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Elective Cesarean: 3 Reasons Why (or Why Not)

posted by Mama Hope | September 19th, 2008 in Natural Childbirth

Yale University scientists have recently unveiled a study revealing that elective Cesarean weakens the mother-baby bond. It appears that volunteering for major surgical interventions in the birth process is not a good thing. Among the pros and cons of elective cesarean, scientists say the cons are growing.

To me, such recent developments in science are important in that they begin to call to question the concept of medical infallibility. Not everything your doctor offers you may be good for you! So many of us continue to believe that if something is medically possible, it must be advisable in every circumstance. But studies like these put on our thinking caps. The big question is: Does science have the power to shift popular conceptions of scientific power? That’s a slippery one. Sound off!

Elective Cesareans Weaken Maternal Bonding

mother baby bonding at risk
Creative Commons License photo credit: greenapplegrenade

Interestingly, the Yale study was performed comparing mothers who birthed vaginally against those who chose elective cesarean births, excluding those who underwent emergency cesareans. Mothers who chose elective cesareans showed lesser activity in brain centers related to mother-baby bonding.

By limiting the study to those cesareans which were elective, the study ruled out the possibility that differences in brain activity among the mothers were caused by trauma due to the unplanned procedure. It also, however, introduced the possibility that the differences are actually based on personality — could mothers who plan detachment to the birthing process experience a similar detachment with their babies?

Professor Walker said there might be specific personality characteristics within the [elective cesarean] group which made maternal bonding more difficult.

He said it was also possible that women who had a Caesarean were slightly disengaged from the birth process in comparison to those who went through a natural delivery. — BBC News, Sept. 2008

Although this may be possible in some cases, scientists’ knowledge of hormone levels and the birthing process points to a more direct physical relationship between natural birth and maternal bonding.

Oxytocin levels, a key ingredient in maternal behavior, have been shown to have a direct relationship to uterine contractions and vaginal stimulation during birth, with the Yale study representing yet more verification for the concept.

Cesareans Increase Likelihood of Postpartum Depression

If that’s not enough, add on the fact that these same hormone levels seem to contribute to an increase in postpartum depression amongst cesarean birth mothers.

The researchers also examined the brain areas affected by delivery conditions and found relationships between brain activity and measures of mood, suggesting that some of the same brain regions may help regulate postpartum mood. — MSN Life & Style, Sept. 2008

Cesareans Increase Risk of Newborn Breathing Problems

And finally, there’s the health of baby. Studies released in late 2007 show that newborns born to cesarean birth have increased risk of respiratory problems. Once again, the reason seems to be related to hormones, which incidentally also seem to be the OB-ward’s favorite thing to mess with in moms in labor. Did I hear somebody say it’s time for some ‘pit’?

One explanation is that hormonal and physiological changes associated with labour are necessary for lungs to mature and that these changes may not be present in infants delivered by elective caesarean section. — Science Daily, Dec. 2007

The Big Questions

Is science finally catching up with itself, unveiling data that reveals its own limitations? And more importantly, will this prompt more mothers to choose natural birth?

In my mothers generation, technology was a shining godhead of man’s prowess. We went to the moon for crying out loud. And with that glorious light of industry shining above us all, massive numbers of folks shifted toward acting in ways that their grandparents, I’m sure, saw as kinda funny. (And yes, I used the word “man” on purpose.)

Infant formula is the most obvious example. There is no way you’d convince a typical Depression-era mom to shell out the big bucks for formula when she can make the stuff herself for free! But skip ahead, and millions of moms are convinced that if the guy in the white coat says it’s better, it must be.

Fast forward one more time, turns out formula actually isn’t better, science proves itself wrong. Now the big food retailers are scrambling to recoup their investments by marketing “special formula” with DHA, making it more “similar” to breastmilk.

…Hmm, I got an idea of how to get some milk for baby that’s really a lot like breastmilk.

What’s next, brand-name cesareans that are “more like” natural birth? Now with new and improved maternal bonding hormones?

