Caesarean section - "Caesarean section at will without indications. Is it possible to? My experience.". Cesarean section without indications: does the woman in labor have the right to choose Arrange a caesarean section without indications

03.12.2022

Recently, I became a mother for the third time. The third son is now the fifth month.

It so happened that this child was unplanned, the youngest child at that time was only 1.3 years old. But, there was no option not to give birth, so now I am a mother of many children)))

Only when I saw two stripes on the test, I immediately knew: I would not give birth myself. The memory of the last birth was too fresh.

I must say that I decided on a second child only 10 years after the first. For 10 years I tried to forget this nightmare)))

Readers may think that I had a terrible birth with serious complications, but no. The only peculiarity of my labors is they are swift. Those. I sit, watch a movie, and after 1.5-2 hours I already have a baby))) Well, all the bonuses of a rapid birth are an episiotomy to avoid tears, rolled necks in children and, in general, the shock of the fact that it's all so fast. The stitches hurt, you can’t sit, it hurts to wear pants.

So, I wanted a caesarean section. I reasoned like this: there will still be seams, so let them be better where they can be processed normally. Well, plus, avoid pain from contractions. And I won't break a child's neck. Such strange reasoning...

But I also understood that no one would do a caesarean without evidence. So, I'll come up with evidence, I decided.

I didn’t have to think for a long time, I had symphysitis in my second pregnancy, but the discrepancy was small and I gave birth myself.

This time I complained a lot, did an ultrasound of the pubic joint, there was a discrepancy, it exceeded the norm, but it was far from a ban on natural childbirth. I did not give up))) I went to the orthopedist, portrayed torment, pain and suffering, and literally begged for a recommendation for operative delivery.

But, in the maternity hospital, they did not agree with this, and urged me to give birth myself.

But, I cried, stood my ground, begged, and in the end, the manager gave the go-ahead. But, because at this point, my pregnancy was 37-38 weeks, I was not assigned a date for the operation.

And then the May holidays began and planned operations were not carried out.

And then those who had a longer term were put on the plan.

And I was lying and waiting for at least the date of the operation.

I hated the whole world and everyone who called and wrote, asking one question - WHEN???

As a result, on May 3, at a period of 38 weeks, at the next CTG, I was diagnosed with contractions, and on examination, the opening was 6 cm.

The planned CS did not work out, it was an emergency one.

Well, now, in fact, about the operation of the COP.

Preparation for the operation consisted of an examination by an anesthetist, an enema, and placement of a catheter. Oh, and antiemetic medicine, I ate in the morning)))

Putting in a catheter is the most terrible memory.

I had an epidural anesthesia, I did not feel the injection in the spine at all. The anesthesia worked quickly and I felt so good, it’s just a buzz, nothing hurts, it doesn’t pull, calmness appeared)))

I felt only light touches, it seemed to me that they were just touching my stomach with a finger.

When they took out the child, they pressed hard on the stomach and ribs, that was a little unpleasant.

The son was taken out 20 minutes after the start of the operation, another 30 minutes were sewn up. The baby was immediately put on the breast.

Then I was transferred to the bed and taken to the intensive care unit. The child was there before me)))

At first it was good, I rested. But soon the anesthesia began to fade and my stomach began to ache. I asked for an injection, I was anesthetized and the pain went away. Periodically, my stomach was crushed, it was sensitive, but not painful. I didn’t get cold, I didn’t have a headache, I felt really good!

The legs moved away for a long time, they were like strangers.

Also, an injection of heparin is placed in the stomach, preventing thrombosis. After that, the stomach was covered with bruises and petechiae from the fact that he was constantly poked.

After 6 hours, they picked me up and took me to the toilet. To be honest, getting up for the first time hurts. The feeling of contractions appeared and the abdominal muscles were very sore. In a bent state, I went to the toilet.

And slipped in the toilet😱😵

Here sparks flew from my eyes, I felt bad, I almost fainted. The nurse managed to pick me up, sit me down and stick ammonia.

Well, from that moment, in principle, the postpartum period was no different from the period after natural childbirth. I took care of the child myself. Milk came quickly, the child was not even fed with a mixture.

My stomach ached, but tolerable, if you do not lie down for a long time, then you can even walk straight. But if you lie down, it's hard to get up. That's why I didn't go to bed.

A day later, we were transferred to the postpartum ward. It was more difficult there because the beds were uncomfortable and one day I couldn't get out of it quickly and missed dinner. She lay like a beetle on her back.

For 3 days I was given painkillers injections, antibiotics and oxytocin. After two natural births, I was also injected with oxytocin and antibiotics. There is no difference.

