(Epistemic status: male, no medical education, but had some discussions about this topic)
If I understand it correctly, the greatest danger of C-section is its impact on the following pregnancies. Once you have a C-section, you almost certainly must get a C-section the next time, simply because the scar tissue makes the related body parts much less flexible, and flexibility is exactly the thing you need during childbirth. After you had two C-sections, I think the third pregnancy becomes a huge health risk either way. In other words, once you have a C-section, forget about having a big (biological) family, ever.
So, even if you contemplate C-section for your last childbirth, how confident you are that you won’t change your opinion later? For example, I know couples who had two kids, felt that that was enough… but ten years later changed their minds (as the childcare became much easier) and had a third child anyway. What is the chance this might happen to you?
Before we start statistically comparing C-section vs vaginal delivery, it is worth mentioning that vaginal delivery can be done in different positions. This probably depends on country; in mine, the position almost always used in hospitals is lying on your back. If you consider human physiology, a delivery on your back means that you are pushing the baby upwards, over your tailbone. Intuitively, does that feel like a good idea? The alternatives are lying on your side, pushing horizontally; or squatting, pushing downwards. (Or delivery in water, no idea what are the benefits of that.) So, if we look at the data about vaginal delivery, it makes sense to ask “which position?” because maybe the outcomes are significantly different. Similarly, there is a difference between epidural and no epidural. On one hand, it reduces the pain; on the other hand, it probably interferes with your instincts.
What I am trying to say here is that looking at a statistic that compares one value of “risk of vaginal delivery” with another value of “risk of C-section” is skipping over details that might be relevant. If you conclude that C-section is not that bad compared to the vaginal delivery, you will not explore the possibilities how to reduce the vaginal delivery risk by doing something less usual.
Anecdotally my mother is a nurse practicioner and has had me and all of my siblings via C section with zero regrets, and claims it’s ridiculous that more women don’t do so, so without citation I suspect the thesis here that you can’t have large families is misled or confused (absent my taking a few seconds to consult the literature to actually verify).
What I described above (vaginal delivery not recommended after C-section, pregnancy not recommended after multiple C-sections) is currently a “best practice” in my country, but there are also people who criticize this as insufficiently evidence-based. Sadly, that would not surprise me at all. :(
The keyword for this topic is “VBAC” (vaginal delivery after cesarean) for those who want to read more.
(Epistemic status: male, no medical education, but had some discussions about this topic)
If I understand it correctly, the greatest danger of C-section is its impact on the following pregnancies. Once you have a C-section, you almost certainly must get a C-section the next time, simply because the scar tissue makes the related body parts much less flexible, and flexibility is exactly the thing you need during childbirth. After you had two C-sections, I think the third pregnancy becomes a huge health risk either way. In other words, once you have a C-section, forget about having a big (biological) family, ever.
So, even if you contemplate C-section for your last childbirth, how confident you are that you won’t change your opinion later? For example, I know couples who had two kids, felt that that was enough… but ten years later changed their minds (as the childcare became much easier) and had a third child anyway. What is the chance this might happen to you?
Before we start statistically comparing C-section vs vaginal delivery, it is worth mentioning that vaginal delivery can be done in different positions. This probably depends on country; in mine, the position almost always used in hospitals is lying on your back. If you consider human physiology, a delivery on your back means that you are pushing the baby upwards, over your tailbone. Intuitively, does that feel like a good idea? The alternatives are lying on your side, pushing horizontally; or squatting, pushing downwards. (Or delivery in water, no idea what are the benefits of that.) So, if we look at the data about vaginal delivery, it makes sense to ask “which position?” because maybe the outcomes are significantly different. Similarly, there is a difference between epidural and no epidural. On one hand, it reduces the pain; on the other hand, it probably interferes with your instincts.
What I am trying to say here is that looking at a statistic that compares one value of “risk of vaginal delivery” with another value of “risk of C-section” is skipping over details that might be relevant. If you conclude that C-section is not that bad compared to the vaginal delivery, you will not explore the possibilities how to reduce the vaginal delivery risk by doing something less usual.
Anecdotally my mother is a nurse practicioner and has had me and all of my siblings via C section with zero regrets, and claims it’s ridiculous that more women don’t do so, so without citation I suspect the thesis here that you can’t have large families is misled or confused (absent my taking a few seconds to consult the literature to actually verify).
Writing after discussion with my wife:
What I described above (vaginal delivery not recommended after C-section, pregnancy not recommended after multiple C-sections) is currently a “best practice” in my country, but there are also people who criticize this as insufficiently evidence-based. Sadly, that would not surprise me at all. :(
The keyword for this topic is “VBAC” (vaginal delivery after cesarean) for those who want to read more.