Which is better: cesarean or mom? The child is too large with a clinically or anatomically narrow maternal pelvis

Children are increasingly being born through cesarean section. In Russia, the share of these surgical interventions is already 23%. Causes caesarean section not always medical - many women insist on surgery due to strong fear before childbirth. A new concept has even appeared in the world - tokophobia. Why are women afraid of natural childbirth, and is caesarean section safe without indication?

How is a caesarean section better than a natural birth – the advantages of the method

It is the only choice if there are absolute medical indications. The operation helps the baby to be born if the mother has a narrow pelvis, discrepancy between the size of the fetus and the birth canal, placenta previa, etc.

Caesarean section without medical indications also has some advantages:

Pain relief makes the birth of the baby comfortable.
The fetus does not pass through the birth canal, which means there are no perineal ruptures.
Caesarean is much faster than natural childbirth.
The operation can be scheduled for convenient time, day of the week.
The outcome of a caesarean section is much more predictable.
The child does not receive birth injuries during contractions and pushing.

Caesarean really relieves a woman from painful contractions . It is this advantage of the operation that makes it so fashionable.

A big plus for modern woman is and no perineal tears and weakening of the tone of the vaginal walls. Many women worry about whether they will maintain their sexual attractiveness after having a baby.

Faster delivery with the help of Caesarean section there is no doubt. After all, childbirth takes 12-20 hours, and surgery only takes 30-40 minutes. However, the recovery period after surgery is much longer than after natural childbirth.

The predictability of the outcome of a cesarean section and the absence of birth injuries to the baby would attract most reasonable women. However, just these advantages are always in question. Oddly enough, there are even more children with cervical trauma and postnatal encephalopathy after cesarean than after normal childbirth.

In addition to some advantages, a caesarean section without indications also has obvious disadvantages.

Video: Caesarean section - pros and cons

Why is caesarean section worse than ER?

A caesarean section is a serious operation that carries certain risks for mother and baby. It is known that severe complications for the mother are 12 times more common during caesarean section than during natural childbirth.

Anesthesia is a big risk . can cause great harm to health.

In some cases, general anesthesia ends in shock, circulatory arrest, damage to brain cells, pneumonia. Spinal and epidural anesthesia can be complicated by inflammation at the puncture site, inflammation of the spinal cord membranes, injury to the spine and nervous tissue.

Other disadvantages of cesarean are not related to anesthesia

Difficult recovery period.
Greater blood loss than during natural childbirth.
The need for bedding and protective regime, interfering with caring for the baby at first.
Suture pain pain syndrome.
Difficulties of becoming breastfeeding.
You cannot play sports or do abdominal exercises for several months.
Cosmetic stitch on the skin of the abdomen.
A scar on the uterus, complicating subsequent pregnancies and childbirths.
Adhesive process V abdominal cavity.
Danger to health and life in case of early pregnancy (sooner than 2-3 years).
The need for regular medical supervision in the postoperative period.
The effect of anesthesia on the baby.
At the moment of birth, a child does not produce proteins and hormones that affect mental activity and adaptation.

Recovery period after a caesarean section it is quite difficult. Stress for the body is associated both with the operation itself and with the abrupt termination of pregnancy.

Hormonal imbalances manifest themselves in difficulties in starting breastfeeding . Milk appears much later than after natural childbirth. In some cases, the baby has to be fed additionally from the first days of life, which does not contribute to normal lactation.

A woman has to limit yourself in food, watch your digestion, move moderately . In the first months, it is not recommended to lift weights of more than 2 kg, play sports, swim in ponds, or be sexually active. Due to weakness and the danger of the suture breaking, the woman cannot fully care for the newborn.

Blood loss and inflammation after the intervention can lead to the development anemia, adhesions in the abdominal cavity, the occurrence of chronic pelvic pain syndrome .

Pain in the postoperative period continues for several days. Suture pain persists for a long time . Almost all women have to resort to painkillers in the first days after cesarean section.

The effect of a caesarean section on a child is discussed by pediatricians, teachers and psychologists. Research shows that Children born as a result of surgery adapt less well and are prone to developmental delays. As adults, they more often demonstrate immaturity and an inability to cope with stress.

Recent scientific work in this direction has shown that during natural childbirth, the concentration of a special protein called thermogenin increases in the child’s body, affecting higher blood levels. nervous activity and memory.

Which is better: caesarean section or natural childbirth: the opinion of specialists and patients

Obstetricians and pediatricians clearly believe undesirable caesarean section without medical indications . The operation carries too many risks and does not make the birth of a child comfortable for the mother.

Obstetricians consider caesarean section without indications undesirable, since all subsequent pregnancies will be burdened by this fact . After surgical delivery, it is necessary to carefully protect yourself for 2-3 years, since imminent birth and abortion is extremely dangerous for the suture on the uterus.

At the same time, you can’t delay too long with another baby: Less than 10 years should pass from the previous cesarean to the next pregnancy.

Pediatricians especially emphasize negative impact of unindicated caesarean section on natural feeding And further development baby. These problems can be overcome, but creating them for yourself unnecessarily is very short-sighted.

The opinion of pregnant women about caesarean section was studied. In Russia, every tenth woman insists on operative delivery, without having evidence. Those women who have encountered complications with the birth of their first child are most likely to be afraid of natural childbirth.

What is better for certain problems

In the field of gynecology and among ordinary people, debates do not subside about what is better: natural childbirth or caesarean section - natural abilities or human intervention. Both methods of delivery have their pros and cons, advantages and disadvantages, supporters and opponents. If this concerns not philosophical reasoning, but a responsible decision on how to give birth healthy baby, you need to approach this very seriously, weigh the pros and cons and choose the so-called golden mean.

Caesarean section: pros and cons

Today, the trend is that even those women who do not have indications for this operation are asked to perform a caesarean section. This is an absurd situation: imagine that the person himself insists on being given cavitary incision for no reason.

The myth about the absence of painful sensations during this method. In fact, the question of which is more painful: cesarean or natural childbirth is very ambiguous. In the first case, pain in the suture area occurs after surgery and lasts about 2-3 weeks, or even longer. When you give birth to a baby on your own, the pain is stronger, but it is short-lived. All this can be understood if you evaluate the advantages and disadvantages of both methods.

Advantages

Is the only way out in the presence of a number of medical indications: helps the birth of a child with a narrow pelvis in a woman, large size of the fetus, placenta previa, etc.;
pain relief makes the process of childbirth comfortable, it goes easier: after all, most young mothers are afraid of not being able to withstand painful contractions;
no perineal tears, which means a faster return to your sexual attractiveness and sex life;
proceeds faster in time: the operation usually lasts about half an hour (from 25 to 45 minutes) depending on the condition of the woman in labor and her individual characteristics, while natural childbirth sometimes takes up to 12 hours;
the ability to schedule surgery at a convenient time, choice optimal day weeks and even dates;
predictable outcome, unlike natural childbirth;
the risk of hemorrhoids is minimal;
absence of birth injuries during pushing and contractions - both for the mother and the child.

Plus or minus? Often among the advantages of a cesarean section is the absence of birth injuries and damage to the woman and her baby during pushing and contractions, however, according to statistics, there are more newborns with injuries to the cervical spine or suffering from postnatal encephalopathy after such an operation than after natural ones. independent childbirth. So there is no clear answer as to which procedure is safer in this regard.

Flaws

Serious complications for the health and well-being of a young mother as a result of a cesarean section occur 12 times more often than during natural childbirth;
Anesthesia and other types of pain relief (spinal or epidural) used during caesarean section do not pass without a trace;
difficult and long recovery period;
excessive blood loss, which can subsequently lead to anemia;
the need for bed rest for some time (up to several months) after a cesarean section, which greatly interferes with caring for the newborn;
soreness of the suture, which forces you to take medicinal painkillers;
difficulties in establishing lactation: in terms of breastfeeding, cesarean delivery is worse than natural birth, since in the first days after the operation the baby has to be fed with formula, and in some cases the mother may not produce milk;
a ban on sports after a caesarean section for 3-6 months, which means the inability to quickly restore your figure after childbirth;
ugly, unaesthetic seam on the stomach;
after a cesarean section, natural childbirth may not be allowed in the future (more about this here);
a scar on the surface of the uterus, complicating the next pregnancy and childbirth;
adhesions in the abdominal cavity;
inability to get pregnant in the next 2 years ( best option- 3 years), since pregnancy and new births will represent serious danger, and for the health and life of not only the young mother, but also the baby;
the need for constant medical supervision during postoperative period;
harmful effects of anesthesia on the baby;
the child does not produce special substances (proteins and hormones) that affect his further adaptation to environment and mental activity.

Keep in mind that...
...general anesthesia in some cases ends in shock, pneumonia, circulatory arrest, and serious damage to brain cells; spinal and epidural often entail inflammation at the puncture site, inflammation of the meninges, spinal injuries, nerve cells. Natural childbirth exclude such complications.

Today there is a lot of talk about harmful effects anesthesia during cesarean section on both the mother and baby. And yet, if there is even the slightest danger to the health or life of one of the participants in the birth (mother or baby), and the only way out is a caesarean section, you need to listen to the recommendations of doctors and use this technique. In other cases, the question of which birth is better is decided unambiguously: preference should be given to the natural course of this process.

Natural childbirth: pros and cons

The answer to the question why natural childbirth is better than cesarean section is obvious: because in the absence of medical indications surgical intervention V human body is not the norm. It leads to various complications And negative consequences. If you look at the pros and cons of independent childbirth, their ratio in quantitative terms will speak for itself.

