Elective Cesarean Section
There are many paths to consider when a person becomes pregnant. The parents must decide whether to keep the child or not, then what type of care they will have while pregnant, and finally how they will bring the child into the world. There is the traditional method of birth where the infant is pushed through the vagina and there is Cesarean Section, or C-Section, wherein the baby is removed from the mother’s womb surgically. The latter method is most often utilized when there is a potential health risk in a traditional birth. However, in recent years, it is becoming more and more common for women to choose C-Sections for reasons such as being able to schedule when the child will be born, less recovery time, and assorted other benefits. In the 1960s, birth by C-Section accounted for approximately 3% of the population. At present C-Sections make up over 30% of births. In many parts of the world, like China, the number of C-Section births is closer to 50% (Harmon 2010). 11.7% of births were elective Cesareans, that is they were C-Sections which were performed although no medical risk to mother or child was perceived. This growing rate has led to some in the medical profession becoming concerned that people are putting perceived convenience ahead of their own safety, as well as what is best for the soon-to-be child.
Cesarean sections are performed very frequently and it is the responsibility of those attending the patient and her unborn son or daughter to ensure that the mother-to-be understands all the potential risks of the choice she makes. There is far less danger to women undergoing C-Sections in the modern era than there have been in the past, but the World Health Organization (WHO) warns that reduction of health risk is only in regard to women and babies who were in more danger from a traditional birth (Harmon 2010). Any elective surgery, as an unnecessary Cesarean section would be, is dangerous to the patient being operated upon. The WHO has made it known that they are officially against the prevalence in elective C-sections.
There are also economic concerns regarding Cesarean sections. They are more expensive than a traditional birth because more technology is utilized. More tools and equipments must be used in order to make sure the operation is performed successfully (Misra 2006,-page 272). Additionally, if the infant is removed from the mother too soon, there will have to be supplemental care, including placement in intensive care facilities.
Risks/benefits to patient:
The benefits, as stated above, of an elective Cesarean are the ability to choose when the child will be born and the faster recovery time as compared to vaginal delivery. For women with stricter time constraints such as rigid maternity leave, this can ensure that they are allowed the maximum time with their child. Women who have cosmetic concerns about their bodies can ensure that they will be able to retain the initial integrity of their vagina and not risk tearing of the skin or tissues. Elective Cesarean also allows the mother to schedule the delivery with her obstetrician or physician and ensure that the child is delivered by the desired medical professional.
Besides risks to the mother, C-Sections can lead to health problems in the child being born. In some cases, the child has been removed from the mother before the baby was healthy enough to survive outside the womb and tragedy was the result. Among the issues facing C-Section babies are potentially deadly respiratory problems. Further research and study is required to curb this issue. Rosie Maternity Hospital in Cambridge, England performed research into which weeks of pregnancy would be safest for Cesarean sections in terms of potential respiratory problems for the infant. This team was able to determine that if children were born after the 39th or 40th week of pregnancy and not before, doctors and nurses were far less likely to have to deal with treating respiratory complications (Morrison 2005). By no means does this mean that C-Sections performed after the 40th week will have no risk of respiratory problems, but that the statistics prove this timeframe to be much safer than earlier on in the pregnancy.
Another major risk that concerns medical officials regarding elective C-Sections is the potential for children to develop severe allergies. In a study researching the correlation between elected Cesarean and children’s allergies that was performed in 2008, five allergies were found to be caused or at least worsened by a nontraditional birthing method (Bager 2008). These included: food allergy/food atopy, inhalant atopy, eczema or atopic dermatitis, allergic rhinitis, and asthma which could result in hospitalization. The researchers determined that, like the case of respiratory correlation, there was indeed an increased likelihood of developing dangerous allergies should they be removed from their mother’s womb before the infant is able to sustain itself properly.
Actual/desired patient outcomes:
The patient may choose Cesarean section for health-related problems. The majority of C-Sections are still performed for these reasons. However, there are a growing number of women who have C-Sections rather than vaginal births for reasons other than medical risk. The patient who has an elective Cesarean may choose to have one because of any of the benefits described earlier, i.e. faster recovery time and the ability to choose when the infant will be born. An elective Cesarean does indeed provide the patient with these benefits, unless complications arise from the surgery.
The nurse’s job is two-fold: supporting the doctor who is treating the patient and treating the mother-to-be herself. Before the operation, the nurse’s job is to assess the patient’s current condition and prepare the patient for surgery. This can include, but is in no means limited to, inserting IVs, ensuring paperwork is signed, and confirming that tall pertinent information has been collected. In the operating room itself, specially trained labor and delivery nurses may assist the doctor. After the delivery, both mother and infant will need additional care in order to avoid medical complications. It is the nurse’s role to attend to both patients at this time. Researchers have determined that the higher the number of nurses caring for a patient before, during, and after a Cesarean section, whether elected or not, has a direct correlation to how well that patient and her infant will recover (Gagnon 2007).
Cesarean sections have increased in the United States and around the world. If these numbers remain consistent, then it is quite likely that C-Sections will overtake vaginal births as the “normal” or traditional mode of infant delivery. Whether this proves true or not, it is incumbent on the medical profession and the nurses in particular to relate to prospective mothers the dangers of both forms of childbirth. It is equally important that mothers be made aware that elective Cesarean is a surgical procedure and, with any unnecessary surgery, short-term and long-term repercussions could make health risks in the near or distant future for both the mother and the infant.
Bager, P. (2008). “Caesarian Delivery and Risk of Atopy and Allergic Disease: Meta-Analysis.”
Clinical and Experimental Allergy. 38. 634-42.
Gagnon, Anita (2007). “Continuity of Nursing Care and Its Link to Cesarean Birth Rate.” Birth.
34: 1. 36-31.
Harmon, Katherine (2010). “Elective Cesarean Sections are Too Risky, WHO Study Says.”
Misra, Arpit (2006). “Impact of the HealthChoice Program on Ceasarian Secition and Vaginal
Birth After C-Section Deliveries: A Retrospective Analysis.” Matern Child Health J. 12. 266-274.
Morrison, John J. (2006). “Neonatal Respiratory Morbidity and Mode of Delivery at Term:
Influence of Timing of Elective Cesarean Section.” BJOG: An International Journal of Obstetrics and Gynecology. 102:2. 101-106.
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