There are several factors that go into the decision to perform - a C-section versus a natural vaginal birth. A natural birth allows the baby to come to full maturity and prepare to enter the world. Moreover, final fluid exchanges between mother and child are able to naturally occur as the mother's body readies for the birthing process. C-sections are much riskier procedures on many levels for both mother and their infant.
There are a few reasons that an emergency C-section may be warranted for fetal indications. The most concerning reasons are if the umbilical cord comes out before the baby (cord prolapse), if the heart beat drops below 100 beats per minute (bradycardia) and does not come back up, or if there is excessive bleeding. In these situations the mother should be operated on - as quickly as possible not to exceed the first twenty – thirty minutes.
The reason the C-section must be rushed is because in these situations, the baby can have limited access to oxygen. If oxygen is limited, a healthy infant can exist twenty minutes with lowered oxygen. However, if the infant was having issues prior to delivery, other serious issues can occur as a result. Lack of oxygen intake can exist even if the baby is healthy – but often can be an indicator that the mother is not well. Concerns with the mother's health should be addressed immediately, because if the doctors miss these signs, it can cause serious problems for both mother and baby.
C-section rates in the U.S. are very high (33% on average – to as high 60-70% in some communities), often because of elective C-sections -- despite putting the child and mother at much more risk. Any major surgery risks excessive bleeding, infections, permanent damage or scarring, as well as risk to the other abdominal organs. A C-section can also hinder a mother’s ability to have a natural birth in the future as each time the uterine muscles are cut, the weaker they can become. After three or four C-sections, the mother risks excessive bleeding, a hysterectomy, or issues with the placenta not separating from the uterus and possibly death.
If a natural birth occurs, there are times when a mother can retrospectively realize that the doctor should have acted sooner and performed a C-section. Upon birth of the child the baby is immediately checked for heart rate and responses. This is done at one, five and ten minutes if things are not going well. If the child is rushed to the NICU, needs incubation or resuscitation, is blue or without a healthy color to the skin, there is cause for concern that something was happening during or prior to the labor that could have been caught. If there is not enough oxygen to the brain, this could cause any number of neurological or developmental issues.
If you, or anyone you know, has had complications due to a C-section, or a possible lack of one, please contact us and we will be happy to advise on the appropriate next steps to be taken.
A talented medical expert with over three decades of experience, Dr. Charles Bowers, Jr. is an esteemed member of Ross Feller Casey, LLP's Medical Forensic Evaluations Department.
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