The seam on the abdomen was treated twice with a spray. All. The stitches were not removed, they are self-absorbable. They were ready to discharge me on the 5th day, but unfortunately, my child and I ended up in pathology. There, I didn’t remember the operation at all.

This is what mine looked like a day later.

Here it is now, 4 months later.

The only problem is that the skin around the seam is still not sensitive.

By the way, although the operation was emergency, the incision was horizontal, the skin was cut, the muscles were not cut, but moved apart, and then the incision was already on the uterus.

I want to summarize my review and highlight the pros and cons for myself personally.

No contractions
No perineal tears
Less risk of birth injury in baby
Stomach stitches are easier to care for than crotch stitches.

The postpartum period is more painful.

Antibiotics and oxytocin were injected to me both after natural childbirth and after cesarean, there is no difference here.

The child was with me immediately after natural childbirth, and after caesarean, there is no difference here either.

According to my feelings, I will say this: it was easier for me to endure a caesarean than a natural birth, I recovered faster. The third child, the only one of all, does not have a twisted neck.

A lot has been said about the possible harm of drugs that are used during a cesarean section, as well as the consequences of neglecting the need for a child to pass through the birth canal. But some mothers still think that “giving birth” on the operating table, thanks to the incision made by the doctor in the abdominal wall, is easier. A few go to the doctor to ask for a CS. Meanwhile, there are clear indications for caesarean section in the official 2019 list.

On the territory of the CIS countries, this includes Russia, Ukraine, and Belarus, there are unified medical protocols that clearly spell out absolute and relative indications for the appointment of a caesarean section. In most cases, they refer to situations where natural childbirth poses a threat to the health and life of the mother and fetus.

If the CS doctor recommends, you can’t refuse it, because, as they say, all the rules are written in blood. There are states in which the mother herself decides how to give birth to her. This is the case, for example, in England. We do not have such a practice, however, as well as laws prohibiting a woman from going under the knife, without explicit evidence.

Moreover, all these indications are conditionally divided into 2 groups:

Absolute - they are not discussed, since if they are detected, the doctor simply appoints the day and time of the operation. Ignoring his recommendations can cause serious harm to the body of the mother and baby, even death.
Relative. They combine cases in which natural childbirth is still possible, although it can also be harmful. What to do with relative indications is decided not by a woman, but by a council of doctors. They weigh all the pros and cons, necessarily explaining the possible consequences to the future woman in labor, and then come to a common decision.

And that is not all. There are unplanned situations in which other factors are identified during pregnancy or during childbirth, on the basis of which an operation can be prescribed.

Absolute maternal and fetal indications

Placenta previa. The placenta is the baby's place. The diagnosis is made when it blocks the entrance to the uterus from the side of the vagina. In childbirth, this condition threatens with severe bleeding, so doctors wait until 38 weeks and prescribe an operation. They can operate earlier if bleeding begins.
Its premature detachment. Normally, everything should happen after the baby is born, but it also happens that detachment begins even during pregnancy. In view of the fact that everything ends with bleeding, which threatens the life and health of both, an operation is performed.
Irregular scar on the uterus, which is the result of another operation in the past. Under the wrong one is understood the thickness of which does not exceed 3 mm, and the edges of which are uneven with inclusions of connective tissue. The data is established by ultrasound. Do not allow cesarean with a scar and in cases where during its healing there was an increase in temperature, inflammation of the uterus, the seam on the skin healed for a long time.
Two or more scars on the uterus. It is worth noting that not all women decide to have a natural childbirth after a cesarean because of the fear of scarring. Doctors can explain the pros and cons of the procedure, but no more. There is an order from the Ministry of Health, according to which a woman can write a refusal from the EP in favor of a caesarean section, even with a normal scar, and she will have to undergo an operation. True, the question of EP is not even raised if there were several scars. Even before the start of childbirth, a woman is simply operated on.
Anatomical narrowing of the pelvic bone up to 3-4 degrees. The doctor takes measurements. Under such conditions, water can break in advance, contractions weaken, fistulas form or tissues die, and finally, hypoxia can develop in a baby.
Deformities of the pelvic bones or tumors - they can prevent the crumbs from calmly coming out into the world.
Malformations of the vagina or uterus. If there are tumors in the pelvic area that close the birth canal, an operation is performed.
Multiple uterine fibroids.
Severe preeclampsia, not amenable to treatment and accompanied by convulsive seizures. The disease entails a violation of the functions of vital organs and systems, in particular, the cardiovascular, nervous, which can affect both the condition of the mother and the condition of the baby. With the inaction of doctors, a fatal outcome occurs.
Cicatricial narrowing of the uterus and vagina, which appeared as a result of previous births, surgical interventions. In such conditions, the stretching of the walls for the passage of the child endangers the life of the mother.
Severe heart disease, nervous system, diabetes mellitus, thyroid problems, myopia with changes in the fundus, hypertension (it can affect vision).
Genitourinary and enterogenital fistulas, sutures after plastic surgery on the vagina.
Rupture of the perineum 3 degrees in history (damaged sphincter, rectal mucosa). They are difficult to take in, besides, everything can end with fecal incontinence.
Pelvic presentation. In this condition, the risk of birth injuries, including trauma to the head, increases.
Transverse position of the fetus. Normally, the baby should lie head down just before birth. There are times when he turns several times, especially for small children. By the way, it is not recommended to give birth on your own even to small ones (weighing less than 1,500 kg). Do you know why? It turns out that in such conditions, passage through the birth canal can squeeze the head or testicles (in boys), which will lead to the development of infertility.
Age indication. Late pregnancy in primiparas in combination with other pathologies. The fact is that after 30 years, the elasticity of the vaginal muscles deteriorates in women, resulting in severe tears.
Death of a mother. If for some reason a woman's life cannot be saved, doctors fight for her baby. It has been proven that he is able to remain alive for several hours after his death. During this time, the operation should be carried out.
Threatened uterine rupture. Its causes can be both numerous births earlier, which have thinned the walls of the uterus, and a large fetus.