Advantages

the birth of a child is a normal process provided for by nature: female body designed so that the baby at birth acquires everything he needs for normal life, - this is why cesarean is worse than natural childbirth;
the child gains experience in overcoming difficulties, difficulties and obstacles, which helps him in later life;
there is a gradual but completely natural adaptation of the newborn to new conditions;
the baby’s body is being hardened;
immediately after birth, it is better for the child if he is placed on the mother’s breast, which contributes to their inextricable connection and the rapid establishment of lactation;
the postpartum recovery process for the female body as a result of natural childbirth is much faster than after a traumatic caesarean section;
Accordingly, the young mother in this case can independently care for the baby immediately after discharge from the maternity hospital.

Scientific fact! Today, all kinds of studies are being conducted about the effect of cesarean section on the baby. It is discussed not only by doctors, but also by teachers, pediatricians, and psychologists. According to the latest scientific findings, children who were born in this way adapt less well, often lag behind in development, and when growing up, they often demonstrate low resistance to stress and infantilism, in contrast to those who were born during natural childbirth.

Flaws

natural childbirth involves severe pain during contractions and pushing;
painful sensations in the perineum;
the risk of ruptures in the perineum, which entails the need for sutures.

It is obvious that a caesarean section differs from a natural birth both in the methods of influencing the female body, in the course of the entire process, and in its consequences. You need to be especially careful when complex, ambiguous situations arise.

Which is better: cesarean or natural birth for certain problems?

The question of which is better: cesarean or natural birth arises in certain cases when there are deviations from the normal development of the fetus and the course of pregnancy. If any problems arise, doctors analyze the situation and offer the woman two options - agree to the operation or give birth at her own peril and risk. What to do to the expectant mother in such an exciting and ambiguous situation? First of all, you need to listen to the doctor’s opinion, but also understand at least a little about the problem that has arisen in order to make the right decision.

Large fruit

If an ultrasound showed that a woman has a large fetus (this is considered a hero weighing over 4 kg), the doctor must correctly assess her physical indicators, body features and figure. Natural childbirth in such a situation is quite possible if:

the expectant mother herself is far from small;
examination shows that the bones of her pelvis will easily separate during childbirth;
Her previous children were also all large and born naturally.

However, not all women have such physical characteristics. If expectant mother a narrow pelvis, and the baby’s head, according to ultrasound readings, does not match its size pelvic ring, it is better to agree to a caesarean section. It will avoid complex tissue ruptures and make it easier for the baby to be born. Otherwise, natural childbirth may end tragically for both: the baby will injure himself and cause serious damage mom.

After IVF

Today, the attitude of doctors towards childbirth after IVF (procedures in vitro fertilization) has changed. If 10 years ago it was only possible to have a caesarean section without any other options, today a woman in such a situation can give birth on her own without any problems. The following factors are indications for cesarean section after IVF:

the desire of the woman herself;
age over 35 years;
multiple births;
fetoplacental insufficiency;
chronic diseases;
if infertility has lasted for 5 years or more;
gestosis;
threat of miscarriage.

If the expectant mother who has gone through IVF is young, healthy, feels great, and the cause of infertility was a man, she can give birth if she wishes naturally. Moreover, all stages of independent childbirth in this case - contractions, pushing, passage of the birth canal by the child, separation of the placenta - proceed in the same way as after natural conception.

Twins

If an ultrasound showed that there will be twins, monitoring the condition of the mother and babies becomes more careful and attentive on the part of doctors. There may even be questions about whether a woman can give birth to them on her own. The indication for cesarean section in this case is the age of the woman in labor over 35 years and the presentation of both fetuses:

if one baby is positioned with the butt down and the other with the head down, the doctor will not recommend a natural birth, since there is a risk that their heads may catch on each other and be seriously injured;
with their transverse presentation, cesarean section is also performed.

In all other cases, if the expectant mother is healthy, twins are born on their own.

Birth of monochorionic twins

If the birth of monochorionic twins, who are nourished from the same placenta, is expected, they rarely occur naturally and without complications. There are too many risks in this case: premature birth of babies, they often become entangled in the umbilical cord, the birth itself lasts much longer than usual, which can lead to weakening labor activity. Therefore, in most cases today, mothers of monochorionic twins are offered a caesarean section. This will avoid unforeseen situations and complications. Although in gynecological practice there are cases when monochorionic twins were born naturally and without any problems.

Breech presentation of the fetus

If in the last weeks of pregnancy a breech presentation of the fetus is diagnosed, the woman in labor is hospitalized to determine the method of delivery. Natural childbirth is possible in the following cases:

if the mother’s age is under 35 years;
if she is healthy, she has no chronic diseases and at the time of birth she feels excellent;
if she herself is eager to give birth on her own;
if there are no abnormalities in the development of the fetus;
if the ratio of the size of the child and the mother’s pelvis allows him to pass through the birth canal without problems and complications;
breech presentation;
normal head position.

All these factors together can allow a woman to give birth on her own, even with a breech presentation. But this happens only in 10% of such situations. Most often, the decision is made to have a caesarean section. When the baby is born in a breech position, the risk of an unfavorable outcome is too high: the umbilical cord loops fall out, the child’s condition suffocates, etc. Excessive extension of the head is also considered dangerous, which can lead to birth injuries such as damage to the cervical spine or cerebellum.

Asthma

Bronchial asthma is not absolute indication for a caesarean section. Everything will depend on the degree and stage of exacerbation of the disease. During natural childbirth, there is a risk that the woman will begin to choke and her rhythm will be disrupted. correct breathing, which means so much at the birth of a baby.

But modern obstetricians know how to get out of this situation and minimize the risks for both mother and baby. Therefore, if you have asthma of any kind, you need to consult several specialists 2-3 months before giving birth, who will determine the degree of possible risks and advise whether in such a situation it would be better - a cesarean section or a natural birth.

For rheumatoid arthritis

Whether a woman with rheumatoid arthritis can give birth naturally, only a doctor can decide after examining the features of this disease in each specific case. On the one hand, rheumatologists and gynecologists often decide on a cesarean section for the following reasons:

the load on the knees during the birth of a baby is very large;
With rheumatoid arthritis, the pelvic bones can diverge so much that the woman in labor will then have to observe a month of bed rest, since she simply cannot get up;
The disease belongs to the category of autoimmune, and they all have an unforeseen and unpredictable outcome.

At the same time, AR is not an absolute and unshakable indicator for cesarean section. Everything will depend on the woman’s condition and the nature of the disease. Many natural births in such a situation ended quite happily.

Polycystic kidney disease

Enough serious illness is polycystic kidney disease, when multiple cysts form in their tissues. In the absence of exacerbation of this disease and feeling good mothers may allow her to give birth naturally, although in most cases, in order to avoid complications and unforeseen situations, doctors advise having a cesarean section.

If you don’t know what to give preference to, it is better to rely on the doctor’s opinion rather than making independent decisions, focusing on fashion trends from the West, where surgery to remove (not give birth!) a child from the mother’s womb has become commonplace. Weigh the pros and cons: if there is a threat to the health and especially the life of the unborn baby, do not hesitate, trust the doctors and agree to a caesarean section. If there are no medical indications for this operation, give birth yourself: let the baby be born naturally.

The opinion of specialists and doctors that cesarean or natural childbirth is better. What are the indications for cesarean section, and in what cases is cesarean not necessary?

“Natural birth or caesarean section? What to choose?" — the expectant mother timidly types into a search engine. Why does such a question arise, because just a few decades ago it did not worry women. The answer was obvious: natural childbirth and only with serious threats or risks of caesarean section.

The real boom in cesarean sections occurred at the end of the 20th century. Moreover, this method of giving birth to a child was not always justified by medical indications; often expectant mothers were afraid labor pains, about which they wrote and talked so often, they ordered an operation. On the one hand, this method is really simpler: the doctor gives anesthesia (epidural or general anesthesia) and removes the child through the stomach. But is it really that simple?

Caesarean section pros and cons

The operation has undeniable advantages:

with the help of a caesarean section you can save the life and health of the mother and/or child if natural childbirth is impossible for medical reasons;
absence of birth injuries;
the absence of a number of problems that arise after childbirth (vaginal stretching, hemorrhoids, organ prolapse, problems with intimate life);
no pain during childbirth.

The disadvantages of the operation include:

longer recovery, since the operation involves penetration into the uterine cavity;
severe postoperative pain;
a suture on the uterus, which may become thinner and rupture during the next pregnancy;
During surgery, there is a higher risk of bleeding and infection from outside.

From personal experience

I had an emergency caesarean section, because at 41 weeks the baby pinched the umbilical cord with his hand, he began to lack oxygen and had an emergency operation. It’s clear that I didn’t have much of a choice, but I really wanted to give birth naturally. What can I say after two years?

Firstly, psychologically, in my opinion, cesarean is more difficult than natural childbirth: it’s scary to lie on operating table and wait, it’s terribly unpleasant when you feel “hands” in your stomach (! yes, with spinal anesthesia there is no pain, but you feel everything that happens remotely), severe nausea during the operation, terrible pain after a caesarean section, but no one will let you rest, it’s impossible (so that there is no inflammation)! At 7:30 p.m. I had an operation, at 5 a.m. they made me get up and go to the toilet myself, at 11 a.m. I went to another floor and gave the child away. Due to postpartum euphoria, the pain is of course quickly forgotten.

Secondly, the child has a subluxation of the cervical vertebrae C1, C2, this occurs in almost all “cesarean babies” and in some children after natural birth. I advise you to go to an osteopath immediately after the maternity hospital.

