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C-sections; an honest look and why they are definitely NOT the easy way out…pun not intended!

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Frustratingly there is still a stigma and even certain level of judgement within our society attached to having a caesarean section (C-section.) It is still sometimes viewed as the “easy way out”, although perhaps less so than in the past. It has even been glamorised by celebrities such as Victoria Beckham. The coining of the phrase “too posh to push” came from the elective C-section she had to deliver her first child. As someone who has had a C-section I find the connotations behind phrases like that baffling. Trust me when I say it is anything but glamorous -unless limping around feeling like you’ve been run over by a lawnmower appeals to you! 

More than that I feel it is incredibly misleading to pregnant women who are naturally nervous about the prospect of childbirth. It may lead them to believe that a C-section is a way to avoid all the “mess” involved in it. Caesareans are in fact very messy. They are painful, risky and greatly prolong the mothers recovery time. Any medical professionals worth their salt will agree. It is a major abdominal surgery that involves slicing through multiple layers of tissue -skin, fat, abdominal muscles and the uterus- and they try to avoid it if at all possible. A woman’s body is built to naturally deliver a baby vaginally. There is nothing natural about having one cut out of you, and that is very much reflected in the aftermath. 

Of course oftentimes a caesarean birth is unavoidable. In certain cases a C-section will be planned and booked ahead of time, and in others it will be an emergency situation. There are a multitude of reasons why a caesarean might be a safer mode of delivery than a vaginal birth.

Reasons for a planned C-section

  • A pre-existing medical condition of the mother that would put her and/or her baby at high risk during a vaginal delivery, for example a heart condition. 
  • Problems with or birth defects of the baby, in which case a caesarean delivery may reduce fetal stress. 
  • Placenta Previa; a complication occurring when the placenta is positioned over the cervix, effectively blocking the exit for the baby. 
  • Carrying multiples; when birthing more than one baby there are many potential risks involved and the majority are done by caesarean. I delivered my twins by C-section because my son was head down but my daughter was above him and in the breech position i.e. sitting upright like a little frog. A vaginal delivery would have put her, and me, in danger.
  • The mothers hips are very narrow and/or the baby is large. This is known as cephalopelvic distortion (CPD). 
  • A repeat C-section after having had one previously. 

Reasons for an emergency C-section

  • Prolonged labour that is not progressing and in which the mother or baby are showing signs of medical distress such as dipping heart rates.
  • Cord prolapse; a rare scenario during which the umbilical cord drops through the cervix first which can cut off the baby’s oxygen supply.
  • Placental abruption; thankfully also a very rare circumstance, during which the placenta comes away from the uterus before the baby is born, again cutting off the oxygen supply. 
  • The baby is in an abnormal position such as breech that will compromise it’s passage through the birth canal. 

Potential complications

Complications of a C-section are rare, but it is important to be aware of them. Potential problems include of course infection (of the wound and the uterine lining) and blood clots. Excessive bleeding or haemorrhaging from the uterus can also occur, and reactions to the epidural. In my case the epidural didn’t work atall and I had to go under a general anaesthetic. This is particularly unfortunate and only happens in 9-12% of cases. But it meant I didn’t get to see my baby until two hours after she was born, and felt pretty groggy when I did. 

Afterwards 

After a C-section the mother will stay in hospital with her baby for 4-5 days. During this time it is best to walk (or more realistically hobble) around as much as possible, within reason of course. It’s necessary for you to be mobile and to have taken your first –terrifying– poop before you’re allowed to leave. I was shocked when a nurse encouraged me out of bed only 5 hours after the operation. It felt like my insides were going to fall out. But my baby was in the neonatal unit and I wanted to be down there as much as I could, which spurred me through the pain. And I’ll be honest there was A LOT of pain. If you choose to breastfeed your baby as I did, the strongest painkiller you can take is Paracetamol. Yep that’s right, the same pills you take at home for a mild headache. It’s not an easy ride by a long stretch, but the nurses do everything they can to help take care of you and your baby. 

