Pro and contra planned or desired cesarean

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What is a desired Caesarean section?

An optional caesarean section or a desired section of a cesarean section is a caesarean section made without medical necessity. In this respect, he differs from the planned caesarean section, for which, although already (sometimes several weeks) before birth, an appointment is set, but for medical reasons. Reasons for a planned caesarean section may be, for example, breech position of the baby when the placenta is in front of the cervix (placenta praevia) or if you expect multiple births. One can also plan a caesarean section, because there are problems at birth could , without there being a current risk for mother and child.

Officially, there is no or hardly any wish to have an imperial cut in Germany because the health insurance companies only cover the costs of a planned caesarean section for medically necessary reasons. But the border between the caesarean sections is fluid, and sometimes the doctors are happy to meet the wishes of a pregnant woman and find medical justification for what is not really necessary. If you are considering making a caesarean section, then you should weigh the pros and cons carefully and consider alternatives - because a caesarean section on the one hand provides security and predictability, on the other hand it is not without risk as any surgery.

How common are favorite Caisse Cuts?

The number of caesarean sections in Germany is increasing - in 2009 more than 30% of deliveries in Germany were made by caesarean section (Federal Statistical Office 2010). However, there are no studies on how many of these surgeries were desired. However, studies suggest that, although seemingly more and more celebrity women decide to have a wish for an imperial cut, most women naturally prefer childbirth. Only between 3, 7% and 14, 7% would rather have a caesarean section than a natural birth (GEK 2006, Hellmers 2005). Therefore, it is unlikely that many of the cesarean sections actually performed were women's desired sectios.

If you are considering having a caesarean section, then you should talk openly with your doctor and the midwife about it. They show you the advantages and disadvantages compared to natural birth and the possibilities of pain relief.

The advantages of a caesarean section over a spontaneous belt

Plannability

A preferred Caesarean section can be planned. This means that you already know days or weeks in advance when the birth will take place (unless unforeseen things happen in between).In the age of mobility, this is an advantage for many couples because the partner can plan their business trips and meetings accordingly.

Simple Birth Preparation

There is little need for preparation for a Caesarean section. You do not have to familiarize yourself with the individual stages of birth. Nevertheless, you should attend a birth preparation course, because there you will learn more about pregnancy and baby care. In addition, can make very nice contacts with other pregnant women.

Fewer Birth Pains

As contractions are usually eliminated and you are anesthetized during surgery, either under general anesthesia or through regional anesthesia (spinal or peridural anesthesia), you will not have a labor pain.

But even with a normal birth, one can opt for a peridural anesthesia and then also has no labor pains.

Avoiding Risks

You do not run the risk of a cervical rupture or episiotomy during caesarean section.

Problems with the afterbirth are rarer than with a natural birth.

Caesarean section does not alter your vagina - which may reassure some who fear a change in sensation in sex after a normal birth.

Although you will not necessarily avoid pelvic floor weakness as it is primarily due to exercise during pregnancy, you will find it difficult to cope with incontinence following a cesarean section (GEK Study 2006). Pelvic floor exercises should be done after birth anyway.

Psychological Benefits of a Caesarean Section

Many pregnant women have a great need for security and want everything to go well. This desire is countered by the fear of pain at birth and the fear of not having a natural birth. Some women who have had a traumatic birth before, want to avoid such an experience. Modern medicine and the naturalness with which Caesarean sections are made today promise enormous security. Instead of trusting nature, you trust the routine of the doctors. If you also feel that way, then caesarean section can be psychologically beneficial to you.

The Disadvantages of a Wishful Caesarean Cut versus the Spontaneous Breech

Less Spontaneity

The tension has been rising in recent weeks: when does the baby set off? Many women are full of anticipation and enjoy these moments of uncertainty. With a wish-Caesarian cut you take this ""surprise effect"". And you bring the birth experience, which is felt by many women as liberating and good.

Postpartum Pain

After surgery, you will feel the scar on your pubic bone and can not get up for about a day. It also means that you need help when your baby is crying because they can not lift it out of the crib and carry it to bed.You will need a urine catheter and eventually a drainage for the scar, through which the excess blood drains. That will hinder you. It takes about six weeks to heal completely. The scar will be felt for a few more weeks. Over the years, it will fade to a silvery, thin line, yet some women later bother with the scar.

Possible risks and problems for the mother

Every operation is always a general risk. But the modern techniques and the high standard of hygiene have made the caesarean section a relatively easy routine intervention.

The most common problem after surgery is mild constipation, which you can overcome with plenty of fluid and mild laxative medication. Occasionally, there are problems with the emptying of the bladder, in contrast, they put you a disposable catheter. Possible bladder infections are treated with plenty of fluids and possibly antibiotics.

