Cesarean: 9 myths and truths about the surgery

Fear of feeling pain, of damaging the musculature of the vagina, of seeing the baby hanging from the umbilical cord or the desire to schedule the delivery date. These are the main questions raised by pregnant women who decide to have a cesarean section. The surgical option is very common in Brazil: according to the Ministry of Health, last year, of the 3 million births in the country, 52% were cesarean sections. The average is well above the rates of European countries (25%) and the percentage considered ideal by the World Health Organization (15%). However, in some cases, surgery is even necessary.

Below we reveal nine myths and truths about cesarean sections:

1. Can the cesarean delivery be scheduled or advanced?

IN TERMS. According to the Nascer survey, coordinated by the Oswaldo Cruz Foundation, 34% of cesarean sections performed in Brazil occur without the woman having any signs of labor. The survey points out that 28% of them do not have a disease or problem that would indicate surgery – that is, it is done most of the time by choice of the pregnant woman or the doctor. The obstetrician Victor Bunduki, professor at the Faculty of Medicine of the University of São Paulo (USP), explains that the cesarean section can save the life of the mother and the baby. “We make this option when the child is very large or at risk, if there are infections, and in pregnant women with diabetes”, he says. The problem is when surgery is done indiscriminately, especially in elective deliveries, that is, fully programmed. Why does it happen? Cláudio Bunduki, professor of the gynecology department at the Federal University of São Paulo (Unifesp) points out one of the reasons: the series of myths in relation to normal childbirth. “Out of fear, they opt for a cesarean section, believing that it is easier and safer”, he says. Some women, however, opt for a cesarean section because they want to choose the day and time of the baby’s birth because they believe that the date may reflect in numerology or choice of sign. Scheduling the birth of a baby this way can be very dangerous. According to the World Health Organization (WHO), low-risk labor is performed between 37 and 42 weeks of gestation. But this does not mean that every child is prepared to leave the womb before the last days of this safer period. The baby’s lungs, for example, complete development in the last few days of pregnancy. A few days (more or less) make a lot of difference in the development of the baby. Of course, there are exceptions when the pregnancy goes beyond 39 weeks or when there is really a health reason for the mother to perform a cesarean section.

2. If I don’t have a cesarean section, can the baby be hung by the umbilical cord?

MYTH. There is a device that monitors the fetal heartbeat throughout labor. It indicates whether the cord is squeezing the baby.

3. Does C-section recovery take longer?

TRUTH. A cesarean section is a medium-sized surgery. The doctor makes a deep cut to reach the uterus. There is hospitalization of three to four days, use of medicine and antibiotics, in addition to waiting a week to remove the stitches. In normal delivery, recovery happens soon after the baby is born, and discharge occurs between one and two days.

4. If the baby is too big, should I opt for a cesarean section?

IN TERMS. If there are difficulties for the child to pass through the mother’s pelvis, a cesarean section may be the best solution. However, labor can begin normally.

5. Can I avoid labor pains by having a cesarean section?

TRUTH. If the pregnant woman has not yet entered labor and the cesarean section is scheduled, there is no pain during the procedure. However, the postoperative period is longer and more painful. There is a greater risk of maternal infection and respiratory problems in the baby.

6. Does natural childbirth cause changes in the vagina that affect sex life?

MYTH. In this case, the fear is of losing muscle tone in the vagina and perineum. But, with well-oriented exercises before and after childbirth, it is possible to prepare this musculature well to have the necessary elasticity for the baby’s passage and, later, to recover its tonus.

7. Is the cesarean section more expensive than normal delivery?

TRUTH. In the public network, pregnant women do not pay the costs of childbirth, whether normal or cesarean. For those who will use the private network, expenses are higher.

8. If I have a cesarean section once, will I no longer be able to opt for normal delivery?

MYTH. The scar made in the cesarean section will not break if the next child is born vaginally. If the mother and fetus are doing well, the next baby can be born through the genital route.

9. Pregnant women with high blood pressure cannot have a normal delivery?

TRUTH. According to physician Cláudio Bunduki, hypertension is one of the maternal indications for performing a cesarean section. “When there is uncontrolled pressure, the mother’s life is at risk”, he says.