Third, pain in the suture area even after two years due to the weather, in the first days of menstruation, etc. This is the most annoying. Lower back pain, because... there was a puncture of the spinal cord (anesthesia).

Therefore, I wish everyone an easy natural birth and not even think about caesarean without indication!

Obstetricians and gynecologists in our country treat caesarean section as serious medical operation, which, as a rule, is not carried out without serious reasons.

Indications for elective caesarean section are:

narrow pelvis of the expectant mother (not necessary!). The operation can be performed if the size of the expectant mother’s pelvis does not allow her to give birth naturally;
placenta previa. The operation is prescribed when the placenta is above the cervix and closes the child’s natural exit routes;
mechanical barriers (fibroids in the cervix);
mother’s diseases (heart disease, kidney disease, progressive myopia);
large size of the child, breech presentation, multiple entanglement of the umbilical cord (not necessary!);
multiple pregnancy;
genital herpes developing on latest dates pregnancy.

After a cesarean section, it is quite possible to give birth on your own. If you have found an experienced doctor who knows how to deliver and can monitor the condition of the suture, then, if desired, give birth naturally. After all, the birth of a child through the birth canal is like the birth of a butterfly. If she does not go through this difficult path of hatching from the cocoon on her own, she will not become so wonderful and beautiful.

When is a caesarean section not necessary?

Is surgery necessary, or can I give birth on my own? There are many indications for which doctors recommend surgery:

If the child is in the pelvic position. In such a situation, it is quite possible to give birth on your own. The mother will have to make more efforts and find an experienced midwife who knows how to deliver such births;
In a situation where the baby is in the facial position, it is also possible to give birth naturally. This causes severe pain on the mother’s back, but is not pathological and does not require a cesarean section.
Umbilical cord entanglement in very in rare cases may be the basis for the surgical method of childbirth. But you can give birth with an entwined umbilical cord yourself. An experienced obstetrician should be able to carefully remove the umbilical cord during labor. There are many examples of women giving birth to healthy and strong children with double and triple entanglements.
At poor eyesight Doctors also recommend a caesarean section. However this is not prerequisite. In such a situation, it is necessary to reduce attempts, which can be facilitated by vertical birth. During such births, the uterus itself can cope with squeezing out the fetus.
With a narrow pelvis, it is quite possible to give birth naturally. It should be understood that a woman has an internal and external pelvis. During childbirth, it is the internal pelvis that plays a major role.
Giving birth to twins naturally is difficult, but possible. It requires a lot of patience from mom and good experience at the midwife. Twins are also not an indicator for cesarean section if the pregnancy is progressing normally and there are no other concomitant indications.
Sometimes doctors diagnose weak labor and begin to resort to various stimulations, including caesarean section. But in practice there are many cases when contractions and uterine dilatation occurred several hours before the birth itself. And that's okay.

Benefits of Caesarean section

In the century population explosion, when there are sometimes no places in maternity hospitals, it has become more profitable for doctors to perform surgical births.

It takes much less time and does not require specific knowledge and resources. A caesarean section takes 1-2 hours, and natural childbirth can sometimes last up to 20-plus hours. Natural childbirth requires qualified knowledge correct acceptance childbirth in different poses. While in a caesarean section everything is simple - cut it, took out the baby, sewed it up.

Many mothers, having not fully studied the process of childbirth and not having knowledge of how to relieve pain during labor, may themselves ask for surgery. In such a situation, not every doctor can indifferently listen to cries and pleas to perform a cesarean section for several hours. And at the request of mommy, he decides to have surgery.

Remember that natural childbirth is the best thing you can give to your child and experience yourself, even despite the pain that accompanies it. If you do not have critical indications for intervention, do everything naturally!

Natural childbirth pros and cons

Natural childbirth is provided for by nature itself, therefore positive aspects they have more:

more comfortable emotional condition mothers;
childbirth takes place in several stages, so the child has time to “prepare” for new conditions and adapts faster;
the likelihood of complications (infection, bleeding) is lower than with a caesarean section;
the recovery process is faster;
milk comes faster.

Even natural process, laid down by nature itself, there are negative aspects:

complications during childbirth or after childbirth (ruptures);
problems with genitourinary system and intimate life.

In our country, the attitude towards caesarean section is ambiguous. On various websites and forums you can find comments that directly insult women who became mothers as a result of a caesarean section. Of course, this approach cannot be considered correct, because motherhood is not only about giving birth to a child. Nowadays, about 15% of children are born by caesarean section (approximately every seventh child). A caesarean section often helps save the life of both the baby and his mother.

The very question of choosing a method of delivery is not entirely appropriate; of course, natural childbirth is preferable, but not every woman can give birth herself without risking her health and the health of her baby. Complications can arise both during natural childbirth and as a result of cesarean section. Tune in for the best and remember that any child, regardless of the method of birth, needs love, affection and care.

Caesarean section is classified as surgical intervention, as a result of which a baby is born. IN Lately it is steadily gaining popularity. The increase in the number of caesarean sections performed in many cases is explained not by medical indications, but by the fear of the mother in labor. What are the pros and cons of this operation?

Indications for caesarean section

Caesarean section is conventionally divided into two options depending on the time of decision-making. The planned procedure is predicted in advance, since even during pregnancy the woman has indications for its implementation. Emergency cannot be foreseen in advance, since it is carried out in cases where during natural childbirth problems arise. serious problems and complications.

The prognosis for a cesarean section may vary throughout pregnancy. An indication for surgery is, for example, a low-lying placenta, but over time it can migrate, rising into upper sections. Of course, in such cases there is no need for surgical intervention. The fetus inside the uterus can also change its position. In order to avoid mistakes and carry out artificial childbirth only in case of urgent need, the pregnant woman and the fetus must be under constant medical supervision. On the eve of a cesarean section, it is recommended to undergo another ultrasound examination.

The main purpose of a caesarean section is to preserve the life and health of the mother and child, therefore it is justified when:

performing a caesarean section during the first birth, the stitch from which is cause for concern;
improper attachment of the placenta;
an excessively narrow pelvis or deformation of its bones;
incorrect position of the fetus;
multiple pregnancy;
large fruit weighing more than 4 or 5 kg;
pathological diseases of the woman in labor.

If a pregnant woman has heart problems (severe heart failure), cervical fibroids, renal failure, then the doctors insist on performing a caesarean section. Even the presence genitourinary infection is an obstacle to natural childbirth, as the risk of infecting the child with such an infection during passage through the birth canal increases. Myopia also represents great danger, since during childbirth there is a sharp drop in pressure and the retina can detach, which will lead to loss of vision for the woman in labor.

An emergency caesarean section is performed for complications that arise suddenly during labor. Unfortunately, if during childbirth contractions are either completely absent or weak, then natural childbirth is not possible. An obstacle to normal labor can be the abruption of the placenta ahead of time, which threatens the health of both the woman and the child. A clinically narrow pelvis may have acceptable (normal) dimensions, but not suitable for a particular large fetus. It is this discrepancy between the size of the fetus and the individual parameters of the pelvis that leads to protracted labor and complications. In this case, doctors insist on performing a caesarean section.

The main purpose of a caesarean section is to preserve the life and health of the mother and child.

Advantages and disadvantages

The main and most important advantage of a cesarean section is the provision of conditions that allow preserving the life and health of the woman in labor and the child. There are pathologies that do not allow childbirth to occur naturally.

During childbirth, detected weak labor activity can lead to the death of the child, and only a cesarean section eliminates this danger. Large fruit causes ruptures not only of the perineum, but also of the uterus, provoking dangerous bleeding.

Making a decision to perform a cesarean section prevents a woman from acquiring many other pathologies. In particular, with a large stretch of the vagina or during an emergency episiotomy during childbirth, prolapse of the vagina itself, as well as uterine prolapse, can be triggered. Urination is also impaired, becoming uncontrollable and spontaneous.

For many women, the big advantage is the absence of pain.

In case of complicated childbirth, special forceps or vacuum extraction are used to extract the child, which, unfortunately, can lead to traumatic brain injuries. Therefore, surgical intervention protects not only the mother in labor, but also the child from undesirable consequences.

Caesarean section belongs to the category of complex abdominal operations

A caesarean section takes approximately forty minutes.. But even such a short surgical intervention belongs to the category of complex abdominal operations. Of course, both at the time of the operation and after it, complications may arise that affect the health of the mother and child. The recovery period increases significantly, difficulties arise with feeding the child, and the risk of developing postpartum depression appears.

Caesarean section (video)

This video contains scenes that are not suitable for viewing by particularly impressionable people.

Possible consequences

After a caesarean section, some young mothers fall into postpartum depression, the reason for which, according to doctors, lies in a sharp break in contact with the fetus.

The recovery period is aggravated by the presence of a postoperative suture. In case of non-compliance medical recommendations it can diverge, bringing additional difficulties to the woman. For at least two months, the young mother must avoid any physical activity. For this reason, she cannot pick up the child, which limits the possibility of constant contact with him. Difficulties also appear when feeding the baby. In the first days, and sometimes weeks (with general anesthesia during a caesarean section), the mother is not allowed to breastfeed the baby, since the milk contains remnants of anesthesia, which negatively affects the health of the newborn.

Operation may be disrupted intestinal tract, which leads to chronic constipation.

Risk of occurrence postoperative complications three times higher than in women who gave birth in a natural way.