After surgery, of any kind, wound infections can occur.

Blood clotting changes during pregnancy, so there is an increased risk of thromboembolic complications. Another danger is a possible high blood loss that may (but very rarely) require a blood transfusion.

In very rare cases, other organs, such as the bladder or bowel, are injured during the operation, which would require further surgery.

Prolonged Stay in the Clinic

After a caesarean section, you usually have to stay longer in the hospital. On average, women stay in the clinic for 6, 3 days following a complication-free caesarean section; women who have had no complications after vaginal discharge go home on average after 3, 8 days (GEK study 2006).

Possible sequelae for the mother

Possible after-effects after a Caesarean section are the risks of growths and adhesions after each operation, which can lead to constant pelvic pain.

Although it is possible to spontaneously give birth to the next child after a Caesarean section, the probability of another Caesarean section is higher. For one thing, there is a risk that the scar tears during the Presswehen. Also, in a follow-up pregnancy after Caesarean section, the likelihood is slightly greater that the placenta completely or partially obstructs the cervix (placenta praevia) or does not dissolve by itself and must be removed under anesthesia.

Possible risks to the baby

Occasionally the child is injured by Caesarean section. There may be small cuts or abrasions (Smith et al., 1997), which heal well in most cases.

Studies show that children who were born by caesarean section have more frequent respiratory problems (Schneider 2001).These occur mainly in children, in which the mother had no contractions, so just in a planned or desired Caesarean section, or are brought before the 39th SSW to the world.

From a holistic point of view, caesarean section is not recommended, as one sees the contractions as a preparatory phase for entry into life. Caesarean section tears the child out of the warmth and security of the uterus into the light, into the cold and loud operating room.

Whether the type of birth ""caesarean section"" for a child is better or worse than a spontaneous birth, the spirits divorce: Some call the caesarean section the safest method, the others claim that the child is the stress situation of childbirth for his later life needs.

Psychological Consequences of a Caesarean Section

Caesarean section will not give you the same birth experience as if you squeezed the child out with your own or your child's strength. Many fathers also consider a spontaneous birth to be much more intensive and report that they have remembered more of this than after a cesarean section.

Possible sequelae for the baby

A Norwegian study has established an association between the allergy incidence in children and caesarean section. Caesarean children of mothers with known allergies are seven times more likely to have an allergy than children born vaginally (Eggesbo 2003).

Final overview

From a purely medical point of view, here's a tabular overview of the benefits and Caesarian section risks:

Caesarean section risk

No difference between caesarean section and vaginal delivery

Low caesarean section risk

Wound and scar pain Bladder and ureteral injuries Uterine removal
  • Follow-up
  • Thrombosis or embolism
  • Prolonged hospital stay
  • Placenta previa in follow-on pregnancies
  • Uterine rupture in follow-on pregnancies
  • Respiratory and adjustment disorders of the newborn
  • Bleeding
  • Infections
  • Pain during intercourse
  • Post-natal depression
  • Infant mortality (except breech presentation)
  • Cerebral haemorrhage
  • Early childhood Ie Brain Disorders
  • Pain in the vagina-perineal area (cuts or lacerations)
  • Problems with the afterbirth (placenta retention)
  • Urinary incontinence
  • Uterine-vaginal depression
  • Sources
  • Berlin Midwives Association et al. :
  • Caesarean section: Yes! No! Maybe. An information booklet for the pregnancy.

first Edition, January 2009

www. ProFamilia. de [as pdf-file, 5321kb] Eggesbo 2003. Eggesbø M, Botten G, Stigum H, Nafstad P, Magnus P.: Is delivery by cesarean section a risk factor for food allergy?

J Allergy Clin Immunol. 2003 Aug; 112 (2): 420-6.

www. ncbi. nlm. nih. gov Hellmers C., Schücking B.: Desired and Experienced Birth Mode of Primitives

. The midwife 2005; 18: 79-82

Lutz U., Kolip K. u. a. : The GEK Caesarean Section Study Publication Series on Health Analysis, Volume 42, Bremen / Schwäbisch Gmünd April 2006

media. gek. de [pdf file 541kb] Schneider K., Schelling M., Gnirs J., Lack N: Desire and morbidity risks in mother and child

. In: Huch A, Chaoui R, Huch R (Hrsg): Caesarean section. 2001 (pp. 118-121), UNI-MED Verlag AG, Bremen.

Smith J., Hernandez C., Wax J. (1997): Fetal laceration injury at cesarean delivery . Obstet Gynecol 1997; 90: 344-5

Federal Statistical Office Germany. 30 percent of all deliveries by cesarean section. Number of the week No. 047 of 24. 11. 2009

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