Once you are home you have to rest as much as possible for at least 6 weeks. That means no lifting anything heavier than your baby, no driving, no exercise and no sex. You will bleed just as much and for just as long as you would after a vaginal birth. For me it was a good 5-6 weeks before I started feeling as though I could move around a bit more freely. 

What they don’t tell you

  • Engaging your abdominal muscles in the week afterwards is agonising.

In the first week after you’ve had the surgery, laughing, coughing and especially sneezing is off the table. Your abdominal muscles are literally shredded and anything that engages them reminds you of that. For the first few days after my C-section my lungs were rattly from the anesthesia but I was petrified to cough. Eventually a nurse advised I clutch a pillow to my stomach and muster up the courage to clear my lungs. It felt great but boy did it make my eyes water.

  • Sex might hurt.

You are advised against sex for atleast 6 weeks afterwards to avoid infection. This is true however you gave birth. The majority of women feel the need to wait even longer. But regardless of when you feel OK to try keep in mind that even after a caesarean sex may well be painful. “But my hoo-hoo will be unscathed!” I hear you cry. It was a shock to me too. But the drop in Estrogen in the postnatal period, especially if you are breastfeeding, means less blood flow to the vagina. The result is a very fragile hoo hoo!

  • The tummy shelf.

Every new mum will naturally have a “mum tum” for a while, maybe even forever. But after a caesarean you also have the scar tissue from the incision, generally just above the bikini line. This area cuts in and causes your belly to overhang it. Gulp. This is a permanent new feature, although becomes less obvious over time as your tummy shrinks back a little. 

My top tips

Look if you are facing a C-section you might be scared, understandably so. But you’re going to bring a precious new baby into the world soon. That alone makes you an absolute warrior. Having a C-section is not a walk in the park but you have got this. Just like the millions of women who have done this before you. It is necessary for the safety of you and your baby, so you will get through it.

Here are some tips I hope will help.

  • Buy yourself some large, high waisted underpants and leggings ahead of time. You will not be able to tolerate anything rubbing against your lower belly for a while.
  • Get up and start walking as soon as you possibly can after the procedure. It hurts like hell, but walking *gently* and frequently in the following days will make a huge difference to how fast and well you heal. I found the more I walked, the less pain I had. 
  • When it is time to remove the dressing -mine was only on for one night before the nurses wanted it off- get into a warm shower and do it yourself. It will come off easily and painlessly, plus the water will wash away any dried blood and make you feel fresh. Have your partner or a nurse with you or just outside the door just in case you get lightheaded or need some help.
  • A postpartum belly band or wrap will help carry and support your heavy tummy afterwards, and reduce the pressure on your wound. Read all about them here on ‘what to expect’.
  • Continue to sleep with your pregnancy pillow for a few weeks afterwards until you feel more able to comfortably turn over in bed. It will also protect you against accidental kicks and nudges from your other half during the night. 
  • Take your time, go at your own pace, and ask for help if you need it.

Take away.

I think we have established that a C-section is absolutely not the easy or glamorous route to take. It’s not a cop-out or a cheat, it’s not the lazy way through childbirth. It’s real, it’s serious and it takes a lot longer to recover from than a vaginal birth. In my opinion anyone who chooses one over a vaginal birth is seriously misguided and misinformed. Don’t do it if you don’t have to.

But sometimes there is just no other safe option, and the stigma needs to be removed for these women. Women like myself who have wondered, albeit briefly, whether they should have “tried” a vaginal birth first, even though it almost definitely would have ended badly. 

The first recorded successful C-section (i.e. both mother and baby survived) was in Switzerland in the 1500’s. The good news there is that surgeons, nurses and the pharmaceutical companies have had approximately five hundred and twenty years to hone their skills. Nowadays it is a fairly routine operation to perform and with fantastic success. 

And look at it this way, when your child is a little older and driving you insane, or you want them to do something they are resisting, you can pull out the best emotional manipulation there is…

THEY CUT YOU FROM ME!”

I’d love to hear from you. If you have any questions about C-sections or would like to share your experiences, please leave a comment or get in touch.

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