The baby himself suffers from a caesarean section.. Primarily from the effects of an anesthetic substance. In this case, the most negative effect is on the respiratory and nervous systems. The baby is lethargic after birth due to the effects of muscle relaxants. During natural childbirth, the child gradually adapts to the new environment, and in this case there is a sharp contact with an unfamiliar environment, which subsequently affects the nervous system and is also the cause of vascular dystonia.

The lungs of the fetus in the womb are filled not with oxygen, but with amniotic fluid; during natural childbirth, it is expelled, and the lungs are filled with oxygen. During a caesarean section, the baby is removed with lungs filled with amniotic fluid, which causes pneumonia.

Caesarean section or natural birth?

Experts are convinced that a caesarean section should be carried out strictly for medical reasons when it comes to saving the life and health of the woman in labor and the child; in other cases, natural childbirth should be adhered to. Nature has endowed a woman with this ability for a reason and created the basis for the comfortable birth of a baby. According to doctors, a caesarean section is not so harmless.

In addition, after the operation, you should not plan a second pregnancy and allow abortions in the next three years. Women are advised to take special precautions.

Based on the results of observation by specialists, it was noticed that children born by caesarean section subsequently have problems with the nervous system. They have a hard time coping with any stress and are prone to depression and sudden mood swings. There are often cases when such birth became the cause of autism.

Pediatricians are sounding the alarm due to the increasing number of caesarean sections. Unfortunately, on this moment The percentage of women wishing to give birth unnaturally, rather than by caesarean section, is increasing. Among such women, there are especially many who had their first birth with complications.

The opinion of Dr. Komarovsky (video)

Childbirth is the moment when a mother meets her baby; it is advisable that it take place naturally. If, due to certain circumstances, this becomes impossible, then in this case a decision is made to perform a caesarean section. In any case, you must believe in the best, because a lot depends on your attitude. Health to you and your baby!

Any woman carrying a child dreams of childbirth being painless, easy and quick. At the same time, many expectant mothers, fearing excruciating suffering during the birth of a baby, ask the question: what is better - cesarean or natural childbirth? It should be noted right away: according to doctors at maternity hospitals, natural childbirth is much safer for the woman herself and her child.

Natural childbirth

Because of the fear of upcoming pain, some women, on the eve of delivery, persuade the doctor to perform a caesarean section. Should not be doing that. Nature has done everything so that a woman can safely bear a fetus and give birth to a child on her own. The female body is designed in such a way that when a child is born, it can adapt to future life as quickly as possible. Experts note that babies who are removed from their mother’s body by caesarean section experience quite a strong shock. For a baby accustomed to the womb, this is a complete surprise. In the future, such children are more susceptible to emotional experiences, mental disorders, and neuroses. But prolonged contraction of the uterus during the birth of a child naturally benefits the newborn. Moreover, the baby experiences positive stress, because the formation and preparation of all his vital important functions happens gradually.

An important advantage of natural childbirth is that the risk of side effects and complications for the woman and child is significantly reduced, since most often it does not require penetration into the mother's body. Some women subsequently report a feeling of deep satisfaction from the fact that they could independently control the process of the birth of their baby. Severe pain becomes a thing of the past, and the importance of the event remains for life. In addition, there are special techniques that help a woman in labor significantly reduce pain.

Finally, compared to surgery, the recovery process after natural childbirth is much faster. Also, do not forget that after a cesarean section the likelihood of another pregnancy sharply decreases, and there is no talk of a third one at all.

C-section

First of all, it should be remembered that a caesarean section is an abdominal surgery. Therefore, one should not take for granted statements that a caesarean section is the easy way reproduction of a child (no pain, the newborn’s head is not subject to deformation, etc.). Not a single surgical intervention takes place without leaving a trace on the body. The doctor will never decide to perform a caesarean section unless there is a serious reason for it. Indications for the birth of a child using this operation are a clinically narrow pelvis of the woman in labor, heavy bleeding, fetal hypoxia, its transverse position, placenta previa, cervical cancer and many other serious pathologies.

Like any abdominal operation, a cesarean section involves the use of painkillers (anesthesia), postoperative sutures. In progress artificial birth the woman loses a lot of blood. After surgery, the rehabilitation process can be quite long. The woman in labor feels for a long time in the lower abdomen nagging pain, and some women have the syndrome pelvic pain remains for life.

There are often cases when a caesarean section is not entirely successful and ends with such serious complications as discrepancy surgical sutures, formation of ligature fistulas and adhesions in the abdominal cavity, development of hematomas, heavy bleeding. Uterine rupture may even occur. Intestinal injuries sometimes occur and Bladder. Many women report a violation menstrual cycle, lack of milk in the first days after childbirth.

Thus, when wondering what is better - cesarean or natural childbirth, you should not deceive nature. If there is no threat to the life of the mother and child, natural childbirth is the most reliable path to happy motherhood.

Almost every woman faces the choice between a natural birth or a cesarean section, and there will definitely be many “advisers” among friends and relatives who will advocate for one method or another. In fact, in this situation, the choice should be made solely on the basis of medical indications - if a cesarean section is indicated, then this operation should be performed. If they are not there, then there is no point in interfering with the natural process. However, there may be exceptions here, which in most cases are associated with the fact that the woman is simply afraid to give birth herself and insists on having a cesarean section. Although not every obstetrician-gynecologist will do this.

The rise in popularity of caesarean section is due to the persistent misconception that childbirth this way will be painless. In fact, pain symptom will be observed in both cases, but only after cesarean section discomfort in the suture area occur after surgery and do not stop for 14-20 days (and often longer). The pain during natural childbirth is short-term, but more intense, so it is impossible to say unequivocally that any of the childbirth options is preferable.

Be that as it may, childbirth naturally have many more advantages, however, there are situations in which surgical intervention is by definition impossible. In order to answer the question of whether natural childbirth or cesarean is preferable, it is necessary to consider in more detail the advantages and disadvantages of each delivery option, as well as to find out the indications and contraindications for its implementation.

What is better - caesarean or natural childbirth if there are any problems?

As a rule, in this situation the choice is in favor of a cesarean section, since no one wants to take risks. In any case, a pregnant woman needs to talk with her doctor and draw conclusions regarding which birth would be preferable for her. The doctor will explain in detail the degree of risk and help you accept correct solution. Although, the most reasonable decisions are to follow the recommendations of an obstetrician-gynecologist, since he understands many things that are not accessible to the awareness of a person who is not related to medicine by definition, because deciding which is better - a cesarean section or a natural birth is very a responsible step that future parents will have to take together.

Advantages and disadvantages of vaginal delivery

Most significant benefits will be listed below:

A woman’s body is designed in such a way that the birth of a child, provided it occurs through natural channels, allows it to properly adapt to the environment.
After natural delivery, the baby is immediately put to the breast - this ensures the formation of a stable, inextricable connection on a subconscious level, and also significantly stimulates lactation.
The recovery period for a woman’s body is significantly reduced due to the fact that the natural processes of metabolic regulation in the body are not disrupted. This allows the new mother to immediately begin caring for her.

The disadvantages are as follows:

Severe pain syndrome, which is observed during contractions and pushing.
For a certain period of time, painful sensations in the perineum will be observed.
There is a high probability of ruptures in the perineum. In turn, this leads to the need for sutures.

Pros and cons of a cesarean section

In many cases, this operation is the only way out of the situation. Don't get me wrong - this isn't even a question of how to give birth safer. It simply cannot be otherwise, despite all the arguments in favor of the fact that natural childbirth is better for a number of reasons!
The anesthesia provided makes the birth process itself somewhat more comfortable. You don't have to be afraid of contractions.
Low probability of perineal rupture, opportunity to return to sexual activity earlier.
If in some cases a natural birth lasted about 12 hours, a cesarean birth rarely takes longer than 45 minutes.
Ability to schedule an operation for a specific date and time;
The outcome of childbirth is predictable.
Maximum reduction in the risk of hemorrhoids.
Eliminating the possibility of birth injuries.

Among the disadvantages of cesarean section, the following should be highlighted:

Negative effects on metabolism and women's health.
The need for a fairly long bed period makes it difficult to care for a newborn baby.
Problems with lactation - in the first days the baby will have to be fed with formula, in any case, since there will be no milk.
A ban on sports activities for a period of six months.
The presence of a seam on the stomach.
Undesirable effects of anesthesia on the child’s body.
Violation humoral regulation in a newborn, which is associated with interference in the natural course of the birth process. This subsequently leads to a decrease in adaptogenic abilities.

The listed signs indicate why cesarean is worse than natural childbirth, however, all these are relative problems, the probability of which is far from 100%.

Large fruit

If the weight of the fetus predicted by ultrasound is more than 4 kg, then in this case there is a high probability of an indication for delivery by cesarean section. The decision is made taking into account an assessment of the mother’s physical characteristics, physique and figure. In principle, natural delivery is allowed - but only in the following cases:

hypersthenic physique of the expectant mother;
examination data indicate that during childbirth the bones of her pelvis will easily separate;
the upcoming birth is not the first and all previous children were born through natural birth.

But not all women meet these parameters. If the expectant mother has a narrow pelvis, and the size of the fetal head, according to ultrasound, does not correspond in size to the pelvic ring, a cesarean section is indicated, since there is a high probability of traumatizing the child during natural childbirth.

Breech presentation of the fetus

In case of breech presentation of the fetus, natural delivery is allowed in the case of a combination of the following factors:

the age of the woman in labor does not exceed 35 years;
no history of somatic pathology;
desire to give birth on your own;
absence of any violations in terms of the child’s development;
the ratio of the size of the child and the mother’s pelvis will not cause any difficulties;
normal position of the head.

