Nearly one out of every three American babies now enters the world through a surgical birth. And while C-sections are generally quite safe, “the safest method for both mom and baby is an uncomplicated vaginal birth,” Spong says.
The best way to reduce the number of Csections overall is to decrease the number of them among low-risk women who are delivering their first child. That’s because having an initial C-section “sets the stage for a woman’s entire reproductive life,” says Main. “In this country, if your first birth is a C-section, there’s a 95 percent chance all subsequent births will be as well,” he says.
A C-section is major surgery. So it’s no surprise that as rates for the procedure go down, so do the numbers for several complications, especially infection or pain at the site of the incision. Rare but potentially life-threatening complications include severe bleeding, blood clots, and bowel obstruction. A C-section can also complicate future pregnancies, increasing the risk of problems with the placenta, ectopic pregnancies (those that occur outside the uterus), or a rupture of the uterine scar. And the risks increase with each additional cesarean birth.
Babies born by C-section can be accidentally injured or cut during the procedure and are more likely to have breathing problems. They are also less likely to breastfeed, perhaps because of the challenges of starting in a post-surgical setting.
In some situations, such as when the mother is bleeding heavily or the baby’s oxygen supply is compromised, surgical delivery is absolutely necessary. But women can maximize their chances of avoiding an unnecessary cesarean by finding a caregiver and birthing environment that supports vaginal birth.
When choosing a practitioner and hospital or birthing center, ask about C-section rates, particularly rates for low-risk women having their first child. The target rate for that population should be around 15 percent, according to ACOG. Although it can be difficult to find a hospital with a C-section rate that low, you might be able find one that meets the more modest goal of about 24 percent, which was set by the government’s Healthy People 2020 initiative.