Long Term Effect of Caesarean Section

by Dr. Nor Ashikin

My sister-in-law chose to have a Caesarean section to deliver both her children because she could not endure the pain of natural childbirth. She is now pregnant with her third child and planning to have another Caesarean section. What are the long-term effects of another C-section?

Why the growing popularity of Caesarean deliveries? Convenience may be one reason : with Caesarean section (C-section), a woman — and her obstetrician — can choose the time of childbirth and preserve a 'virginal vagina'. Safety could be another reason.

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Women who have C-section deliveries, can have a normal vaginal delivery with later pregnancies, depending on the type of C-section performed and the reasons for it.

Many women who attempt a vaginal birth after a Caesarean (VBAC) delivery are successful. However, there is a small risk of uterine rupture associated with VBAC attempts, which can endanger the mother and the baby.

In the case of your sister-in-law after 2 previous C-sections, the obvious and safest mode of delivery is another C-section, as the risk of uterine rupture is higher if she were to deliver vaginally.

As for long-term effects, with all types of abdominal surgery, a C-sections is associated with risks of post-operative adhesions, incisional hernias (which may require surgical correction) and wound infections. Other risks include severe blood loss (which may require a blood transfusion).

Lately, studies have implied that the chances of later urinary or fecal incontinence are greater in women who have passed a baby through their birth canal, indicating C-sections may be wise now that everyone's living into her 70s and 80s and even beyond. This is still controversial, but there is enough evidence to make this an important consideration.

Recently, the American College of Obstetricians and Gynecologists, sent out a technical bulletin (an official pronouncement) that maternal choice C-sections are not unethical, making them a legitimate option. Many people feel that if a woman has a right to terminate her pregnancy, she should also have a right to decide how her baby should be born.

More info on CAESAREAN SECTION here.

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