- All the risks associated with major abdominal surgery. Anesthetic accidents, damage to blood vessels, accidental extension of the uterine incision, damage to internal organs, etc. Even though they are a dime a dozen and you probably know loads of people who have had c-sections, maybe even had one yourself, it is still very invasive surgery.
- Prematurity can be an issue with a scheduled c-section. Most doctors schedule for 38-39 weeks to avoid you going into labor and needing an ‘emergency’ section. The problem is that all our technology can’t tell for sure how far along you are. So unless you know your day of conception, your due date could be 2-4 weeks off. They could take the baby 6 weeks early. I’ve read many a scheduled cesarean story where they take the baby straight to the NICU for developmental problems associated with prematurity. You run these same risks when you are induced early on.
- Lacerations can happen to the baby during any c-section, but there is a huge increase in the possibility (about 6% vs. 1%) the surgeon will accidentally nick your baby with the knife when it is breech.
- Infection. You have a much much much higher risk (very scientific, I know) of both short and long term infection when you have cesarean birth.
- The recovery period is much longer and you are discouraged from picking up older children during this time.
- Baby misses out on the birth hormones (catecholamines) that help prepare her for survival, especially lung function. She also misses out on the contractions which squeeze fluid out of her lungs and the good bacteria from your vagina that help colonize her gut (probiotics). Respiratory problems are considerably higher in cesarean born infants.
- Hemorrhage, anemia, infections and thrombosis (for you) are more common with cesarean section than with vaginal birth.
- Head entrapment can still occur. The safest breech cesarean will be performed by a doctor who has breech delivery skills. You are still taking a baby out a small hole butt-first. The surgeon either has to maneuver the head free (sometimes resulting in injury) or extend the incision.
- Death is about three times more likely for the mother with a planned cesarean than with a vaginal delivery (a very tiny chance either way) and equally likely for the baby (see analysis of Term Breech Trial).
- Studies have been done to compare maternal morbidity and mortality in breech mamas with planned cesarean vs planned vaginal births. A white paper about the high c-section rate in the US explained,
A large Canadian study compared all low-risk healthy mothers with an elective cesarean for breech presentation (as a model for cesarean risk without labor) to healthy mothers attempting vaginal birth. It found that women who had cesareans had a three-fold higher rate of severe morbidity. The cesarean surgery carried with it five times the risk of cardiac arrest and wound hematoma, three times the risk of major infection, and more than twice the risk of anesthetic complication and hysterectomy. Similar findings come from a study in the Netherlands, which found four maternal mortalities (two due to venous thromboembolism and two due to sepsis) for a rate for 1 per 2,127 scheduled cesarean deliveries for breech presentation.