E1 A C-Section is Major Surgery, and Comes with Major Risks

A C-section is the only major surgery where not only are you responsible for your own recovery, but you are specifically sent home in charge of someone else,

but a lot of women will tell you that it's not always portrayed that way, that it feels like their C-section has been minimized.

Welcome to the Labor Lessons podcast, real-life lessons from real-life labor and delivery experiences, offering support and the knowledge that you are not alone on your birthing journey. The purpose of this podcast is to educate based on others' past experiences. It is not intended as medical advice.

I'm your host, Carly, c-section mom, VBAC mom, and mom who's simply passionate about birth.

Thank you so much for joining us for the first episode of the Labor Lessons podcast. We're gonna go ahead and just jump right in and get started. So our first lesson is that a C-section is major surgery and comes with major risks. So the reason for this being episode number one is that my C-section was what spurred my interest in and my passion for birth, for learning about the birthing world, for learning how to have a better birth next time.

So to give you a brief introduction to my story, I had a C-section in 2018, I went into labor on my own. My water broke. I was, I was actually teaching at the time, my water broke in the middle of the day. Um, and I finished out the day, came home, my husband and I went to the hospital. I got an epidural. I fully dilated.

I pushed for three hours and baby was stuck. We found out later on, she was posterior. Well, actually we knew that when we got to the hospital that she was posterior, um, which is a story for another day, but she was posterior and she was stuck and I couldn't get her out. I had a fairly easy recovery, um, but I still had a bit of trauma from the birth.

I felt, I just remember feeling totally out of control. I felt like birth was happening to me. Like I was not an active part of birthing my daughter. Um, I remember feeling mistreated, unheard by the staff at the hospital, by my doctor who, by the way, I had never met until I showed up at the hospital that day in labor.

So I didn't have a rapport with her. There was no connection with her. And I, afterwards I felt like my body had failed me and I knew that I didn't wanna do the same thing again. I knew that next time I wanted a better birth and I would do anything to get it.

So let's go over what is a c-section and what's involved.

A C-section is when the baby is delivered through an incision in the mother's abdomen and uterus. There are seven layers that the doctor has to go through to get the baby out. They are: skin, fat, fascia, which is a thick and fibrous connective tissue. The abdominal muscles, which are separated, not cut.

Peritoneum, which is a membrane that lines the abdominal cavity. The bladder, which is pulled aside. The uterus and the amniotic sac. Now that's eight layers if you count the amniotic sac, seven, if you just count to get to the uterus.

So this is major surgery we're talking about here, but a lot of women will tell you that it's not always portrayed that way, that it feels like their C-section has been minimized.

And there's a few reasons why I think that is. The first one is that it's not usually known ahead of time that you're going to have a C-section. So you might go into labor naturally on your own, like I did. Or you might be induced. So the vast majority of C-sections are unplanned, uh, failure to progress, failure to descend, um, or emergencies.

Baby's heart, baby's heart rate drops, baby's in distress. When that happens for emergency C-sections, they happen very quickly. They might have you from the hospital, from the delivery room onto the operating table in under 10 minutes. You're either given general anesthesia or a spinal, if you don't already have an epidural, and they have baby out very fast. For the ones that are unplanned, not emergency, like my C-section was, it's still quick for surgery.

You go in for knee surgery and you know, you're there at seven in the morning. They prep you. They don't take you back until maybe 10. You might have tests done ahead of time to make sure you're fit for surgery. Your surgery is scheduled months in advance. This is not like that at all. And for this reason, I think this is also why C-sections are minimized because they're very quick and you don't know ahead of time that they're happening.

The second reason why I think that C-sections might be minimized is that the focus afterwards is usually on the baby. Uh, you'll hear a lot from women who've had C-sections that a lot of people will say to them "Well, as long as you're okay and as long as baby's okay, that's all that matters". But we know that that's not all that matters.

Anytime you have to have surgery, especially unnecessary surgery, it's a big deal. Whether or not you're physically okay afterwards, it's a big deal. And there are a lot of complications that can come with that. Especially for me, where I feel where I feel it was an unnecessary surgery. Um, now I'm dealing with a whole, a whole list of things that could possibly happen afterwards for something that could have been avoided. So, yes, we're grateful that mom and baby are okay, but that's not, that's not all that matters.

And going along with the second point about the focus being mainly on the baby, a C-section is the only major surgery where not only are you responsible for your own recovery, but you are specifically sent home in charge of someone else.

And you may also have toddlers or older children who you also have to take care of. You may also be learning how to breastfeed and you're dealing with visitors, people who want to come to your house all hours of the day and the night to see the baby. Now, after you have knee surgery, you don't really have a lot of visitors who wanna come to your house, who expect to be entertained or don't expect to be entertained, but who are there at your house, who you feel like you have to entertain. After a C-section you have a lot of family, friends, family from maybe out of town who wanna come and stay with you, who wanna help you by holding the baby.

Um, so for these reasons, I think that a lot of times this is why C-sections are minimized. I know from personal experience that I felt like my C-section had been minimized. And for, for these reasons, exactly for these reasons. Um, so yeah.

