International Cesarean Awareness Month: Understanding the Rise in C-Sections

Cesarean sections, or C-sections, have become increasingly common worldwide, with more deliveries being done through surgery than ever before. C-sections are sometimes necessary for the safety of both mother and baby, but the rising rates have sparked discussions about whether all of them are medically justified. This makes International Cesarean Awareness Month a timely opportunity to understand why C-section rates are increasing, when the procedure is truly needed, and how expectant parents can make informed choices for a safe birth experience. Let’s begin by looking at the history and significance of this awareness month.

History and Significance of International Cesarean Awareness Month

International Cesarean Awareness Month, observed every April, was established to raise awareness about the increasing rates of C-sections and promote informed birth choices. The movement was initiated by the International Cesarean Awareness Network (ICAN), a nonprofit organization dedicated to reducing unnecessary C-sections and advocating for vaginal birth after cesarean (VBAC) when safe.

The month serves as a platform to educate parents about the risks and benefits of C-sections, encourage discussions on birth options, and support those recovering from cesarean deliveries. It also highlights the importance of access to evidence-based maternity care and reducing the overuse of surgical births. By spreading awareness, the initiative empowers expectant parents to have meaningful conversations with healthcare providers and make informed decisions about their birthing plans.

Why are C-Section Rates Increasing?

The global rise in C-section rates has sparked discussions about the factors driving this trend. Several medical, social, and institutional influences contribute to the increase:

• Advancements in Medical Care: Improved surgical techniques and safer anaesthesia have made C-sections a more viable option, reducing risks for both mother and baby in complicated pregnancies.
• Increase in High-Risk Pregnancies: Conditions such as gestational diabetes, hypertension, and advanced maternal age are more common these days, often making C-sections the safer choice.
• Hospital Policies and Medical Practices: Some hospitals have protocols that favour C-sections over prolonged labour, sometimes due to concerns about legal risks or efficiency in managing deliveries.
• Patient Preferences and Scheduling Convenience: Planned C-sections allow parents and doctors to schedule deliveries in advance, reducing uncertainty. In some cases, expectant mothers opt for C-sections due to fear of labour pain or past birth trauma.
• Limited Awareness About VBAC: Many women who have had a previous C-section may not be informed about the possibility of a vaginal birth after cesarean (VBAC), leading to automatic repeat C-sections.

What are the Pros and Cons of a C-Section?

C-sections can be lifesaving in certain situations, but like any medical procedure, they come with both benefits and risks. Understanding these can help expectant parents make informed decisions about their birthing plan.

Pros 

• Life-Saving in Emergencies: C-sections are crucial when vaginal delivery poses risks to the mother or baby, such as in cases of fetal distress, placenta previa, or umbilical cord complications.
• Planned and Predictable: Scheduled C-sections allow parents and doctors to plan the birth in advance, reducing uncertainty and stress.
• Lower Risk of Birth Trauma: In some cases, C-sections can prevent complications like oxygen deprivation, shoulder dystocia, or perineal tears that may occur during vaginal delivery.
• No Labour Pain: Since the procedure is performed under anaesthesia, mothers avoid the intense pain associated with vaginal childbirth.

Cons 

• Longer Recovery Time: Compared to vaginal births, C-sections involve a longer hospital stay and recovery period due to the surgical incision.
• Increased Risk of Complications: Potential risks include infections, blood clots, and complications in future pregnancies, such as uterine rupture or placenta issues.
• Delayed Skin-to-Skin Contact: Some mothers may experience a delay in holding or breastfeeding their baby immediately after birth due to post-surgical monitoring.
• Potential Breathing Issues for Baby: Babies born via C-section may have a slightly higher risk of transient tachypnea, a temporary breathing difficulty.

What Happens During a C-Section?

A cesarean section (C-section) is a surgical procedure used to deliver a baby through an incision in the mother's abdomen and uterus. Here’s what to expect during the process:

Before the Procedure

• The mother is given either spinal or epidural anaesthesia, which numbs the lower body while keeping her awake. In emergency cases, general anaesthesia may be used.
• The surgical team prepares the abdomen with antiseptics, and a sterile drape is placed to maintain a clean environment.
• A catheter is inserted to drain urine, and an IV line is set up for fluids and medications.

During the Procedure

• A horizontal or vertical incision is made in the lower abdomen, followed by a second incision in the uterus.
• The doctor carefully delivers the baby, clears the airways, and cuts the umbilical cord.
• The placenta is removed, and the uterus and abdominal layers are stitched up.

