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| |    Cesarean Birth by Lisa Rodriguez, R.N. and Marjorie Greenfield, M.D. reviewed by Marjorie Greenfield, M.D. Even though most babies are born by the vaginal route, it is a good idea to familiarize yourself with all types of deliveries, since unpredictable circumstances can arise. Understanding the possibilities can help you feel more secure and allow you to be a more active participant in your own care. What is Cesarean Section? In cesarean section, also called c-section, the baby is born through a surgical incision in her mother's abdomen and uterus. For most women and their infants, vaginal birth is a better and safer option than cesarean, with a shorter and less painful recovery. There are times, however, when the risks of vaginal delivery outweigh the risks of surgery. In these situations, a cesarean can be a lifesaving procedure for the mother or the baby. In some situations, the risk of vaginal birth and the risk of cesarean are about equal and the decision can be made based on personal preference. This partially explains the different rates of cesarean for different doctors, hospitals and communities. The procedure Cesarean involves two incisions--one into the abdomen and one into the uterus. The skin incision is usually a "bikini" incision across the lower abdomen, but in some circumstances may be an up-and-down incision, from the pubic hair to the belly-button. The uterine incision is usually a "low transverse" incision (across the lower uterus), allowing the woman to labor in the future without great risk of uterine rupture. The direction of the skin incision does not indicate how the uterine incision was done. The surgical note or the word of the surgeon is the best judge of what type of cesarean was done and whether a future vaginal birth after cesarean (VBAC) would be safe. Risks of cesarean Because it involves surgery, cesarean creates some risks that are not usually present for vaginal birth. Although major complications of cesarean are not common, there can be injury to other internal organs such as the bladder, ureters (tubes that come down from the kidneys), or bowel. Excessive bleeding can occur, leading to anemia (low blood count) or even the need for blood transfusion. Very rarely there is an injury to the fetus during the surgery. In addition, there can be a complication from the anesthetic, especially if you need general anesthesia for the surgery. In most cases it is safer to have an epidural or spinal if possible.
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