Caesarean section: pros and cons of the procedure? Doctor's answer

Caesarean section operation has become more and more popular in recent years. Many women who are afraid to give birth naturally see it as an alternative to physiological childbirth. There is an opinion that cesarean is quick and safe, it goes away without complications that can happen during childbirth in any woman. After him, both mother and child are guaranteed to be healthy. Is this so and can a cesarean be considered a full-fledged replacement for natural childbirth? Does this operation carry risks for mom and baby? What complications occur after a cesarean section? Obstetrician-gynecologist and perinatal psychologist Oleksandr Kobasa spoke about this live with the main doula of Ukraine Yulia Shushaylo.

"Fast, Convenient, Next"

The caesarean section has been worked out to the point of automaticity today / istockphoto.com

In just 40 years, the caesarean section has gained great popularity in our country. Back in the early 80s, this procedure in obstetric practice was about 2-3% of the total number of births, and only in clinics that dealt with the pathology of pregnancy did up to 5%. Now, according to Alexander Kobasa, in large cities of the country, the percentage of caesareans reaches 25, or even 40%. And the point is not at all that the number of problem pregnancies has increased. The operation has ceased to be a means of saving the life of the mother and the child, in many clinics it is offered as alternative to natural childbirth.

Now the cesarean section is literally "put on stream", says Alexander Kobasa. This is a high-quality procedure, with modern technology and a well-developed course of the operation. If earlier they resorted to it only in emergency cases, now they offer it even when the risk for the mother and child is minimal. Why? “It's very simple,” the expert explains. - In order to carry out a normal natural birth, it takes 4 to 24 hours. The caesarean section lasts on average 23 minutes. There are virtuosos who can do this operation from start to finish in 10 minutes. Fast, convenient, next. Conveyor".

The risks of a cesarean section for a woman

Maternal instinct may be missing after cesarean section / istockphoto.com

Many women voluntarily go to caesarean. First, because of the fear of childbirth and unforeseen complications of the process. Secondly, in order to avoid deformation of the birth canal, which during childbirth necessarily expand and stretch, many have painful ruptures. A caesarean section helps avoid these risks. Moreover, the modern technology of the operation can be called sparing.

“Now we are minimizing what is called the cut,” explains Alexander Kobasa. “We do not cut, but sever tissues, so recovery after surgery is easier and faster. After transverse separation, the uterus is restored so well that the second birth after a cesarean section may well take place naturally. "

In physical terms, after a cesarean, a woman is recovering quite quickly today, Alexander Kobasa admits. However, at the level of the psyche, the consequences can be much more serious. “This operation is always carried out under a general or epidural anesthesiathat was tested on animals, the expert notes. - Scientists drew attention to such a phenomenon: females who gave birth to a cub under anesthesia, after giving birth, refused to accept and feed them. That is, pain relief in childbirth depresses the maternal instinct. If the female did not feel the process of childbirth at the physical level, it means that the baby simply does not exist ”.

In relation to women, this phenomenon has been neglected. It is understandable, because we are people and are guided first of all by the brain. However, Alexander Kobasa says that about 25% of women after a cesarean section complain that they do not feel the maternal instinct. “They say: I understand with my head that the child is mine, but there are no feelings for him,” says the doctor. "Maternal feelings in this case appear in 2-3 months, as a rule, after something happens to the child, and this triggers the maternal instinct."

Complications of a caesarean section for a child

Caesarean immunity is lower than naturally born / istockphoto.com

The main problem of children who were born during a cesarean section is weak immunity. “The passage of a child through the birth canal is a process of his adaptation to new living conditions,” explains Alexander Kobasa. - The child receives his mother's microflora and begins to populate his body with the first microorganisms. It is very important that these are really my mother's germs. Because the child already has protection from them: the mother shared antibodies and immunoglobulins with the baby. On the basis of this protection and in the process of a collision with mother's microflora, it is much easier for a child to develop his own immunity. "

“In a cesarean section, the child is pulled out of the sterile environment into the surrounding microbial space. He has no protection from external microbes, - continues Alexander Kobasa. - You need to develop immunity yourself, and it's quite difficult. Therefore, the "Caesarean" immunity is much worse than that of naturally born children. "

To remedy this situation at least a little, today doctors offer this solution: during a cesarean section, moisten a large sterile gauze napkin with saline and insert it into the mother's vagina. After the operation, when the baby is removed from the uterus, this napkin is used to wipe his face and respiratory tract in order to "transfer" his mother's microflora to him and start the immune system.

There is another complication of cesarean, which few people know about. “During this operation, the child's cervical spine is always injured,” emphasizes Alexander Kobasa. - It does not depend on the experience of the doctor: the very technology of removing the child, whether we like it or not, provides for the subluxation of the head. This is not dangerous for later life, but at the same time, it does not pass completely without a trace. Such a microtrauma can then manifest itself at the age of 30-40 years as unreasonable headaches. On MRI, in this case, a completely insignificant displacement of the cervical vertebrae is found. And this, whatever one may say, leads to disruptions in the functioning of the brain and nervous system. So with the help of a caesarean section, we save lives, but at the same time we degrade its quality. "

Cesarean planned or caesarean in childbirth?

For a caesarean section, it is better to wait for the harbingers of childbirth / istockphoto.com

However, there are situations when a cesarean section is really necessary. There are a number of obvious indications for this operation. For example, central placenta previa, obvious large-fruited (child weight more than 3700 g) with breech presentation, anatomically narrow pelvis of a woman in labor. In these cases, doctors often prescribe surgery as planned - usually at 36-37 weeks. That is, before a woman's possible onset of labor.

Alexander Kobasa is against this approach and recommends, if possible, to wait for the harbingers of childbirth. This is an indicator that a woman's body is functionally ready for childbirth, which means that after the operation, recovery will be faster and easier. In addition, this is a guarantee that the baby will be born fully full-term.

 “A child is born not because the time has come, but because he is ready and mature,” the expert explains. - Each baby has its own time in the womb. For some it is 36 weeks, and for someone 42 weeks. When the baby is ready to be born, it starts this process. Its endocrine glands actively produce hormones that go into the mother's body. The mother's body, having received a signal from the child, begins to rebuild from the state of pregnancy to the state of childbirth. This is a period of harbingers, which suggests that the birth of a child will not be premature. "

“A planned cesarean with a scheduled date is always easier than an emergency one in childbirth. But if we look at it from the point of view of the physiology of the mother and the child, then it is better to wait for the contractions, ”the expert sums up.

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