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The Boston Globe

Health & wellness

Ultra Sound Pregnancy

Some truths about (unplanned) C-sections

Adapted from the Ultra Sound Pregnancy blog on Boston.com.

Taking a childbirth class was one of the best decisions I made during my pregnancy. It allowed three hours a week of undistracted time to communicate our labor and birth plan. And — thank goodness — it shot down my husband’s idea of shoving me in his police cruiser and, sirens on, speeding to the hospital, like in a movie.

But I have a confession: I wasn’t always paying attention in class. Like that hour on Cesarean, or C-sections. I didn’t think I would need to know about that method. That is until, 18-plus hours of labor later, my doctor mentioned it as an option. Here are a few thoughts that came to mind then, and some truths about C-sections (a.k.a the Cliff Notes version of that part of class I overlooked).

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I need to decide right away: Maybe not. There’s a difference between unplanned and emergency C-sections. An emergency C-section happens when the health of the mother or the baby are at immediate risk. An unplanned one happens when the labor gets off track, but there’s no urgency, says Dr. Toni Golen, director of labor and delivery at Beth Israel Deaconess Medical Center. “A common reason is the labor may not be progressing. That’s something where it’s unplanned but not necessarily an emergency,” she said.

If I say no to a C-section, I’ll be putting my baby at risk: A C-section was one of many options that was presented to me when it seemed like my labor stopped progressing. According to Dr. William Camann, director of obstetric anesthesiology at Brigham and Women’s Hospital, one of the most common questions a woman asks when something unexpected happens during labor is if there’s anything she can do differently to get things back on track. In many cases, there are.

If a woman has not had an epidural, sometimes changing positions or even getting up and moving around may help, said Camann. Also, getting an epidural may change labor as well, he said. It can relax the muscles and provide some rest.

Having a C-section puts a limit on the number of children a woman can have: Not necessarily. Multiple Cesareans bring their own risks, but there is no limit on the number of babies a woman can have. Among the risks is a higher chance that the placenta will attach to the uterus in a way that makes it difficult to remove after birth, according to Golen.

I will miss out on the most important first minutes of my baby’s life: C-sections are done using a regional anesthesia. Typically, no sedatives are used. Many times, depending on the reason for the C-section, a woman is able to engage her baby just as she would during a vaginal delivery. In fact, Brigham and Women’s Hospital is just one of many places that have taken part in a movement called the “family-centered Cesarean,” says Camann.

Bottom line: Labor is unpredictable. That’s why it’s so important to communicate your desires to your support team (partner, mother, etc.) before go time. It’s even more important to have a talk with your doctor about the options for you.

Read this blog at www.boston.com/lifestyle/health/pregnancy.
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