Only if all of the above factors are present, natural delivery is allowed, but such a combination of circumstances is possible only in 10% of the situations under consideration.

Childbirth after in vitro fertilization

If in the recent past all women in labor who became pregnant through IVF were sent for caesarean section, now there are exceptions. But still, surgical intervention is performed after IVF in the following situations:

The desire of the woman in labor.
Age exceeding 35 years.
Multiple births.
Presence of signs of fetoplacental insufficiency.
A history of chronic diseases.
For infertility that has been observed for more than 5 years.
Preeclampsia.
The likelihood of a threatened miscarriage.

If at least one of the above factors is present, the advisability of a cesarean section is not questioned in any case, since one cannot risk a child whose conception was so problematic. But in the case when the problem of conception was problems with the father’s health, and expectant mother has no abnormalities, there are no indications for a cesarean section, then why doesn’t she give birth herself? After all, already at the stage of childbirth, it does not matter in what way the child was conceived - all stages of this process (contractions, pushing, passage of the birth canal by the child, separation of the placenta) are no different.

Possible complications

As a result of a cesarean section, the child's adaptive abilities will be reduced, but this statement is largely relative. The most important thing to understand is that when choosing between the advisability of a cesarean section or a natural delivery, you need to pay attention to the recommendations of your attending physician, since only he is able to objectively assess the health of a pregnant woman.

Let me first tell you about myself.

At the time of pregnancy I was fully 27 years old. This is the first and long-awaited pregnancy. Previously, for a long time, I struggled with endomentriosis and a cyst in the ovary. The onset of pregnancy was facilitated by treatment with the drug Visanne. Thanks to this drug Endometriosis was minimized and the size of the cyst decreased.

The pregnancy proceeded generally well, with only occasional uterine tone.

Doctors confidently stated that there were no indications for a cesarean section.

Based on reviews from friends and acquaintances, I still chose paid childbirth (more details). Since the stories about the attitude towards free patients in the maternity hospital were not fire.

On the appointed day, I met with the doctor I had chosen at the maternity hospital. After the examination, the doctor confidently announced that I would give birth myself.

At 40 weeks, I went to the maternity hospital waiting for labor to begin.

During the examination on the chair, the doctor announced some not very pleasant news for me - the cervix is very narrow, there is a chance to give birth on my own, but it is very small. The period, according to her, is not critical, we will wait for the start of labor.

There were no warning signs like the neighbors in the department had.

A week passed... nothing happened. I was already ready for a caesarean section, as long as everything was fine with the baby, because... I've heard a lot about the consequences of "walking around".

The doctor announced that cesarean operations are not done “right and left,” and that confirmation is needed that stimulation methods are used to the fullest extent. I signed a consent form for stimulation and received the first mifepristone tablet.

Use of the substance Mifepristone
Medication interruption intrauterine pregnancy in the early stages (up to 42 days of amenorrhea), confirmed by a pregnancy test; preparation and induction of labor during full-term pregnancy; emergency (postcoital) contraception within 72 hours after unprotected sexual intercourse or if the method of contraception used cannot be considered reliable (10 mg tablets); treatment of uterine leiomyoma (up to 12 weeks of pregnancy) (50 mg tablets).

The description of the drug was frightening, and even the end working week, but I trusted the doctor and took the first pill.... Nothing... After which, I took the second pill, and again nothing...

In constant expectations and worries, I did not pay attention to the nausea at night. In the morning, during the rounds, during the examination on the chair, my water broke and contractions began. A council of doctors was convened, and a decision was made to operate. Because the cervix did not dilate even a millimeter, the baby did not descend.

And as per the law of meanness, all the operating rooms were filled to capacity. I barely survived this unbearable pain during contractions. All this hell continued for an hour and a half. After which, it was still possible to get one of the operating rooms out of the queue (it was not for nothing that the doctor agreed for 20 thousand). I was already happily “running” to the operation that I was so afraid of earlier, if only the pain would end sooner. I have never experienced anything more painful in my life; contractions occurred with a small interval of 1-2 minutes.

The operation went well and the environment in the operating room was positive. The anesthesiologist encouraged and joked throughout the operation.

After the anesthesia, I felt great, the pain went away, and now there was a pleasant feeling of relaxation.

After 20-30 minutes I heard my baby crying. These are indescribable sensations, such happiness to become a mother and finally see your little one, your little blood!

The baby was born healthy, thank God, she only swallowed amniotic fluid, which, according to the pediatrician, is not dangerous to the baby’s health.

After the operation was completed, the baby was transferred to the intensive care ward, and I was transferred to the intensive care unit.

Many people previously feared unbearable pain after surgery, and long period recovery.

And you know, I realized that a lot depends on the inner mood! I never thought that I had so much confidence in my abilities and desire to get back on my feet as soon as possible. There was no self-pity like there was before.

You know, there were girls in intensive care who could not get out of bed for a long time. I got up very quickly and tried to walk more, as the doctors recommended.

There was pain, but not the same as during contractions. Painkillers were injected constantly, thanks to this, the pain was practically not felt.

The recovery period passed quickly, and a week later I was already running around the house and calmly caring for the child.

Now three months have passed, and I already forget that there is a seam. The seam, by the way, is barely noticeable, cosmetic.

Contents:

What is better for certain problems

In the field of gynecology and among ordinary people, debates do not subside about what is better: natural childbirth or caesarean section - natural abilities or human intervention. Both methods of delivery have their pros and cons, advantages and disadvantages, supporters and opponents. If this concerns not philosophical reasoning, but a responsible decision on how to give birth to a healthy baby, you need to approach this very seriously, weigh the pros and cons and choose the so-called golden mean.

Caesarean section: pros and cons

Today, the trend is that even those women who do not have indications for this operation are asked to perform a caesarean section. This is an absurd situation: imagine that a person himself insists on having an abdominal incision made for no reason.

The myth about the absence of painful sensations during this method led to this state of affairs in gynecology. In fact, the question of which is more painful: cesarean or natural childbirth is very ambiguous. In the first case, pain in the suture area occurs after surgery and lasts about 2-3 weeks, or even longer. When you give birth to a baby on your own, the pain is stronger, but it is short-lived. All this can be understood if you evaluate the advantages and disadvantages of both methods.

Advantages

It is the only solution in the presence of a number of medical indications: it helps the birth of a child with a narrow pelvis in a woman, a large fetus, placenta previa, etc.;
pain relief makes the process of childbirth comfortable, it goes easier: after all, most young mothers are afraid of not being able to withstand painful contractions;
no perineal tears, which means a faster return to your sexual attractiveness and sex life;
takes place faster: the operation usually lasts about half an hour (from 25 to 45 minutes) depending on the condition of the woman in labor and her individual characteristics, while natural childbirth sometimes takes up to 12 hours;
the ability to schedule an operation at a convenient time, select the optimal day of the week and even the date;
predictable outcome, unlike natural childbirth;
the risk of hemorrhoids is minimal;
absence of birth injuries during pushing and contractions - both for the mother and the child.

Plus or minus? Often among the advantages of a cesarean section is the absence of birth injuries and damage to a woman and her baby during pushing and contractions, however, according to statistics, there are more newborns with injuries to the cervical spine or suffering from postnatal encephalopathy after such an operation than after a natural, independent birth. So there is no clear answer as to which procedure is safer in this regard.

Flaws

Serious complications for the health and well-being of a young mother as a result of a cesarean section occur 12 times more often than during natural childbirth;
Anesthesia and other types of pain relief (spinal or epidural) used during caesarean section do not pass without a trace;
difficult and long recovery period;
excessive blood loss, which can subsequently lead to anemia;
the need for bed rest for some time (up to several months) after a cesarean section, which greatly interferes with caring for the newborn;
soreness of the suture, which forces you to take medicinal painkillers;
difficulties in establishing lactation: in terms of breastfeeding, cesarean delivery is worse than natural birth, since in the first days after the operation the baby has to be fed with formula, and in some cases the mother may not produce milk;
a ban on sports after a caesarean section for 3-6 months, which means the inability to quickly restore your figure after childbirth;
ugly, unaesthetic seam on the stomach;
after a cesarean section, natural childbirth may not be allowed in the future (more about this here);
a scar on the surface of the uterus, complicating the next pregnancy and childbirth;
adhesions in the abdominal cavity;
inability to get pregnant in the next 2 years (the optimal option is 3 years), since pregnancy and new births will pose a serious danger, and for the health and life of not only the young mother, but also the baby;
the need for constant medical supervision during the postoperative period;
harmful effects of anesthesia on the baby;
The child does not produce special substances (proteins and hormones) that affect his further adaptation to the environment and mental activity.

Keep in mind that...
...general anesthesia in some cases ends in shock, pneumonia, circulatory arrest, and serious damage to brain cells; spinal and epidural often entail inflammation at the puncture site, inflammation of the membranes of the brain, injuries to the spine and nerve cells. Natural childbirth eliminates such complications.

Today there is a lot of talk about the harmful effects of anesthesia during cesarean section on both the mother and the baby. And yet, if there is even the slightest danger to the health or life of one of the participants in the birth (mother or baby), and the only way out is a caesarean section, you need to listen to the recommendations of doctors and use this technique. In other cases, the question of which birth is better is decided unambiguously: preference should be given to the natural course of this process.

Natural childbirth: pros and cons

The answer to the question why natural childbirth is better than cesarean section is obvious: because in the absence of medical indications, surgical intervention in the human body is not the norm. This leads to various complications and negative consequences. If you look at the pros and cons of independent childbirth, their ratio in quantitative terms will speak for itself.