Dear mothers! Absolute medical indications for caesarean section should not be regarded as a sentence, and even more angry at the doctor. It's just circumstances that leave him no choice.

Relative maternal and fetal indications

There are situations when, when making a decision, doctors consult with a woman. Interestingly, in 80% of cases, they agree to surgery unconditionally. And the point here is not only the excitement for the child, although it also plays a crucial role.

Mothers weigh all the pros and cons, taking into account the qualifications of modern surgeons, the quality of the suture material, and finally, the conditions for performing operations, and consciously try to reduce any risks to nothing.

List of relative indications for CS:

There are situations when a woman going for a natural birth still ends up on the operating table. This happens if there are problems during the process itself.

Indications for emergency caesarean section

The decision to operate is made in the active stage of labor when:

Absence of labor activity (if after 16 - 18 hours the cervix slowly opens).
Prolapse of the umbilical cord. It can shrink, which will make it difficult for oxygen to flow to the baby.
When hypoxia is detected. In such conditions, during contractions, the child may suffocate.

An emergency caesarean section can also be performed in other cases that pose a threat to the life and health of the woman in labor and her baby.

Note! Cord entanglement is not a clear indication for CS, although doctors may suggest this method to a woman in labor. It all depends on the length of the umbilical cord itself, and the type of entanglement (tight, not tight, single, double).

A caesarean section has not only disadvantages, but also.

Do caesarean section without indications

Due to the fact that caesarean section is a serious operation associated with a huge risk to the health of the mother, it is never performed at will. Neither fear, nor tears, nor hemorrhoids aggravated on the eve of childbirth will help a woman to dissuade doctors.

Everything will pass, and this will pass. The main thing is to pull yourself together and give birth. After all, there is no going back!

The operation of caesarean section is a topic that does not leave indifferent any expectant mother. From the time of its inception to the present day, the surgical method of childbirth has been a cause for fear, misconception and heated debate.

Recently, a large number of supporters of caesarean section have appeared. Many pregnant women seriously believe that the operation is just one of the options for childbirth that they can choose on their own, such as vertical birth or childbirth in water. Some even argue that a caesarean section is a more modern, easy and painless version of the birth of a child, it is supposedly easier and safer for mom and baby than a long and complicated process of natural childbirth. In fact, this is not true; operative delivery is a special type of obstetric care, indispensable in cases where natural childbirth is impossible for a number of reasons or even dangerous to the life of the mother or fetus. However, neither the less painful nor the safer way of giving birth "caesarean" can not be called. Like any other surgical intervention, operative delivery is associated with significant risks to the health of the mother, both during the operation itself and in the postoperative period. That is why a caesarean section is never performed simply "at the request" of the patient, without real medical indications.

Indications for caesarean section

Indications for operative delivery are divided into absolute and relative. Absolute indications include situations in which childbirth through the birth canal is in principle impossible or dangerous to the life of the mother and / or fetus. Here are the most common absolute indications for delivery by caesarean section:

Complete placenta previa- attachment of a child's place in the lower segment of the uterus, in which it completely covers the area of \u200b\u200bthe internal os of the cervix. In this case, childbirth through the natural birth canal is impossible: the placenta simply closes the baby's exit from the uterus. In addition, at the very first contractions, accompanied by the opening of the cervix, the placenta will begin to exfoliate from the area of \u200b\u200bthe internal pharynx; this can lead to the development of massive bleeding, which poses a real threat to the life of the mother and baby.