Truly, cesareans are no joking matter. There are many mothers, some of which are my good friends, who plan for natural and home births, but find themselves among the small percentage of moms who instead find themselves preparing for surgery due to real medical complications. There are real reasons to protect the health of baby and mother in these circumstances. Yet, when cesareans are looked on lightly, how will we keep a perspective on what those reasons are? How will we draw that line?

C-Section vs. Natural Birth: Surfing the Pros and Cons

The shift that needs to be made in order to both ensure safer births and protect early maternal bonding is not one that relates to the ability of science to deal with unfortunate circumstance, but one that relates to our culture’s belief in its ability to grasp the complete infinite details of the human machine and its capabilities.

The wonder is not in our technological abilities, but in the fact that those abilities have come this far in comprehending such a vast and complex system that is the mammalian body. We still have a long way to go.

What we need is some perspective. Not just the scientists. All of us.

Advances in neuroscience point to these same concepts. The more we learn about the brain, the more we learn how much we do not know, and how much we truly have to learn. In the case of birth, oxytocin and yet undiscovered hormones are clearly a vast horizon of knowledge. Stepping into that territory lightly, succumbing to the temptations of synthetic hormones and elective surgeries, is proving itself to have unexplored consequences.

Consider these facts:

  • The rate of c-sections is growing, from 20.7% of U.S. births in 1996 to a record high of 31.1% in 2006.
  • This despite the fact that maternal risk of mortality is over three times higher with cesarean delivery.
  • And the fact that infant mortality for cesarean deliveries among low risk pregnancies is more than twice that for vaginal births.

Yet mothers even now are considering elective cesareans as a viable and, I can only assume, “harmless” option. Perhaps if moms could come to see that what science can do is truly dwarfed by our bodies potential, elective cesarean would intuitively seem less attractive, and cesareans would more commonly find their rightful place as a major surgical operation, a practice of last resort that we are grateful to have available.

If you’re considering an elective cesarean, either due to concerns over labor pain or a wish for more control over the experience, please do consider the consequences and risks to your health and your baby’s before making a decision.

For me, natural birth is incredibly empowering, and my birth at home was beautiful, peaceful, and even at times comical! My posts on natural childbirth share my experiences and some great resources for birth preparation.

Some excellent birth stories to read if you’re considering elective cesarean vs. natural birth:

Natural birth has come under attack in the media, yet science is gradually revealing that whenever possible, births that occur with the benefit of natural hormones and birth processes have the advantage.

What Einstein Would Say

Albert Einstein said, “Education is the progressive realization of our ignorance.”

We can only hope that science will continue to make its underlying ignorance as visible to us as its body of knowledge. It seems that by discrediting itself from time to time, revealing its own limitations alongside its greatest strengths, science actually opens the door from one era into the next. From one of blind faith and questionable science to one of scientific humility, coupled with a greater measure of good health.

Love,

Mama Hope

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4 Responses to “Elective Cesarean: 3 Reasons Why (or Why Not)”

  1. I’ve had 3 vaginal births and 1 c-section. The c-section is much more difficult to recover from (weeks) vs. the natural birth (days). Having a new baby is very tiring, why someone would volunteer to do it along with recovering from major abdominal surgery is beyond me.

    mommyknowss last blog post..Hollow Legs (coffee contest continues)

  2. Mommyknows,

    Thanks for some perspective from one who has had a c-section! Surgery, for me, seems intuitively scary, though I know we humans are powerful folk and can come through it on top. You go! for getting through yours. I think it’s we women sharing our true stories that helps give other women the knowledge they need to make decisions that are best for them.

    Thanks!

  3. I’m facing a C-section for my current pregnancy, just because the hospital I’m by doesn’t do VBAC. Very frustrating.

    I did vaginal with my first, urgent C-section with my second, as I had low amniotic fluid and was at risk for miscarriage. I’ll take the recovery from vaginal any time! And I’m looking to switch OBs when my hubby’s new insurance kicks in, which will also allow me to switch hospitals to one that does allow VBAC. It’s not so far away as to be a problem, either.

    Stephanie - Green SAHMs last blog post..Planning My Fall Garden

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