Interview with Dr. Georges Eglin, gynecologist-obstetrician, who shares with us his experience and gives advice for women who have - or have had - a cesarean section.
Overall, is there too much caesarean section?
We have a caesarean section rate of 18%, which could be around 12%, if we took into account a certain number of decision factors.
A first caesarean section should rarely be scheduled in advance. Except in exceptional cases, it is better to let the test of work take place, so the first contractions must take place. If the indication for Caesarean section is given before the start of the work (eg, presentation of the seat), it is best to wait until 39 weeks of amenorrhea. If the health condition of the baby allows, the longer we wait, the better. All is done to avoid altering the mother-child bond through avoidable separation.
It should be noted, however, that there is also legal pressure around obstetrics, because if there has never been a trial for caesarian abuse, there has been caesarean section not made in time!
Is there a way to make this birth less traumatic?
Yes of course, we can do a lot. Already, one can more or less estimate, by following the woman who has to give birth, her relative risk of having a caesarean section. It's hard to talk about it during her pregnancy, but it's essential to talk about cesarean delivery before, so she will not be traumatized if it should happen to her. Once the decision is made in the course of work, it must be explained why one can not take risks. Because with the comfort provided by the epidural, some women are ready to continue trying the way down any cost.
The father's place is also very important, almost more than for a natural birth. It is still difficult in some services for reasons related to the risks of nosocomial infection. But emotionally, the presence of the father is quite justified alongside the mother. When the team is in, the obstetrician can lower the field so that the mother can see her baby right out. If there are no problems for the baby, we can offer skin to skin.
Does a caesarean necessarily mean that the next delivery will be a caesarean too?
No. If the reason for the first caesarean section is not repeated (for example, a baby sitting, or a dilation that was stagnating), then there is no reason not to try to give birth naturally the next time ! However, there are women who, for reasons of personal convenience, wish to have a second caesarean section. In recent times, we have more access to this type of request because it is the woman's choice.
What to say to disappointed moms?
Mothers should still be reminded, even if the caesarean section seems insurmountable, that the decision was made because of an estimated risk on the surveillance parameters during delivery. It sounds obvious, but the bottom line is really that the mother and the child are in good health. When many deliveries have been performed, we know how difficult it is to put in place these effective safeguards to protect the mother and the child; do not over-medicalise ... without taking risks! For obstetricians, childbirth requires constant vigilance and we can not afford to take risks with the mother or the baby, whether during a vaginal birth or cesarean section. .
See also our video: Childbirth of twins: Is a cesarean section mandatory?