be kept in mind that, however, the responsibility of the decision on the method of birth belongs to both the doctor and the mother. The mother’s choice is important, but the doctor’s recommendation can make the difference.

Advantages and disadvantages

Caesarean is only recommended in cases where its benefits outweigh the risks of natural birth. In the case of pregnancy without maternal or fetal risks, the usual indication is of natural birth. If using caesarean section without medical justification, then the risks for the mother and child come into question. But the risks are of different categories. For the mother, there are risks as with any surgery: thromboembolic complications, intra- and post-operative bleeding, lesions of internal organs during surgery, post-surgical infections. In the case of the baby, caesarean section carries the risk of prematurity, since the operation can be scheduled before the term of birth, when the baby is not fully prepared for extrauterine life.

In general, Caesarean section is desired by mothers due to labor and pain fear, but it must be known that there is pain after surgery. The recovery period is more difficult after the surgical birth and often involves the administration of strong analgesics, difficulties in initiating breastfeeding and the impossibility of taking care of the baby for at least the first two weeks after the operation.

The natural, physiological birth presents many benefits for the mother and the baby, including rapid recovery, easy breastfeeding, the possibility of holding the baby in her arms immediately after birth and its care by the mother from the first days.

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