The Cascade of Interventions, Part 3

Written by Dionna on October 11th, 2010

Birth, Holistic Health, Pregnancy, Preparing for Parenting
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The Cascade of Interventions, Part 31

5. Cesarean Sections

So what is the “cascade of interventions,” exactly? Think of it as a domino effect: one unnecessary medical intervention leads to a long chain of interventions, ending in a traumatic birth and an unhealthy mother and newborn, which in turn can lead to even more long-term problems for both.

Maybe that first domino to fall is the induction of labor when the mother and baby aren’t yet ready.

Maybe it is administration of Pitocin to “speed up” labor.

Maybe it is something as simple as making a laboring mother lie still in bed for an hour while a technician fiddles with the electronic fetal monitor.

Each of these interventions has negative side effects that are proven to increase the chance of further interventions, just like dominoes falling. Often, one of the last interventions before a traumatic birth is a cesarean section.

Photo credit: Santa Rosa OLD SKOOL

In the past 40 years, our cesarean rate has skyrocketed. In 1965 the rate was less than 5%, today it is over 30% – approximately one in three women will have a cesarean, most of those are unnecessary.2

The article Why Does the National U.S. Cesarean Section Rate Keep Going Up? lists several explanations as to why that rate is rising, a few of which are: (a) low access to supportive care during pregnancy and labor, (b) ignorance of the dangers associated with cesareans, and (c) an increase in other unnecessary medical interventions (aka the cascade of interventions).

“When a cesarean is necessary, it can be a life saving technique for both mother and infant.” It is, however, major abdominal surgery, and thus carries with it significant risks to both mothers and newborns.3 In a review of research studies, Childbirth Connection compared the difference in risks and outcomes between vaginal birth and cesarean section. Of 37 possible outcomes reviewed, the evidence shows that cesarean sections are found to involve more risk in 33 of those areas. Vaginal birth involved more risk in 4 areas: (a) pain in the vaginal area (that’s kind of a given), (b) incontinence (both urinary and bowel), and (c) risk of nerve injury to babies’ shoulder, arm, or hand.

And the remaining 33 areas that involve more risk with a cesarean? I have most of them listed below.

Risks to Mothers from Cesarean Section

1) Cesarean sections increase the mother’s risk for hemorrhage (severe bleeding);

2) Cesarean sections increase the mother’s risk for blood clots;

3) Cesarean sections increase the mother’s risk for bowel obstruction;

4) Cesarean sections increase the mother’s risk for longer-lasting and more severe pain;

5) Cesarean sections increase the mother’s risk for infection;

6) Because of scarring and adhesion tissue, cesarean sections increase the mother’s risk for ongoing pelvic pain;

7) Because of scarring and adhesion tissue, cesarean sections increase the mother’s risk for twisted bowel;

8 ) Cesarean sections increase the mother’s risk for a longer hospital stay;

9) Cesarean sections increase the mother’s risk for re-hospitalization;

10) Cesarean sections increase the mother’s risk for poorer overall mental health;

11) Cesarean sections increase the mother’s risk for depression;

12) Cesarean sections increase the mother’s risk for psychological trauma;

13) Cesarean sections increase the mother’s risk for rating her birth experience poorer than a mother who had a vaginal birth;

14) Because cesarean sections usually result in a mother having “less early contact with her baby,” she is also “more likely to have initial negative feelings about her baby”;

15) Cesarean sections increase the mother’s risk for future ectopic pregnancies;

16) Cesarean sections increase the mother’s risk for reduced fertility;

17) Cesarean sections increase the mother’s risk for maternal death at birth;

18) Cesarean sections increase the mother’s risk for serious problems with the placenta in future pregnancies (placenta previa, placenta accreta, and placental abruption);

19) Cesarean sections increase the mother’s risk for an emergency hysterectomy;

20) Cesarean sections increase the mother’s risk for stroke;

21) Cesarean sections increase the mother’s risk for a ruptured uterus in future pregnancies;

Risks to Newborns from Birth by Cesarean Section

22) Because cesarean sections pose challenges in forming a breastfeeding relationship, babies born by cesarean section are less likely to breastfeed and to get all of the benefits of breastfeeding;

23) Babies born by cesarean are more likely to be cut (during surgery);

24) Babies born by cesarean are more likely to have breathing difficulties at birth;

25) Babies born by cesarean are more likely to have asthma during childhood;

26) Babies in future pregnancies are more likely to be born too early;

27) Babies in future pregnancies are more likely to have low birth weight;

28) Babies in future pregnancies are more likely to have a physical abnormality or injury to their brain;

29) Babies in future pregnancies are more likely to have a physical abnormality or injury to their spinal cord;

30) Babies in future pregnancies are more likely to die shortly after birth.4

Why did I list these out? Because it may be the only exposure some women have to why they should try to avoid a cesarean section – and all unnecessary medical interventions for that matter. You and your new baby deserve to have the best shot at a healthy, happy, relaxed start at life. A natural labor and childbirth in a supportive environment can give you just that.

If you do have to undergo a cesarean section, this “Tips and Tools” article has many useful tips on how to have a safer experience. Please also read this article by Dr. Sears for helpful hints on breastfeeding after a cesarean.

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Statements on this website have not been evaluated by the Food and Drug Administration. Products and/or information are not intended to diagnose, cure, treat, or prevent any disease. Readers are advised to do their own research and make decisions in partnership with their healthcare provider. If you are pregnant, are nursing, have a medical condition, or are taking any medication, please consult your physician. Nothing you read here should be relied upon to determine dietary changes, a medical diagnosis, or courses of treatment.

About The Author: Dionna

Code Name: Mama CodeNameMama My NPN Posts

Dionna is co-founder of Natural Parents Network. She blogs about natural parenting and life with a toddler-almost-preschooler at Code Name: Mama. She also co-founded NursingFreedom.org, a site dedicated to normalizing breastfeeding anytime, anywhere.

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