Advantages

the birth of a child is a normal process provided for by nature: the female body is designed so that the baby at birth acquires everything he needs for normal life - this is why a caesarean section is worse than a natural birth;
the child gains experience in overcoming difficulties, difficulties and obstacles, which helps him in later life;
there is a gradual but completely natural adaptation of the newborn to new conditions;
the baby’s body is being hardened;
immediately after birth, it is better for the child if he is placed on the mother’s breast, which contributes to their inextricable connection and the rapid establishment of lactation;
the postpartum recovery process for the female body as a result of natural childbirth is much faster than after a traumatic caesarean section;
Accordingly, the young mother in this case can independently care for the baby immediately after discharge from the maternity hospital.

Scientific fact! Today, all kinds of studies are being conducted about the effect of cesarean section on the baby. It is discussed not only by doctors, but also by teachers, pediatricians, and psychologists. According to the latest scientific findings, children who were born in this way adapt less well, often lag behind in development, and when growing up, they often demonstrate low resistance to stress and infantilism, in contrast to those who were born during natural childbirth.

Flaws

natural childbirth involves severe pain during contractions and pushing;
painful sensations in the perineum;
the risk of ruptures in the perineum, which entails the need for sutures.

Which is better: cesarean or natural birth for certain problems?

The question of which is better: cesarean or natural birth arises in certain cases when there are deviations from the normal development of the fetus and the course of pregnancy. If any problems arise, doctors analyze the situation and offer the woman two options - agree to the operation or give birth at her own peril and risk. What should a expectant mother do in such an exciting and ambiguous situation? First of all, you need to listen to the doctor’s opinion, but also understand at least a little about the problem that has arisen in order to make the right decision.

Large fruit

the expectant mother herself is far from small;
examination shows that the bones of her pelvis will easily separate during childbirth;
Her previous children were also all large and born naturally.

However, not all women have such physical characteristics. If the expectant mother has a narrow pelvis, and the baby’s head, according to ultrasound, does not correspond in size to her pelvic ring, it is better to agree to a caesarean section. It will avoid complex tissue ruptures and make it easier for the baby to be born. Otherwise, natural childbirth can end tragically for both: the baby will injure himself and cause serious damage to the mother.

After IVF

Today, the attitude of doctors towards childbirth after IVF (in vitro fertilization procedure) has changed. If 10 years ago it was only possible to have a caesarean section without any other options, today a woman in such a situation can give birth on her own without any problems. The following factors are indications for cesarean section after IVF:

the desire of the woman herself;
age over 35 years;
multiple births;
fetoplacental insufficiency;
chronic diseases;
if infertility has lasted for 5 years or more;
gestosis;
threat of miscarriage.

If the expectant mother who has gone through IVF is young, healthy, feels great, and the cause of infertility was the man, she can, if she wishes, give birth naturally. Moreover, all stages of independent childbirth in this case - contractions, pushing, passage of the birth canal by the child, separation of the placenta - proceed in the same way as after natural conception.

Twins

if one baby is positioned with the butt down and the other with the head down, the doctor will not recommend a natural birth, since there is a risk that their heads may catch on each other and be seriously injured;
with their transverse presentation, cesarean section is also performed.

In all other cases, if the expectant mother is healthy, twins are born on their own.

Birth of monochorionic twins

If the birth of monochorionic twins, who are nourished from the same placenta, is expected, they rarely occur naturally and without complications. There are too many risks in this case: premature birth of babies, they often become entangled in the umbilical cord, the birth itself lasts much longer than usual, which can lead to a weakening of labor. Therefore, in most cases today, mothers of monochorionic twins are offered a caesarean section. This will avoid unforeseen situations and complications. Although in gynecological practice there are cases when monochorionic twins were born naturally and without any problems.

Breech presentation of the fetus

if the mother’s age is under 35 years;
if she is healthy, she does not have any chronic diseases and at the time of birth she feels excellent;
if she herself is eager to give birth on her own;
if there are no abnormalities in the development of the fetus;
if the ratio of the size of the child and the mother’s pelvis allows him to pass through the birth canal without problems and complications;
breech presentation;
normal head position.

Asthma

Bronchial asthma is not an absolute indication for cesarean section. Everything will depend on the degree and stage of exacerbation of the disease. During natural childbirth, there is a risk that the woman will begin to choke and her rhythm of proper breathing, which means so much during the birth of a baby, will be disrupted.

For rheumatoid arthritis

Only a doctor can decide whether a woman with rheumatoid arthritis can give birth naturally, having examined the characteristics of this disease in each specific case. On the one hand, rheumatologists and gynecologists often decide on a cesarean section for the following reasons:

the load on the knees during the birth of a baby is very large;
With rheumatoid arthritis, the pelvic bones can diverge so much that the woman in labor will then have to be on bed rest for a month, as she simply will not be able to get up;
The disease belongs to the category of autoimmune, and they all have an unforeseen and unpredictable outcome.

Polycystic kidney disease

A fairly serious disease is polycystic kidney disease, when multiple cysts form in their tissues. If there is no exacerbation of this disease and the mother is in good health, she may be allowed to give birth naturally, although in most cases, in order to avoid complications and unforeseen situations, doctors advise having a cesarean section.

Children are increasingly being born through cesarean section. In Russia, the share of these surgical interventions is already 23%. The reasons for a caesarean section are not always medical - many women insist on the operation due to a strong fear of childbirth. A new concept has even appeared in the world - tokophobia. Why are women afraid of natural childbirth, and is caesarean section safe without indication?

How is a caesarean section better than a natural birth – the advantages of the method

Caesarean section is the only choice when there are absolute medical indications. The operation helps the baby to be born if the mother has a narrow pelvis, discrepancy between the size of the fetus and the birth canal, placenta previa, etc.

Caesarean section without medical indications also has some advantages:

Pain relief makes the birth of the baby comfortable.
The fetus does not pass through the birth canal, which means there are no perineal ruptures.
Caesarean is much faster than natural childbirth.
The operation can be scheduled for a convenient time, day of the week.
The outcome of a caesarean section is much more predictable.
The child does not receive birth injuries during contractions and pushing.

Caesarean really relieves a woman from painful contractions. It is this advantage of the operation that makes it so fashionable.

A big plus for a modern woman is no perineal tears and weakening of the tone of the vaginal walls. Many women worry about whether they will maintain their sexual attractiveness after having a baby.

In addition to some advantages, a caesarean section without indications also has obvious disadvantages.

Video: Caesarean section - pros and cons

Why is caesarean section worse than ER?

A caesarean section is a serious operation that carries certain risks for mother and baby. It is known that Severe complications for the mother occur 12 times more often with caesarean section than during natural childbirth.

Anesthesia is a big risk. Anesthesia and regional anesthesia (spinal, epidural) during caesarean section can cause great harm to health.

In some cases, general anesthesia ends in shock, circulatory arrest, damage to brain cells, and pneumonia. Spinal and epidural anesthesia can be complicated by inflammation at the puncture site, inflammation of the spinal cord membranes, injury to the spine and nervous tissue.

Other disadvantages of cesarean are not related to anesthesia

Difficult recovery period.
Greater blood loss than during natural childbirth.
The need for bed rest and protective rest interferes with caring for the baby at first.
Soreness of the suture, pain syndrome.
Difficulties in establishing breastfeeding.
You cannot play sports or do abdominal exercises for several months.
Cosmetic stitch on the skin of the abdomen.
A scar on the uterus, complicating subsequent pregnancies and childbirths.
Adhesive process in the abdominal cavity.
Danger to health and life in case of early pregnancy (sooner than 2-3 years).
The need for regular medical supervision in the postoperative period.
The effect of anesthesia on the baby.
At the moment of birth, a child does not produce proteins and hormones that affect mental activity and adaptation.

The recovery period after a cesarean section is quite difficult. Stress for the body is associated both with the operation itself and with the abrupt termination of pregnancy.

Hormonal imbalances manifest themselves in difficulties in starting breastfeeding. Milk appears much later than after natural childbirth. In some cases, the baby has to be fed additionally from the first days of life, which does not contribute to normal lactation.

A woman has to limit yourself in food, watch your digestion, move moderately. In the first months, it is not recommended to lift weights of more than 2 kg, play sports, swim in ponds, or be sexually active. Due to weakness and the danger of the suture breaking, the woman cannot fully care for the newborn.

Blood loss and inflammation after the intervention can lead to the development anemia, adhesions in the abdominal cavity, the occurrence of chronic pelvic pain syndrome.

Pain in the postoperative period continues for several days. Suture pain persists for a long time. Almost all women have to resort to painkillers in the first days after cesarean section.

Recent scientific work in this direction has shown that during natural childbirth, the concentration of a special protein called thermogenin, which affects higher nervous activity and memory, increases in the child’s body.

Which is better: caesarean section or natural childbirth: the opinion of specialists and patients

Obstetricians and pediatricians clearly believe undesirable caesarean section without medical indications. The operation carries too many risks and does not make the birth of a child comfortable for the mother.

Obstetricians consider caesarean section without indications undesirable, since all subsequent pregnancies will be burdened by this fact. After surgical delivery, it is necessary to carefully protect yourself for 2-3 years, since both early birth and abortion are extremely dangerous for the suture on the uterus.

At the same time, you can’t delay too long with another baby: Less than 10 years should pass from the previous cesarean to the next pregnancy.

Pediatricians especially emphasize the negative impact of a cesarean section without indications on natural feeding and the further development of the baby. These problems can be overcome, but creating them for yourself unnecessarily is very short-sighted.