Transverse position of the fetus- such an arrangement of the baby, in which its progress through the birth canal becomes impossible. In the transverse position, the fetus is located in the uterus horizontally, perpendicular to the mother's spine. In this case, there is no presenting part of the fetus - the head or buttocks - which normally should put pressure on the cervix during contractions, helping it to open. As a result, during childbirth in the transverse position of the fetus, the cervix practically does not open, and the walls of the contracting uterus put pressure on the transverse spine of the baby, which is fraught with severe birth injuries.

narrow pelvis is an absolute indication for operative delivery if a third or fourth degree of a uniformly narrowed pelvis is detected (a decrease in all sizes by more than 3 cm) or an oblique pelvis - a narrowing of the internal dimensions with a mutual displacement of the bones that form the small pelvis due to injury or rickets. With such a degree of narrowing, childbirth through the birth canal is impossible, regardless of the size and location of the fetus.

large fruit is not always an absolute indication for operative childbirth: with normal pelvic sizes, even a large baby can be born naturally. Newborns with a weight of more than 3600 g are considered large. However, with a fetal weight of more than 4500 g, even a normal pelvis may be too narrow for the fetus, and childbirth in a natural way can be risky for health.

Multiple entanglement of the umbilical cord leads to a significant shortening of its length and deterioration of the blood supply to the fetus. In addition, numerous, more than three, loops of the umbilical cord interfere with the normal location of the fetus in the uterus and prevent the movements necessary for the normal biomechanism of childbirth. Biomechanism is the totality of the baby's own movements during birth, helping him to adapt to the size and shape of the mother's pelvis. If the fetus does not have the ability to make the necessary movements - for example, bend, unbend and turn the head, birth injuries are inevitable even with the normal size of the pelvis and the fetus itself.

Maternal illnesses accompanied by a violation of muscle tone and nervous regulation of the pelvic organs. There are few such diseases, and they are quite rare. Childbirth through the natural birth canal in this case is impossible, since with these pathologies productive labor activity does not develop. An example of such an absolute indication for "caesarean" are paralysis and paresis (partial paralysis) of the pelvic organs, as well as multiple sclerosis - a lesion of the nervous system, characterized by a violation of the transmission of nerve impulses to organs and muscles.

Complications of pregnancy and childbirth, which pose a real threat to the life of the mother and fetus, are the main absolute indications for emergency operative delivery.

Actually, the operation, called "caesarean section", was first carried out precisely for the purpose of saving lives. The "vital" indications include an acute violation of the cardiac activity of the mother and fetus, placental abruption, severe forms of late toxicosis (preeclampsia), impaired placental blood flow of the 3rd degree, the threat of uterine rupture or an old postoperative scar on the uterus.

Relative indications include situations in which operative delivery is preferable to natural childbirth:

the woman's age is under 16 or, on the contrary, over 40;
pathology of vision, cardiovascular and neuroendocrine systems;
slight narrowing of the pelvis or an increase in fetal weight;
breech presentation - the location of the baby in the uterus, in which the buttocks or legs are located below;
complicated course of pregnancy - late toxicosis, impaired placental blood flow;
the presence of general and gynecological chronic diseases.

To decide on the need for surgical intervention, one absolute or a combination of several relative indications is sufficient.

Operation or childbirth?

Why is a caesarean section done only according to indications? After all, the operation is much faster than natural childbirth, it is completely anesthetized and eliminates the risk of birth injuries for mother and baby. To answer this question, you need to learn more about the features of operative delivery.

1. Cesarean section is an abdominal operation; this means that doctors need to open the abdomen to remove the fetus. Of all types of surgical interventions, abdominal operations are associated with the greatest number of risks to the life and health of the patient. This is the risk of developing intra-abdominal bleeding, and the risk of infection of the abdominal organs, and the risk of divergence of postoperative sutures, rejection of the suture material, and many others. In the postoperative period, the puerperal experiences significant abdominal pain, requiring medical anesthesia. The recovery of the mother's body after surgical delivery takes longer than after natural delivery, and is associated with a significant limitation of physical activity. If we compare the traumatism of "natural" and "artificial" childbirth, then, of course, abrasions, a perineal incision and even ruptures of the birth canal are incomparable with the traumatism of abdominal surgery.

