I have gotten this question twice now from young first time moms who have had c-sections. They are convinced that a csection is easier. With the c-section rate at 30% in this country, csections are so common they are the new normal way of giving birth. On Sunday night this week, we had 19 patients in postpartum, 13 were c-sections, that's almost 70% of our patients! And let me assure you from seeing csection and vag patients in recovery, a vag birth is almost always easier. Just the nursing care alone for a c-section should be enough to make it clear which on is easier and safer. So I've come up with a new analogy for the next person who really wants to know which one is easier.
Uncomplicated vag deliver, no stitches below the belt: Like recovering from your first marathon that you trained well for but never intended to run as a super-athlete. You will be very very sore and tired for a couple days but overall you will be none the worse for wear.
Vag delivery with 1-3rd degree tear: You ran the marathon and got in a car wreck on the way home. No broken bones but you had to have a couple stitches. Now you are sore and you hurt but in a week or so you will be feeling much better.
C-section after long labor: You ran the marathon then on the way home you got into a horrible car wreck and needed a major surgery to put you back together. Oh and during your recovery you will potentially have full responsibility for a helpless baby. Man, that just sucks!
C-section no labor: I figure you still have a race you just finished because the last couple weeks of pregnancy aren't exactly restful so we'll call it a 10K (not quite as exhausting as the marathon) and you got in the same nasty car wreck on the way home.
Which one sounds easier to you?
One exception: I think some really bad 4th degree tears after long labors could be harder recoveries long term than a scheduled c-sec. BUT the hospital portion of it, the actual nursing care required, the potential for complications, the risks involved, the csection is still harder.
I heard a short snippet on NPR this week that a big group of docs got together to review the data concerning VBACs and safety and issue some new guidelines. Go figure, they decided that VBACs really are pretty safe and a good way to reduce our ridiculous csec rate. We'll see. At my hospital there is currently ONE doc that will do VBACs on a regular basis. ONE!
September 6
3 months ago
Yeah, that whole VBAC issue has me perplexed. Doctors aren't dumb (mostly) so what is the issue? Money? Time? Risk? All of the above? I just don't get it. And that number in your postpartum patients? The 70%? That's not surprising. Awful, but not surprising. I'm shocked these days when a mom I meet at church has had a vaginal delivery.
ReplyDeleteThe VBAC thing is a litigation issue. No one gets sued for doing a csec. You only get sued for doing a csec too late or not at all. The other thing is the ACOG requirement that when a VBAC is laboring the hospital is capable of getting the baby out STAT which is about 18 minutes from decision to section to delivery. That means that the doc has to basically be in house during the labor.
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