Q: I really want to have my baby two weeks before my due date because I have a wedding to go to. Can I just have a Cesarean at 38 weeks?
A: A Cesarean delivery should only be done if a mother is having difficulty delivering her baby, her life is in danger, her uterine contractions are not causing the cervix of the uterus to open or when a baby’s life is in danger. A Cesarean delivery is a surgical delivery. This involves using a surgical instrument that cuts through the skin of the abdomen, then another incision to open the uterus. The doctor reaches into the uterus and pulls the baby through the uterine incision and then through the abdominal wall. The placenta is removed from the uterus and delivered through both openings.
As with any surgery there are possible complications. Any time the skin is cut increases the risk of an infection. The cutting of the uterus also increases the risk of developing a condition known as endometritis. Endometritis is an infection of the wall of the uterus. It is a very painful infection. Having a Cesarean also affects future pregnancies.
Another possible complication and probably the most common is increased bleeding. A woman loses more blood with a Cesarean delivery than she does with a vaginal delivery. Simply this is because she is being cut. Postpartum hemorrhage is a leading cause of death in women giving birth. With the potential of extra bleeding there is also the danger of developing clots. If a blood clot travels to your lungs you could experience a pulmonary embolism. You can die from a pulmonary embolism.
Surgeons are very careful when they are using a surgical instrument. However there is always the risk the instrument can slip and cut things that shouldn’t be cut, such as the bowels or the bladder. This would then require more surgery to repair those damaged organs.
It takes longer to recover from a cesarean than it does a vaginal delivery. Instead of being in the hospital for 1 to 2 days, most mothers who have cesareans require 3 to4 days of recovery in the hospital. Then there is the longer recovery when you go home. Some women report having incisional pain for months after the surgery.
Those are the possible complications for you as the mother. Then there are potential complications for your baby.
One of the most serious is that if you are off on your due date. Babies need time to grow inside their mothers. As you get closer to your due date your baby’s lungs mature so that they can breathe without difficulty. One of the most common problems associated with a cesarean is a baby breathing too fast. We call that tachypnea. When a baby is breathing too fast they cannot eat, they become exhausted, and then they crash.
Hippocrates wrote in his work “Of the Epidemics” that a physician should “first, do no harm.” There is potential harm for both the mother and the baby in doing a Cesarean delivery that cannot be justified with medical evidence.
In Spanish a vaginal delivery is called: Normal. Babies come, for the most part, when they are ready to live easily outside the womb. The best for a baby to be born is the “Normal” way.
We can’t always plan everything they way we want. As John Lennon wrote years ago,” life happens while you are making other plans.” Your friend’s wedding is important, but your health and the health of your baby is most important for you and your family.
Katie Powers, R.N., is a board-certified lactation consultant and perinatal educator at Manatee Memorial Hospital’s Family BirthPlace. Her column appears every other week in Healthy Living. Contact her at firstname.lastname@example.org.