2. To extract the fetus, doctors have to dissect the anterior abdominal wall, the aponeurosis is a wide tendon plate connecting the abdominal muscles, the peritoneum is a thin translucent serous membrane that protects the internal organs of the abdominal cavity and the wall of the uterus. After extraction of the fetus, the uterus, peritoneum, aponeurosis, subcutaneous fat and skin are sutured. Modern suture material is hypoallergenic, aseptic, i.e. does not cause suppuration, and eventually completely resolves, however, the consequences of surgery still remain forever. First of all, these are scars - areas of connective tissue formed at the site of the seam; unlike true cells of an organ, connective tissue cells do not perform any specific functions necessary for the normal functioning of an organ. The tissue formed at the site of the suture is less durable than the organ's own tissue, therefore, subsequently, if stretched or injured, a rupture may occur at the site of the scar. The risk of rupture of the scar on the uterus is always preserved in all subsequent pregnancies and childbirth. Throughout pregnancy, in the presence of a postoperative scar on the uterus, a woman is under especially careful medical supervision. In addition, surgery limits the ability to have more than three children: during each subsequent operation, the tissue of the old scar is excised, which reduces the area of the anterior wall of the uterus and creates an even higher risk of rupture in the next pregnancy. Another unpleasant consequence of any surgical intervention in the abdominal cavity is the formation of adhesions; These are connective tissue strands between the organs and walls of the abdominal cavity. Adhesions can disrupt the patency of the fallopian tubes and intestines, causing secondary infertility and serious digestive problems.

3. The main disadvantage of operative delivery for a baby is that during a caesarean section, the fetus does not pass through the birth canal and does not experience a pressure difference to the extent that it needs to “start” autonomous life processes. With various pathologies of the fetus and mother, this fact is the advantage of caesarean section and determines the choice of doctors in favor of the operation: pressure drops for a long time become an additional burden for the crumbs. When it comes to saving the lives of mothers and babies, surgical delivery is also preferable due to the temporary advantage: from the start of the operation to the extraction of the fetus, an average of no more than 7 minutes passes. However, for a healthy fetus, this difficult path through the birth canal, oddly enough, is preferable to a quick extraction from the surgical wound: the baby is genetically “programmed” for just such a birth scenario, and surgical extraction is additional stress for him.

In the process of moving through the birth canal, the fetus experiences increased pressure from the birth canal, which contributes to the removal of fetal - intrauterine - fluid from its lungs; this is necessary for uniform spreading of the lung tissue during the first breath and the beginning of a full pulmonary respiration. No less important is the difference in pressure that the baby experiences during natural childbirth, and for the start of independent work of his kidneys, digestive and nervous systems. Of great importance is the passage of the crumbs through the tight birth canal and for the full start of the work of the cardiovascular system: in many respects, the launch of the second circle of blood circulation and the closure of the oval window, the opening between the atria, functioning in the fetus during pregnancy, depend on this.

The caesarean section is an additional surgical intervention of the maximum volume for obstetrics and is associated with a significant risk to the health of the mother, it is never performed at the request of the patient. Caesarean section cannot be considered as an alternative delivery option; this is an additional intervention in the natural process, produced strictly for medical reasons. The final decision on the need for surgery can only be made by a doctor who observes the expectant mother during pregnancy and during childbirth.

Surgical childbirth (caesarean section) is carried out according to indications, when there is a threat to the health and / or life of the mother or baby. Today, however, many women in childbirth, out of fear, think about an assisted delivery option, even in the absence of health problems. Is it possible to have a caesarean at will? Is it worth insisting on surgical delivery if there are no indications? The expectant mother needs to learn as much as possible about this operation.

A newborn baby who was born through surgery

CS is a surgical delivery method that involves removing the baby from the uterus through an incision in the abdominal wall. The operation requires some preparation. The last meal is allowed 18 hours before the operation. Before the COP, an enema is given, hygiene procedures are carried out. A catheter is inserted into the patient's bladder, and the stomach must be treated with a special disinfectant.

The operation is performed under epidural anesthesia or under general anesthesia. If the CS is done according to plan, then the doctors tend to the epidural. This type of anesthesia assumes that the patient will see everything that is happening around, but will temporarily lose tactile and pain sensations below the waist. Anesthesia is done by puncturing the lower back, where the nerve roots are located. General anesthesia for surgical delivery is used urgently when there is no time to wait for the action of regional anesthesia.
The operation itself consists of the following steps:

Section of the abdominal wall. It can be longitudinal and transverse. The first is designed for emergencies, because it makes it possible to get the baby as quickly as possible.
Muscle extension.
Incision of the uterus.
Opening of the fetal bladder.
Removing the baby, and then the placenta.
Stitching of the uterus and abdominal cavity. For the uterus, self-absorbable threads must be used.
Applying a sterile dressing. Ice is placed on top of it. This is necessary to increase the intensity of uterine contractions and reduce blood loss.

