Considered by many doctors to be the most suitable route of birth, normal childbirth is something women are supposed to go through. It means that, physiologically, pregnant women are prepared for this great event. However, some complications can define if the birth will follow in a natural way or with interferences. So there are situations in which women cannot have normal delivery. They are very rare, but they exist.
According to obstetrician Dr. Melania Amorim and midwife Ana Cristina Duarte in a blog publication, when there are clinical complications associated with childbirth, c-section can be the best option for the delivery of the baby. The professionals made a list of which indications in fact make the c-section the best option.
Cases where c-section is advised:
- Placenta praevia: when the placenta attaches inside the uterus but near or over the cervical opening, blocking the passage of the fetus.
- Vasa previa: due to the anomalous insertion of the umbilical cord, the blood vessels cross the orifices of the cervix. With labor, the rupture of these vessels may occur, a condition that would harm the fetus. Therefore, a c-section is recommended.
- If a woman has genital herpes and the lesion is active when she goes into labor, surgery is indicated to avoid transmission to the baby (if there is no lesion, there is no need for a caesarean section).
- Transverse or breech positions: before the the labor begins, the medical team can try many procedures to turn the baby. If it doesn't happen and the baby is in transverse position (horizontally, with its buttocks, shoulders and head at the same level) the surgery is the best solution. If it is with the buttocks or the feet downwards, natural birth continues to be a viable alternative so long as the medical team is prepared for this kind of assistance.
- Aids, diseases, unknown immune situation or inadequate treatment during pregnancy: if someone carries the HIV virus they're not obliged to have a c-section. If you developed Aids or if you have a higher viral load, then that should be done. This is to prevent the baby from coming in contact with the blood and risking getting inffected.
- Placental abruption: A serious pregnancy complication in which the placenta detaches from the womb and it may hurt the baby, since it's responsible for providing nutrients and oxygen to the fetus during the pregnancy. When it happens at an early stage, the woman needs to remain in absolute bed rest. When the gestational age is advanced, an emergency surgery is performed.
Although these are the absolute conditions, there are intrapartum conditions that can result in cesarean section surgery, which are more difficult to analyze without knowing details of each case. Examples are cord prolapse, cephalopelvic disproportion, non-tranquilizing fetal heart rate, and prolonged labor.
Scheduling a c-section
Some professionals criticize the high number of c-sections performed recently, a factor attributed in many cases to the convenience of the physician involved, since surgery can be scheduled and requires less work time.
Therefore, it is important to understand exactly when a c-section is necessary so that the surgery is not performed without real need and indication.
According to specialists Dr. Melania and Ana Cristina, even among the situations in which cesarean section is indicated, only the placenta previa and AIDS require the scheduling of surgery. So, in the vast majority of cases, the c-section is or should be determined after the beginning of labor.
The professionals state that, when there is an indication of a pregnancy interruption, in the preterm or in the term (before or after the 38th week), the absolute majority of situations allow the induction of childbirth, not being necessary prior scheduling.
Normal childbirth is the rule, c-section the exception
Dr. Carla Andreucci Polished pointed, on a Facebook group called 'C-section? No, thank you', that all the transformations the woman's body goes through during pregnancy make it more prepared for the pregnancy itself and for the vaginal delivery.
A cesarean section is a medium/large-sized surgery that has risks, therefore, the procedure should be an exceptional choice if the woman, in addition to the pregnancy alterations, has some health problem.
Once c-section, always c-section: myth
It is important to remember, however, that the common phrase "once a c-section, always a c-section" is a great myth. Besides those six conditions, nothing prevents a woman from having a normal delivery if she gets pregnant again. After all, the aforementioned situations are related to pregnancy and not to the woman, who still has a perfect body, adapted to give birth.