The main advantage of a planned cesarean section for women is the elimination of pain during contractions and pushing. But obstetricians call a more rational solution for tokophobia a civilized approach to labor pain relief: spinal or epidural anesthesia.

Many families wonder whether to choose a natural birth or a caesarean section. The choice of the nature of the surgical intervention depends entirely on the doctor’s decision. Like all operations given impact has certain indications. Modern doctors have noted that many women resort to cesarean section on their own. This is a worrying sign. Normally, the number of operations should not be performed on more than 10% of patients. Today this figure is growing. To understand how the operation affects the body of the mother and child, it is necessary to understand its characteristics.

Etiology of surgery

The operation is performed through an access to the abdominal cavity. The child is delivered through various types of incisions. The main intervention is carried out laparoscopically through a small incision above the pubic bone.

The technique allows to minimize trauma to several layers of tissue. In the area of the pubic bone, the tissues are in close contact. This allows you to avoid rough scars and injuries to the child.

This form of seam does not cause problems for a woman. The development of complications with this method of surgery is minimized. The recovery period is not long.

In rare cases, more than heavy section. It is carried out when there is a threat of death of the fetus or mother during labor. This technique is performed by making an incision from the pubis to the navel. A longitudinal incision gives the doctor access to all organs abdominal area. The doctor immediately takes the child out. This technique allows you to reduce the time of access to the uterus to 10 minutes. This reduces the time the fetus lacks oxygen. The disadvantage of this operation is the long healing time and the presence of a rough, noticeable scar. In this case, the scar prevents the woman from wearing open underwear.

As with other interventions, a caesarean section requires the woman to follow a number of rules. They allow the woman to recover.

Positive aspects for the patient

To understand whether cesarean or natural childbirth is better, it is necessary to consider their positive aspects. Caesarean section has a number of positive effects. The following advantages of the operation are highlighted:

short temporary exposure;
elimination of labor;
preservation of genital organs.

Caesarean section has average duration 30 min. During the operation, the patient is under the influence of anesthesia. The child is removed from the abdominal cavity and given to postoperative treatment doctors. The umbilical cord with the placenta is also removed by the doctor. Sutures are placed on the peritoneum.

2 days before surgery, the woman goes to the hospital for preparation. She undergoes various tests. The doctor examines the condition of the blood and urine. A vaginal smear is also examined for the presence of pathogens. The day before the intervention, the woman is prescribed a diet that allows the intestines to cleanse themselves. Before the operation, the patient stops drinking. This allows you to reduce blood pressure.

The operation allows you to avoid the main fears - the impact of labor on the body. All patients before childbirth experience fear of severe pain from the process. For this reason, the majority of women believe that it is better to have a cesarean section, since the process takes place under anesthesia. Increased anxiety observed in patients who are about to give birth for the first time. The first labor can develop within several days. The operation allows you to reduce the intervention time.

There is an opinion that after natural childbirth, the vagina is greatly stretched and cannot restore its shape. Surgery prevents the cervix from dilating and the baby from passing through. This avoids rupture of the vagina and external genitalia. Also, the vagina does not require time to recover and heal. After childbirth, a woman retains her usual forms of genital organs.

If you need to choose whether to give birth yourself or a caesarean section, then you should consider the advantages of natural activities. Natural childbirth has the following positive aspects:

timely hormonal changes;
proper preparation of the body;
rapid milk flow;
lack of healing period;
early discharge from the hospital.

An important aspect during natural childbirth is the hormonal changes in the body. Throughout pregnancy, the body is controlled by progesterone. This substance is involved in the development of the embryo and controls the nutrition of the fetus. If it is missing, then the embryo does not take root. At the end of the gestation period, progesterone levels decrease. Oxytocin takes over the reins. Hormone enhances contractile function uterine body. The fetus begins to descend into the birth canal. Oxytocin also helps ensure that the baby is born head down.

After the process is completed, oxytocin does not stop its action. The hormone helps the uterus gradually return to its original size. Oxytocin also causes prolactin in the mouth. It serves as a lactation activator. For this reason, during natural childbirth, milk comes in 2–3 days. Hormonal changes are the reason why it is better to give birth yourself.

An undoubted advantage is the absence of a healing period. Minor tears do not occur in all women. For this reason, the patient needs a short time to rest after natural childbirth. After a few hours, the woman can perform her usual movements. Eating is also allowed.

If a woman does not have any problems during childbirth, she recovers quickly. The absence of problems gives a chance for a quick discharge. In the majority perinatal centers The woman in labor is discharged home after 3 days.

Negative aspects for a woman

To decide whether to choose a natural birth or a cesarean section, you should study their negative aspects. Caesarean section has such disadvantages as:

postoperative period;
hormonal imbalance;
anesthesia;

The main difficulty with a caesarean section is the postoperative period. The seam requires the woman to follow certain rules. The wound does not allow the patient to make sudden movements. Exercise stress after surgery is prohibited. You should also carefully monitor the healing of the suture. Initial processing is carried out by a specialist.

The seam must be wiped with antiseptic solutions and treated with drying medications. The surface of the wound is closed sterile bandage, which does not allow the penetration of pathogenic microorganisms. Further processing is carried out independently.

There is a risk of developing various postoperative complications. A problem that often arises is the dehiscence of the postpartum suture. The pathology is diagnosed 5–7 days after cesarean section. The reason for its manifestation is non-observance of physical rest. In this case, the woman’s stay in the hospital increases.

There is also a risk of developing a fistula. A fistula is formed due to incomplete dissolution of the medical thread applied to the muscle fibers. The process begins with the appearance of a small compaction on the surface of the seam. After some time, the seal opens and a purulent fluid. When cleaning the fistula canal, the doctor finds remnants of threads. In order for the canal to heal, it is necessary to remove necrotic tissue and apply a new suture.

The operation also harms the condition of the internal organs of the abdominal cavity. The wound healing process is accompanied by the formation of scar tissue. It can penetrate deep layers and affect organs. An adhesion forms on the affected area. The adhesive process is often the cause of further infertility in a woman.

Caesarean section excludes timely changes in hormonal levels. The woman is operated on before the onset of labor. The section must be done no later than the end of the 38th week. In this case hormonal background women remains as during pregnancy.

Oxytocin in the body begins to be produced only when breastfeeding. In rare cases, lactation after surgery is not possible. Since hormones are rearranged over a long period of time, the onset of the patient’s menstrual cycle is delayed. Your first period after surgery may take a few months to begin. If they do not start, the fault may lie in hormonal imbalance. The woman will need long-term therapy.

One more unpleasant moment Caesarean section is anesthesia. Women believe that not giving birth is a good thing. In fact, anesthesia has negative impact. The pathological effects of anesthesia extend to the nervous system and brain function. No more than 5 deep anesthesias are allowed throughout your life. Anesthesia also has other unpleasant consequence. The first hours after surgery, the woman experiences severe headaches and dizziness. Nausea and vomiting are observed. This condition can last no more than a day. During this time, the patient cannot eat. Digestion becomes difficult.

Patients experience severe stress. It is associated with a lack of preparation of the body for motherhood. In natural childbirth, interaction between mother and child is established. This allows you to quickly establish the process of feeding and care. During the operation, this preparation for motherhood does not occur. The incompleteness of the process causes postpartum depression.

There are also negative aspects to natural childbirth. The main disadvantage is the duration and pain of labor. A woman who has given birth knows this feature. But the path has already been prepared for such patients. Repeated births will be faster. If the birth is the first, then it can last up to several days. Dilatation of the cervix is accompanied by pain. The syndrome intensifies with the onset of contractions. Pushing is when the pain peaks. This scares many first-borns.

Second negative point is the appearance of gaps. Violent labor activity is accompanied by the rapid passage of the child along the paths. The paths do not have time to expand to the required size. For this reason, the fetus makes its way sharply with its head. Against this background, ruptures of the cervix, labia minora and vaginal walls occur. Such injuries can lead to the development of further complications in sexual life.

Rapid natural childbirth also has a negative impact. Such activity can cause rapid hormonal changes. Due to this, background disturbance may occur. Restoration of the system is carried out with drug therapy.

Pros and cons for a child

When choosing between childbirth or surgery, the child's condition should be taken into account. The choice should be what is best for the child. Caesarean section has such advantages for the baby as:

application for any size;
rapid birth;
no stress.

Should I choose cesarean or natural childbirth for a large fetus? Surgery should be preferred. A large fruit is considered to be from 4.5 kg. At this weight, the baby may get stuck in the lower birth canal. The problem is aggravated by the development of hypoxia. Intrauterine strangulation of the child occurs. Caesarean section avoids unpleasant complications.

The operation also allows you to give birth to a baby with an abnormal location in the uterine cavity. A caesarean section is prescribed if the baby is transversely localized or the placenta is attached to the anterior wall of the uterus. Natural childbirth will not allow you to do this.

During surgery, the child does not need to make his own way. He saves normal shape. The bones of the skull are not subject to deformation. The fetus is removed from the uterus in a few seconds. He does not get tired during the birth process.

Natural labor also has a number of positive effects. During intrauterine development The baby's lungs are filled with fluid. As it passes through the pathways, it is removed from the lungs. The child is born with a fully prepared respiratory system. This avoids the development of postpartum pneumonia.

In natural activities, the baby experiences a psychological connection with his mother. This helps the baby avoid stress when born.

