PUBLISHED: 5:09 PM on Wednesday, May 31, 2006
Doctors stress increased risk with C-sections
Repeat C-sections are the most common reason for scheduling one.

Five to 10 years ago, physicians would have encouraged expectant mothers who had had a C-section to try having a vaginal delivery, referred to as V-back deliveries. Doctors and hospitals no longer encourage the practice since research showed a higher percentage of uterine rupture in V-back births.

According to Dr. Calvin Siegers, most first-time C-sections are done in response to conditions that evolve during labor. Those conditions include: baby distress, the absence of an active labor pattern, and changes to the mother's heath due to labor.

"Sixty to 70 percent of C-sections are the result of something that did or didn't happen during labor," Siegers said.

Other medical reasons for scheduled C-sections include the baby's position within the uterus, ultra sound evidence that the baby is too big to safely deliver, placenta abnormalities and fetal conditions.

Caesarean deliveries involve major surgery: An incision is made in the mother's abdomen to expose the uterus. A second incision is made in the uterus and the baby is lifted up through the incision. The umbilical cord is clamped and cut and the baby is passed off of the surgical field to the pediatrician, who takes over the infant's care.

The doctor performing the section then delivers the afterbirth through the same incision and then begins the process of closing the opening up a layer at a time - uterus, abdominal wall, skin.

Siegers said an uncomplicated C-section takes up to 45 minutes. Risks involved with C-sections are the same risks involved with any major surgery: infection, bleeding and injury to other organs such as the bladder and bowels.

"It's important to remember that it's (still) risky to have a vaginal delivery," Siegers said. "We're not comparing no risk to some risk."

Recovery for a C-section delivery does typically take longer and can require a longer hospital stay, adding to the cost of delivery. There is also threat of litigation if they don't perform them soon enough to avoid birth defects caused by delayed delivery.

"It's a judgment call doctors have to make," he said. "Nationwide, litigation is a huge issue."