Caesarean section: risks and complications

There are many reasons for giving birth to a child by caesarean section. Complications before or during birth , multiple pregnancies or an elective Caesarean section for fear of a natural birth and the associated physical strain are just some of the factors that can lead to the decision to have an operative birth. In Germany, 30% of children are born by caesarean section every year and the procedure has long since become routine. The caesarean section is therefore generally considered safe, but like any other operation, it also involves risks that you should consider before deciding on an operative delivery.

Risks during caesarean section surgery

Even if a caesarean section is used very frequently these days, it is by no means a harmless procedure. Some complications can occur during and after the operation. Problems that can arise during childbirth include:

• High blood loss : If you have a C-section, several layers of tissue will be cut to deliver your baby. The incision inevitably severes intact blood vessels and creates a severe, open wound. The blood loss is therefore many times higher than with a vaginal birth and is one of the reasons why blood transfusions are necessary in the case of a cesarean birth more frequently than in the case of spontaneous births.
• Injuries to internal organs : During a caesarean section , the lower third of your uterus is incised after the individual abdominal layers have been opened. Even if the doctors and nurses are extremely careful during the operation, injuries to neighboring organs, such as the bladder or intestines, can occur during the operation. These injuries are rarely life-threatening, but can lead to prolonged wound pain or later adhesions and damage to the affected organs.
• Minor injuries to the child : In some cases, the baby may suffer minor abrasions or cuts as a result of the operation. However, these usually heal by themselves and only very rarely need further treatment.

Risks after caesarean section surgery

Especially after the actual operation, many caesarean section patients experience unpleasant side effects, which occur much less frequently with a natural birth. In addition, there are often complications after births by caesarean section, which not only affect the mother but also the newborn.

• Wound healing disorders and infections : Since a large wound is deliberately caused during a caesarean section, it takes longer after such an operation before the new mother can get back on her feet and leave the hospital. As a rule, you stay in the clinic for about seven days after the caesarean section, after a complication-free vaginal birth you can go home after just a few days. Getting up, carrying and caring for your baby is usually more difficult after a caesarean section because of the intense wound pain. In addition, even under sterile conditions, the surgical wound can become infected, which can lead to prolonged pain and wound healing disorders. After a caesarean section, the duration of theweekly flow , as the tissue within the uterus regresses more slowly than after a spontaneous birth.
• Adhesions : While the surgical wound heals within the individual layers of tissue, adhesions may form between your internal organs and tissues. Although you often do not feel these so-called adhesions at first, they can constrict organs and impair their function and mobility. Possible consequences are chronic upper and lower abdominal pain, intestinal constriction and sluggishness or infertility, for example due to an occlusion of the fallopian tubes. In order to prevent painful and permanent adhesions, many clinics offer the option of placing a so-called adhesion barrier on the individual interfaces when suturing the wound. The thin membrane consists mainly of hyaluronic acid and forms a protective film that separates the tissue layers affected by adhesions. After its use, the adhesion barrier slowly dissolves and is broken down by metabolism.
• Problems with subsequent births : It is often said that after a caesarean section, the woman concerned is no longer able to give birth spontaneously. That is not right. However, it is true that there is an increased risk of uterine rupture. The seam that was created by the previous caesarean section is not as resilient as the rest of the tissue and is often a cause of complications during childbirth. It is therefore often recommended to have another caesarean section in advance in order to minimize the risk. The likelihood of placenta previa in another pregnancy after a caesarean section is also up to 60 percent higher than after a vaginal birth.
• Health problems in the child : The consequences of the caesarean birth can affect your child in different ways. Children born by caesarean section occasionally have difficulties adjusting to the new living conditions. In babies born vaginally, the amniotic fluid is pushed out of the lungs on the way through the birth canal and the circulation is optimized by the contractions. This effect does not occur in caesarean births, which in many cases leads to initial respiratory and circulatory problems. In some cases, the newborns also react to the mother’s anesthesia with drowsiness or a delayed start of breathing.

In general, it can be said that a birth, whether spontaneous or by caesarean section, is never free of risks and complications can always occur. Therefore, it is particularly important that before the birth of your child you have your doctor provide you with detailed information about all the options available to you and that you also discuss these with your partner or a person close to you. You should think carefully about your decision so that you can make the best decision for you and your baby.