The disadvantages of cesarean section are considered. The anesthetic substance has a negative effect on the condition of the fetus. It enters the fetus through the placenta. After the operation, the child remains under anesthesia for a long time. Medicine entails the baby’s refusal to take the breast. The child sleeps for a long time. Physical activity is restored only after the drug is removed from the body.

The disadvantage of surgery is the accumulation of fluid in the lungs. After the operation, the lungs are cleaned with a special device. Remaining liquid is retained. After some time they cause inflammation. Fluid again accumulates in the lungs. Pneumonia develops.

Natural labor can also have a negative impact on the child. If the fetus is incorrectly located or large in size, there is a risk of hypoxia. The fruit cannot progress along the way. There is a decrease in oxygen. The child begins to choke. Hypoxia negatively affects the further development of the child.

There is a risk of intracranial pressure. It appears when the fetus does not pass properly through the birth canal. In this process, the bones of the skull narrow to make it easier for the baby to pass through. Bones put pressure on the brain. At strong pressure Fluid accumulates between the bones and brain. Pathology requires drug treatment. If this does not help, surgery is prescribed. IN last years this problem occurs often. It's connected with bad conditions the surrounding world.

Before giving birth, a woman must choose how she will go. To make the choice easier, you should carefully study all the positive and negative aspects of both types of childbirth. You should also consult your doctor. Only after this can a decision be made.

The opinion of specialists and doctors that cesarean or natural childbirth is better. What are the indications for cesarean section, and in what cases is cesarean not necessary?

“Natural birth or caesarean section? What to choose?" - the expectant mother timidly types into a search engine. Why does such a question arise, because just a few decades ago it did not worry women. The answer was obvious: natural birth and only in case of serious threats or risks, cesarean section.

The real boom in cesarean sections occurred at the end of the 20th century. Moreover, this method of giving birth to a child was not always justified by medical indications; often expectant mothers, frightened by the pain of labor, which was so often written and talked about, ordered an operation. On the one hand, this method is really simpler: the doctor gives anesthesia (epidural or general anesthesia) and removes the child through the stomach. But is it really that simple?

Caesarean section pros and cons

The operation has undeniable advantages:

with the help of a caesarean section you can save the life and health of the mother and/or child if natural childbirth is impossible for medical reasons;
absence of birth injuries;
the absence of a number of problems that arise after childbirth (vaginal stretching, hemorrhoids, organ prolapse, problems with intimate life);
no pain during childbirth.

The disadvantages of the operation include:

longer recovery, since the operation involves penetration into the uterine cavity;
severe postoperative pain;
a suture on the uterus, which may become thinner and rupture during the next pregnancy;
During surgery, there is a higher risk of bleeding and infection from outside.

From personal experience

Firstly, psychologically, in my opinion, cesarean is more difficult than natural childbirth: it’s scary to lie on the operating table and wait, it’s terribly unpleasant when you feel “hands” in your stomach (! yes, with spinal anesthesia there is no pain, but you feel everything that happens remotely ), severe nausea during the operation, hellish pain after a caesarean section, and no one will let you rest, it’s impossible (so that there is no inflammation)! At 7:30 p.m. I had an operation, at 5 a.m. they made me get up and go to the toilet myself, at 11 a.m. I went to another floor and gave the child away. Due to postpartum euphoria, the pain is of course quickly forgotten.

Therefore, I wish everyone an easy natural birth and not even think about caesarean without indication!

Obstetricians and gynecologists in our country regard caesarean section as a serious medical operation, which, as a rule, is not performed without serious reasons.

Indications for elective caesarean section are:

narrow pelvis of the expectant mother (not necessary!). The operation can be performed if the size of the expectant mother’s pelvis does not allow her to give birth naturally;
placenta previa. The operation is prescribed when the placenta is above the cervix and closes the child’s natural exit routes;
mechanical barriers (fibroids in the cervix);
mother’s diseases (heart disease, kidney disease, progressive myopia);
large size of the child, breech presentation, multiple entanglement of the umbilical cord (not necessary!);
multiple pregnancy;
genital herpes, developing in the last stages of pregnancy.

When is a caesarean section not necessary?

Is surgery necessary, or can I give birth on my own? There are many indications for which doctors recommend surgery:

If the child is in the pelvic position. In such a situation, it is quite possible to give birth on your own. The mother will have to make more efforts and find an experienced midwife who knows how to deliver such births;
In a situation where the baby is in the facial position, it is also possible to give birth naturally. This causes severe pain on the mother’s back, but is not pathological and does not require a cesarean section.
In very rare cases, entanglement with the umbilical cord may be the basis for the surgical method of childbirth. But you can give birth with an entwined umbilical cord yourself. An experienced obstetrician should be able to carefully remove the umbilical cord during labor. There are many examples of women giving birth to healthy and strong children with double and triple entanglements.
For poor vision, doctors also recommend a cesarean section. However, this is not a requirement. In such a situation, it is necessary to reduce attempts, which can be facilitated by vertical birth. During such births, the uterus itself can cope with squeezing out the fetus.
With a narrow pelvis, it is quite possible to give birth naturally. It should be understood that a woman has an internal and external pelvis. During childbirth, it is the internal pelvis that plays a major role.
Giving birth to twins naturally is difficult, but possible. It requires great patience from the mother and good experience from the midwife. Twins are also not an indicator for cesarean section if the pregnancy is progressing normally and there are no other concomitant indications.
Sometimes doctors diagnose weak labor and begin to resort to various stimulations, including caesarean section. But in practice there are many cases when contractions and uterine dilatation occurred several hours before the birth itself. And that's okay.

Benefits of Caesarean section

In the age of the population explosion, when there are sometimes no places in maternity hospitals, it has become more profitable for doctors to perform surgical births.

It takes much less time and does not require specific knowledge and resources. A caesarean section takes 1-2 hours, and natural childbirth can sometimes last up to 20-plus hours. Natural childbirth requires qualified knowledge of the correct delivery of childbirth in different positions. While in a caesarean section everything is simple - cut it, took out the baby, sewed it up.

Natural childbirth pros and cons

Natural childbirth is provided for by nature itself, so it has more positive aspects:

more comfortable emotional state of the mother;
childbirth takes place in several stages, so the child has time to “prepare” for new conditions and adapts faster;
the likelihood of complications (infection, bleeding) is lower than with a caesarean section;
the recovery process is faster;
milk comes faster.

Even the natural process laid down by nature itself has negative sides:

complications during childbirth or after childbirth (ruptures);
problems with the genitourinary system and intimate life.

Every woman's dream is a quick, easy, painless birth. Therefore, today many mothers who are expecting their first baby and are afraid of natural childbirth would like to give birth by caesarean section. However, in our country, a pregnant woman does not yet have the right to choose the method of delivery; the decision to perform the operation is made by the doctors of the maternity hospital. And yet, let's figure out what is better - a caesarean section or a natural birth.

Indications and contraindications for caesarean section

A cesarean section can be planned (when the impossibility of natural childbirth is known during pregnancy) and emergency (when serious complications occur during natural childbirth).

Indications for elective caesarean section are the following factors:

anatomically narrow pelvis or abnormalities in the structure of the pelvis;
entero-genital and genitourinary fistulas in a pregnant woman;
pronounced varicose veins in the vaginal area;
complete placenta previa;
scar on the uterus;
breech presentation or incorrect position of the fetus;
large fruit;
presentation of umbilical cord loops;
severe fetoplacental insufficiency;
diseases in which natural childbirth is contraindicated (heart disease, myopia, epilepsy, diabetes and etc.);
post-term pregnancy with unprepared birth canal;
abnormalities in the development of the uterus, scars or tumors of the cervix, vagina or perineum.

An emergency caesarean section is performed in the following cases:

premature effusion amniotic fluid or fetoplacental insufficiency in the absence of effect from labor induction within 2-3 hours;
premature detachment of a normal or low-lying placenta;
beginning uterine rupture or its threat;
acute fetal hypoxia;
incorrect position or presentation of the fetus;
eclampsia in pregnant women or an increase in gestosis that cannot be treated;
discrepancy between the sizes of the mother’s pelvis and the baby’s head during childbirth;
weak or uncoordinated contractions.

The main contraindications to caesarean section are intrauterine fetal death, incompatible with life malformations of the baby and the presence of severe infectious diseases in a pregnant woman.

Consequences of caesarean section for the mother

Even if you are very afraid of pain during childbirth, you should not persuade the doctor to give you a caesarean section. By nature, a woman is destined to give birth to a child naturally, through the birth canal. Every day thousands of mothers go through this undoubtedly difficult, exciting and such a beautiful path.

Caesarean section emerged as a way to save a baby in the womb of a dying or recently deceased woman. Despite the fact that in modern obstetrics caesarean section has received wide use, and abroad this operation is often used as an alternative to natural childbirth; any obstetrician-gynecologist will advise giving birth on your own (of course, if there are no indications for cesarean section).

A caesarean section is an operation during and after which serious complications may occur: bleeding, infection or adhesions in the abdominal cavity. Is a caesarean section dangerous? In this case, as with any operation, there is always a risk of injury. internal organs, and in very rare cases, the baby.

After surgical delivery, a woman’s body takes longer to recover than after a natural birth. When is discharge after cesarean section? This usually happens on days 6-7. In the first days, it is difficult for a new mother to move, it is difficult to feed the baby, to take him in her arms. In addition, subsequent natural childbirth after a cesarean section is not always possible. And a natural birth after two cesarean births is a huge risk, which not every obstetrician will agree to take on.

So which is better: cesarean or natural birth? Of course, the latter. However, if you have any indications for a cesarean section, you should not risk your life and health and refuse the operation.