In the absence of any complications, the operation does not last long - a maximum of forty minutes. The baby is taken out of the mother's womb in the first ten minutes.

There is an opinion that caesarean is a simple operation. If you do not delve into the nuances, it seems that everything is extremely easy. Based on this, many women in labor dream of a surgical method of delivery, especially considering how much effort natural childbirth requires. But you must always remember that a coin cannot have one side.

When is CS required?

The attending gynecologist will decide whether the woman in labor needs surgery

In most cases, COPs are planned. The doctor determines whether there are threats to the mother and the baby if the birth takes place naturally. The obstetrician then discusses delivery options with the woman in labor. Scheduled CS is carried out on a pre-arranged day. A few days before the operation, the expectant mother should go to the hospital for a control examination. While the pregnant woman is planned to be in the hospital, the doctor monitors her condition. This allows you to predict the likelihood of a successful outcome of the operation. Also, the examination before the COP is aimed at determining the full-term pregnancy: using various diagnostic methods, it is revealed that the baby is ready for birth and you can not wait for contractions.

The operation has a number of indications. Some factors leave room for discussion about the method of delivery, others are absolute indications, that is, those in which EP is not possible. Absolute indications include conditions that threaten the life of the mother and baby during natural delivery. CS must be done when:

absolutely narrow pelvis;
the presence of obstructions in the birth canal (uterine fibroids);
insolvency of the uterine scar from past CS;
thinning of the uterine wall, which threatens to rupture it;
placenta previa;
foot presentation of the fetus.

There are also relative indications for CS. With such factors, both natural and surgical childbirth are possible. The delivery option is chosen taking into account the circumstances, the health and age of the mother, the condition of the fetus. The most common relative indication for CS is breech presentation. If the position is incorrect, the type of presentation, the sex of the baby is taken into account. For example, in the gluteal-leg position, EPs are acceptable, but if a boy is expected, the doctor insists on a caesarean section in order to avoid damage to the scrotum. With relative indications for caesarean section, only an obstetrician-gynecologist can tell the right decision regarding the way the baby is born. The task of parents is to listen to his arguments, because they will not be able to assess all the risks on their own.

A cesarean may be performed on an emergency basis. This happens if childbirth began naturally, but something went wrong. Emergency CS is carried out if bleeding has begun in the process of natural release, premature placental detachment has occurred, acute hypoxia has been recorded in the fetus. An emergency operation is performed if labor is difficult due to weak contraction of the uterus, which cannot be corrected with medication.

Elective CS: is it possible?

Happy mother with a long-awaited daughter

Whether it is possible to do a CS at the request of a woman in labor is a moot point. Some believe that the decision on the method of delivery should remain with the woman, others are sure that only a doctor can determine all the risks and choose the best method. At the same time, the popularity of elective cesarean is growing. This trend is especially noticeable in the West, where expectant mothers are actively choosing the way to give birth to their own baby.

Women in labor prefer surgical childbirth, guided by fear of attempts. In paid clinics, doctors listen to the wishes of expectant mothers and leave them the right to choose. Naturally, if there are no factors under which CS is undesirable. The operation has no absolute contraindications, however, there are conditions that increase the risk of infectious and septic complications after surgical delivery. These include:

infectious diseases in the mother;
diseases that disrupt blood microcirculation;
immunodeficiency states.

In the CIS countries, the attitude towards the elective CC differs from the Western one. Without evidence, it is problematic to perform a caesarean section, because the doctor is legally responsible for each surgical intervention. Some women in labor, considering surgical delivery as a painless way to give birth to a baby, even come up with diseases for themselves that could serve as relative indications for CS. But is the game worth the candle? Is it necessary to defend the right to choose the way of having a child? To understand this, the expectant mother must understand the intricacies of the operation, compare the pros and cons, and study the risks that exist with any surgical intervention.

Benefits of CS at will

Why do many expectant mothers want to have a cesarean? “Order” the operation of many pushes the fear of natural childbirth. The birth of a baby is accompanied by severe pain, the process requires a lot of effort from a woman. Some expectant mothers are afraid that they will not cope with their mission and begin to persuade the doctor to procaesare them, even if there are no indications for surgical delivery. Another common fear is that the passage of the baby through the birth canal is difficult to control, and there may be a threat to his health or even life.

