C-Section thoughts

Great article, Mark. I actually just recommended it to a friend who recently found out that she and her husband are expecting. Congratulations on the birth of your son!

A few quick comments: You said, regarding C-sections, "It saves Mom a lot of pain and you can schedule your kids’ birthdays from then on."

C-Sections are usually performed using spinal anesthesia, so the mothers can feel nothing below the ribs during the procedure. So yes, in a sense it does save the mom some pain in the short term. However, healing from C-sections can be prolonged, as the muscular disruption is substantial. The skin and fascial healing also takes time and is rather painful. Women who deliver vaginally are usually up and about within one or two days. So, as far as pain relief is concerned, C-section is not the painless choice.

Also, the old adage of "Once a C-section, always a C-section" isn’t true anymore. The research has shown that for many women who have had a C-section in the past, vaginal delivery is possible. VBAC (vaginal birth after Cesarean) provides women the opportunity to deliver non-surgically in hospitals with acute care professionals available, in case of complications. Although there are some increased risks compared to women delivering vaginally with no prior C-section, many women opt to attempt vaginal delivery and most are successful.

VBACs are patient, doctor, and facility dependent. There are many variables to consider, including type of previous c-section, indication for the procedure, size of baby, and fetal position (presentation). The facility has to be capable of handling c-sections (no VBACs at home) with fully equipped ORs, anesthesia, and other acute care staff available. But if all the ducks are in order, why not try for VBAC? What is there to lose anyway? A failed VBAC usually just means a trip to the OR for a C-section. A sucessful VBAC means decreased healing time, more involvement in the delivery, less blood loss, lower infection risk, and an overall safer delivery for mother and baby.