After the Procedure

• The mother is monitored in a recovery room for a few hours to check for any complications.
• Pain management, IV fluids, and antibiotics may be given to aid healing.
• Early movement is encouraged to prevent blood clots, and the mother can usually start breastfeeding once she is stable.
• The hospital stay typically lasts 2-4 days, depending on recovery progress.

Can You Have a Vaginal Birth After a C-Section?

For individuals who have previously undergone a cesarean section, the possibility of a vaginal birth after cesarean (VBAC) is an important consideration. VBAC is a viable option for many women and, in appropriate cases, can offer benefits such as a shorter recovery period, reduced surgical risks, and a higher likelihood of future vaginal deliveries.

Medical research indicates that 60-80% of women who attempt a VBAC have a successful vaginal delivery. However, eligibility depends on several factors, including the type of uterine incision from the previous C-section, the reason for the initial cesarean, overall maternal health, and the presence of any complications in the current pregnancy.

VBAC is generally safe for many, but it does carry certain risks, such as uterine rupture, which requires immediate medical intervention. Therefore, a thorough assessment by a healthcare provider is essential to determine whether VBAC is a suitable and safe option based on individual circumstances.

Final Words

The journey through pregnancy and birth is deeply personal, filled with questions that deserve thoughtful answers. If you're considering your options after a previous caesarean—weighing the possibility of a VBAC, or seeking clarity on what’s safest for you and your baby—know that you don’t have to navigate these decisions alone. At Max Hospital, our consultant obstetricians and maternity care team are here to listen, assess your individual circumstances, and guide you with care. Book a consultation with our specialists to explore your options and ensure a safe delivery.

Frequently Asked Questions

How many C-sections can a woman safely have?

There isn’t a strict limit on the number of C-sections a woman can have, but the risks increase with each surgery. Generally, doctors recommend limiting C-sections to three or four, depending on individual health factors. Multiple C-sections can raise the risk of complications such as placenta previa, placenta accreta, uterine rupture, and adhesions, which may affect future pregnancies and overall health.

Does having a C-section affect fertility?

A C-section does not typically cause infertility, but it may slightly increase the risk of complications that could affect future pregnancies. These include uterine scarring, which can lead to implantation issues, adhesions that may impact the fallopian tubes, or a higher chance of ectopic pregnancy. Most women who have had a C-section can conceive again without problems, but it’s best to discuss any concerns with a doctor.

Are there any long-term effects of a C-section on the baby?

Most babies born via C-section grow up healthy without any long-term issues. However, some studies suggest a slightly higher risk of respiratory problems, such as transient tachypnea, especially if the procedure is performed before 39 weeks. There is also ongoing research into potential links between C-sections and conditions like allergies, asthma, or differences in gut microbiome development, but more studies are needed for conclusive evidence.

Can I request a C-section even if it’s not medically necessary?

Yes, this is known as an elective C-section. Some women prefer a scheduled C-section for personal reasons, such as fear of labour pain or previous birth trauma. However, it’s important to discuss the potential risks and benefits with a doctor, as a C-section is still a major surgery with a longer recovery time and possible complications. A doctor will assess individual circumstances before agreeing to an elective C-section.

Is recovery from a second C-section harder than the first?

Recovery from a second C-section can vary from person to person. Some women find it similar to their first, while others may experience more discomfort due to scar tissue from the previous surgery. The healing process may take longer if there are complications such as adhesions or a weaker uterine scar. Good post-operative care, including pain management, movement, and proper wound care, can help ease recovery.

How soon can I start exercising after a C-section?

Light movement, such as walking, is encouraged within a day or two after surgery to promote circulation and prevent blood clots. However, more intense exercises, such as abdominal workouts and weightlifting, should be avoided for at least 6-8 weeks. Always consult a doctor before resuming physical activity, as recovery times differ based on individual healing.

Will my next pregnancy be considered high-risk after a C-section?

Having a previous C-section does not automatically make a future pregnancy high-risk, but it may require closer monitoring. Factors such as the number of previous C-sections, the type of incision used, and the time between pregnancies can influence the risk level. Some women may be at higher risk of placenta complications or uterine rupture, especially if attempting a vaginal birth after cesarean (VBAC). A doctor can help assess the safest approach for the next pregnancy.