Fear of EP is common. But not all expectant mothers can handle it. For patients who see a lot of threats in natural delivery, the advantages of a "custom" CS are obvious:

An additional bonus is the ability to choose the date of birth of the baby. However, only this should not push a woman in labor to insist on a CS, because, in fact, the date does not mean anything, the main thing is the health of the baby.

The reverse side of the "custom" COP

Many expectant mothers do not see anything wrong with a caesarean section if a woman wishes. The operation is presented to them as a simple procedure, where the woman in labor falls asleep, and wakes up with the baby in her arms. But those women who have gone through surgical childbirth are unlikely to agree with this. The easy way also has a downside.

It is believed that CS, unlike EP, is painless, but this is not true. In any case, this is an operation. Even if anesthesia or anesthesia “turns off” pain during surgical delivery, it returns after. Departure from the operation is accompanied by pain at the suture site. Sometimes the postoperative period becomes completely unbearable due to pain. Some women even suffer from pain for the first couple of months after surgery. Difficulties arise in the "service" of herself and the child: it is difficult for the patient to get up, take the baby in her arms, and feed him.

Possible complications for the mother

Why is a caesarean section in many countries done exclusively on the basis of indications? This is due to the possibility of complications after surgery. Complications concerning the female body are divided into three types. The first type includes complications that may appear after surgery on the internal organs:

Big blood loss. With CS, the body always loses more blood than with EP, because when tissues are cut, blood vessels are damaged. You never know how your body will react to it. In addition, bleeding opens with the pathology of pregnancy, disruption of the operation.
Spikes. This phenomenon is observed during any surgical intervention, it is a kind of protective mechanism. Usually adhesions do not manifest themselves, but if there are a lot of them, then a malfunction in the work of internal organs may occur.
Endometritis. The uterine cavity during the operation "contacts" with the air. If pathogens enter the uterus during surgical delivery, then one of the forms of endometritis occurs.

After CS, there are often complications at the sutures. If they appear immediately after the operation, then they will be noticed by the doctor who did the CS during the examination. However, suture complications do not always make themselves felt immediately: sometimes they appear only after a couple of years. Early suture complications include:

Late complications after cesarean include ligature fistulas, hernias, keloid scars. The difficulty in determining such conditions lies in the fact that after some time women stop examining their seam and can simply miss the formation of a pathological phenomenon.

malfunctions of the heart and blood vessels;
aspiration;
throat injuries from the introduction of a tube through the trachea;
a sharp decrease in blood pressure;
neuralgic complications (severe headache/back pain);
spinal block (when using epidural anesthesia, severe spinal pain occurs, and if the puncture is incorrect, even respiratory arrest can occur);
poisoning with toxins from anesthesia.

In many ways, the appearance of complications depends on the qualifications of the medical team that will perform the operation. However, no one is immune from mistakes and unforeseen situations, so a woman in labor who insists on a caesarean without indications should be aware of the possible threats to her own body.

What complications can a child have?

Caesareas are no different from babies born naturally

Caesarean section at will (in the absence of indications), doctors do not undertake to carry out because of the likelihood of complications in the baby. CS is a well-established operation, which is often resorted to, but no one has canceled its complexity. Surgical intervention can affect not only the female body, but also affect the health of the baby. Complications of a caesarean section affecting a child can be of varying degrees.

With a natural birth method, the baby goes through the birth canal, which is stressful for him, but such stress is necessary for the baby to adapt to the conditions of a new life - extrauterine. With CS, there is no adaptation, especially if the extraction occurs according to plan, before the start of contractions. Violation of the natural process leads to the fact that the baby is born unprepared. This is a huge stress for a fragile organism. CS can provoke the following complications:

inhibited activity from drugs (increased drowsiness);
violation of breathing and heartbeat;
low muscle tone;
slow healing of the navel.

According to statistics, “caesarites” often refuse to breastfeed, plus the mother may have problems with the amount of milk. You have to turn to artificial feeding, which leaves its mark on the immunity of the crumbs and getting used to the new environment. Children born by caesarean section are more likely to suffer from manifestations of allergic reactions, intestinal diseases. "Kesaryata" may lag behind their peers in development, which is due to their passivity in labor activity. This manifests itself almost immediately: it is more difficult for them to breathe, suck, scream.

weigh everything

The CS really rightfully deserved the title of "easy delivery". But at the same time, many forget that surgical childbirth can have consequences for the health of both "participants in the process." Of course, most complications in a baby can be easily “removed” if you pay maximum attention to this issue. For example, massage can correct muscle tone, and if a mother fights for breastfeeding, then the baby's immunity will be strong. But why complicate your life if there is no reason for this, and the expectant mother is simply driven by fears?