And now for the part of the show that I like to call ridiculous things my husband has said to me while pregnant. Ladies, why is it that guys just seem to say the dumbest things? Because they don't think before they speak, because they're trying to be funny? Right after I told my husband that I was pregnant with our first daughter, the first thing he said to me was, "are you sure"?

And then after the initial shock had worn off, he followed that by, "So you've managed to trap me, huh?"  We were already married at this point. So ridiculous.

If you've got a ridiculous thing, your boyfriend or husband has said to you during your pregnancy, visit me at laborlessons.com and we'll share it with the rest of the listeners.

Now, back to the episode.

There are a lot of risks that come along with C-sections and they increase with each subsequent C-section. Now a lot of these have come from the American Pregnancy Association and I will post the link in the show notes. So you have a lot of short term risks and a lot of long term, uh, long term risks.

Like infection. Infection at the incision site, in the uterus or other pelvic organs, such as the bladder. Hemorrhage, which is blood loss. Injury to organs, like your bowel or your bladder. Blood clots, reaction to anesthesia, pneumonia, kidney problems, extended hospital stay, extended recovery time, which can range from weeks to months. And for some of the long term effects, maybe even years.

The risk of additional surgeries, such as a possible hysterectomy, a bladder repair, or even another C-section. Sepsis. Maternal mortality. This is death. At three times the rate of a vaginal birth. 

Adhesions, which are scar tissues that can form inside the pelvic region, which cause blockage and pain. And adhesions can lead to their own complications for future pregnancies, such as placenta previa, which is when the placenta partially or completely covers the cervix. Placental abruption, which is the separation of the placenta from the uterine.

Placenta acreta, which is when the placenta grows too deeply, and might even grow through the uterine wall, which comes with a whole other slew of complications, like preterm birth, hemorrhage, kidney failure, lung failure.

Uterine rupture. Which for anyone who's ever thought about pursuing a VBAC, you know that this is the big thing everyone is so worried about is uterine rupture. But I'm sure they don't tell you that your risk of uterine rupture increases with each C-section that you have. Chronic pelvic pain, pelvic floor issues, not just during a vaginal birth. Secondary infertility, UTIs, chronic back pain, pain during sex, endometriosis, and probably even more that we don't know about or haven't heard about.

So I knew it for myself, even though I had a fairly quick recovery, I experienced some of these long term effects, like adhesions, pelvic pain, back pain, pain during sex.

And these are just the risks and effects to mom. It does not include the risks and long-term effects to baby. And it certainly does not account for the mental and emotional trauma, uh, which can lead to postpartum depression and difficulty bonding with baby. Um, which at this point, I'd like to recommend that if you are struggling to process birth trauma, I highly recommend visiting the International Cesarean Awareness Network, ICAN, online.

And I'll post this in the show notes, too. For anyone who's interested, you can find a local chapter near you, where you can connect with others who live in your area, who are in a similar position. Or you can join, you know, the ICAN Facebook group or your local ICAN Facebook group. So if you have any questions about seeking providers who might be VBAC supportive, uh, people who have had VBACs can tell you, can give you information about providers who might be VBAC supportive. Or, you know, if you're looking for a therapist who specializes, maybe in birth trauma, someone might be able to recommend someone in your area as well.

Now, a lot of these I found on my own. I did my own research after my C-section and I found out these are a lot of the risks that come with having C-sections. At no point, did anybody tell me these. At no point before my C-section, during or after, or even at my six week follow up checkup. Which side note is not, for women, who've just had a baby, one six week checkup is not enough, but that's, I won't get into that at this point. Did anybody, my doctor, tell me about these risks.

I, I found these on my own when I did my own research. When I was considering having a VBAC versus a repeat C-section, I found these risks and long-term effects, and it's actually kind of funny.

I knew that no matter what, after my C-section, before I had done any research, I knew I never wanted to have another C-section again. Um, but once I started doing my research and learning more, I knew that I never wanted to have another C-section again. But my husband was not initially on board with a VBAC and I remember one day he asked me to give him 10 reasons why I'd rather have a VBAC than a C-section.

And inwardly I rolled my eyes 10, are you kidding me? Like three is more reasonable. And then I had another thought right after that: I could give you a hundred reasons why I don't wanna have a C-section. And the only one that really matters is that I don't want another unnecessary major surgery.

But then it dawned on me that maybe he didn't think of it as a major surgery. Cuz he didn't know any of this. I didn't know any of this until I did my research. I just knew how it felt for me personally. So you know what I did, I gave him 10 reasons why I didn't wanna have another C-section and I gave him a couple more after that and we talked about it and eventually we came to the conclusion that yes, a VBAC a was in my best interest. Whether or not I had a successful VBAC, it was still in my best interest to pursue one.

This was a tough lesson for me to learn, but definitely an important one. My C-section is what sparked my interest in and my desire to learn more about the birthing world. And it gave me the fire to fight for my VBAC. It inspired me to learn more about C-sections and the risks that come along with them, risks that no one had ever informed me about.

I had to find out on my own through my own research. It gave me the confidence to advocate for a better birth the next time around. And it also has given me the passion to wanna share that with others as well. So that you also can have a better birth next time around.

Thank you so much for listening to the Labor Lessons podcast today. Until next time.