BusyMamaMD

Seriously, what is the big deal about C-sections?  I know my view is skewed as an obstetrician, but I do not understand the anti-C-section movement.  Granted, if a person can deliver vaginally with the end result of a healthy mom and baby, I am all for it.  But, if there is any concern in my mind that one of those people, either mom or baby, will not end up healthy, I will jump to a Cesarean section in a heartbeat.  Yet, why do people fight it?  ​

Let me clear up a few rumors.  Obstetricians are not evil monsters who love to cut on people and ruin your birth experience.  I am appalled at the posts I see on social media and the stories on various mommy blogs cutting down obstetricians.  I went into ob-gyn because I am passionate about women’s health and love delivering babies… both vaginally and by Cesarean section.  Most of the obstetricians I know are kind, caring, wonderful people who really have the patients’ best interests at heart.  I do not think about reimbursement or convenience.  If I am doing a Cesarean it is because I think you need it!  I am concerned about your health or the baby’s health!

Here are some reasons your doctor might recommend a C-section
1.  Fetal distress: This is a broad reason that could mean a lot of things.  Basically, the baby does not look good on the monitor and I am concerned about brain damage or death if the current situation continues.  Some of those babies might be fine and some might die, but I do not want to take the risk and that is why C-section is recommended.
2.  Cephalopelvic disproportion: This refers to the fact that some babies do not fit.  The baby is too big or your body is too small or some combination.  What is the risk of continuing labor?  Well, if I suspect this and let you go too long, the baby could get stuck.  Really.  I have had horrible emergency C-sections where it has taken a long time to get a stuck baby out of someone’s pelvic bones.  Worse yet, the head could come out and the shoulders get stuck.  This might result in broken bones, nerve damage or even death.  Again, my predictions are not always perfect, but if I have a high suspicion for this, I am going to recommend C-section.
3. Breech presentation (or other malpresentation): In this case, the baby is not head down.  When this is the case, it is far more dangerous to deliver vaginally.  Babies get stuck very easily this way.  If the baby gets stuck on the way out for a long period of time, it can result in death.  Not to say that breech (butt down) deliveries are impossible, but they are very risky.  Why take the risk?

Overall, C-sections are necessary.  Yes, people having been having babies for thousands of years without them, but people used to die… a lot.  It was not uncommon to hear of a woman dying in childbirth 100 years ago.  Still today, maternal and fetal deaths are common in other parts of the world that are less fortunate.  Obstetricians are not pro-vaginal delivery or pro-Cesarean.  We are pro-healthy mom and baby, regardless of the route.  In the end it does not matter how the baby comes out, as long as you both are alive and healthy.  Cesarean sections are not the enemy or the worst case scenario.  One just might save your life.