A caesarean section of your own free will is not worth it. Naturally, a woman should have the right to choose, but it is not for nothing that this operation is performed according to indications. Only a doctor can determine when it is appropriate to turn to a caesarean section, and when a natural delivery is possible.

Nature has thought of everything by itself: the process of childbirth prepares the baby for extrauterine life as much as possible, and although the woman in labor has a big load, recovery is much faster than after surgery.

When there is a threat to the fetus or mother and the doctor insists on a cesarean, it is strictly forbidden to refuse the operation. The doctor always determines the risks, taking into account the fact that it is safer for the life of the woman in labor and the baby. There are situations when caesarean is the only option for delivery. If the method is subject to discussion, it is always recommended to grasp the possibility of natural childbirth. The momentary desire to "caesare" in order to avoid pain must be suppressed. To do this, it is enough to talk with the doctor about the possible risks and likelihood of complications after the operation.

It is 100% impossible to predict how the COP will go in each specific case. There is always the possibility that something will go wrong. Therefore, doctors advocate natural childbirth whenever possible.

If the expectant mother herself cannot overcome her own fears associated with the upcoming moment of the baby's appearance, she can always turn to a psychologist. Pregnancy is not the time for fears. You need to let go of all bad thoughts, not be led by momentary desires, and clearly follow the recommendations of a gynecologist - from regimen correction to the method of delivery.

New fashion for childbirth.

Women who are soon waiting for the birth of a baby, thinking about the process of childbirth, sort out various options for the outcome. Reviews confirm that recently in Moscow more and more pregnant women prefer a caesarean section without indications for natural childbirth and the reason for this is the relief of their own suffering. Fear of pain overshadows the possibility of negative consequences.

But fear is far from the only reason to go under the knife, there are a variety of them, but there are simply absurd ones, such as the desire for a child to be born on a certain date, because it's so great to control the fate of the future little man.

It is generally accepted that the fashion for the operation was introduced by the rich and famous. But after all, this type of procedure cannot be considered as simply safe childbirth without pain. In any case, this is an operation that can have serious consequences in the form of unforeseen situations and complications.

Is it possible to do a caesarean section without indications?

For a caesarean section, you must have strict medical indications. True, if you try, they can be found in almost every pregnant woman.

There are two types of indications for surgery:

Absolute indications for caesarean section:
- clinically narrow pelvis
- transverse or oblique position of the fetus
- complete placenta previa
- various rough scars
- severe preeclampsia
- extragenital pathology
Relative indications for caesarean section:
- myopia
- diabetes
- arterial hypertension
- various infections
- late first birth.

The consequences of "painless childbirth"

Perhaps a caesarean section is not the most difficult intervention, but still it is an abdominal operation that can affect not only the mother, but also the baby himself.

Of course, this type of childbirth is less painful than natural, however, the postoperative period is exactly the opposite, therefore, in the first days, communication between the mother and the child is inferior, because after the operation you need to recover.

Another weighty argument against caesarean without indications is the scheduled date. Future mothers continue to think only about themselves, forgetting about the baby. After all, contractions are the main signal of readiness to be born. A sudden operation can cause irreparable damage to an already frightened baby. Often a peacefully sleeping baby is taken out of the uterus. It is difficult to imagine what a newborn may experience at this moment.

There is an opinion that being born naturally, the child experiences stress, but this is not so. After all, everything is laid down by nature itself. When passing through the birth canal, fluid comes out of the baby's lungs, so that breathing becomes stable rather quickly. This process affects the longer adaptation of the "caesar" to the world around him.

Many mothers note that children born by caesarean section are more passive than their peers, more closed, it is harder for them to make decisions. More often, these are just prejudices that are associated with psychological trauma, when a mother feels inferior because she could not give birth on her own.

Before you decide to take such a step as to voluntarily go for a caesarean section without indications and go under the knife, you need to carefully consider all the nuances and consequences. Throw away your egoism, start learning to think not only about yourself, but also about your own child. Many women dream of giving birth on their own when they are scheduled for a caesarean section, but, alas, fate decreed otherwise. The final decision must be made by 37-38 weeks, because that is when the date of the operation is set.

It should also be noted that everyone's organisms and health are different and have hidden possibilities. For some pregnant women, a cesarean is not a choice, but a necessity, the only chance to become a mother. At this moment, you should not be afraid of surgical intervention, nature is on the side of the woman in labor, she will help the child take the first breath.