Sometimes cesarean sections become strictly necessary to preserve the life and health of the mother or baby, and as the WHO points out, they are indicated when vaginal delivery poses a risk to the mother and child, whether due to abnormal presentation, prolonged labor or fetal suffering; But this organization also indicates that the rate of cesarean sections has been increasing, moving far away from the ideal percentage of 10 to 15%. What happens is that in those cases in which the intervention is not justified, the negative consequences are present not only in the short, but also in the medium and long term.
Immediate risks of a cesarean section
In addition to the immediate risks such as a greater frequency of bleeding, problems derived from infections, consequences of the use of anesthetics, respiratory problems in the baby..., there is another series of sequelae or consequences that are emotional in nature.
When a cesarean section is performed, the natural response mechanism in labor and birth is affected, which also affects the sensitive period, which is that moment after childbirth in which the levels of oxytocin and endorphins in the mother and oxytocin and catecholamines in the baby are elevated, being the bases on which the bond and attachment behavior are established. Furthermore, in a vaginal birth, without mother-baby separation, they remain united, promoting this bond, the beginning of breastfeeding and the regulation of the baby.
In a cesarean section this is not always the case, we know that there are separations, almost immediate, in which the progress of this sensitive period is interrupted, the start of breastfeeding is delayed and the skin-to-skin contact so necessary for mother and baby to regulate themselves is not encouraged.
Psychological risks for the mother
Women undergoing a cesarean section often have feelings of lesser worth, of failure, of not having been able to give birth to their children, as if they were incomplete mothers. This will have a notable impact on their subsequent adaptation to their sons and daughters and even on their bond.
It is true that there are differences between women and also marked by how the cesarean section has been, in the case of an emergency cesarean section, the fact of feeling fear and uncertainty, for one's own life or for that of the baby, come together, which can lead to negative sensations being experienced in the future that can even, depending on the severity of the moment and the mother's experience, lead to post-traumatic stress disorder.
In scheduled cesarean sections, women can have a certain amount of time to prepare for the medical procedure, informing themselves and getting used to the idea of this type of birth.
Long-term consequences of a cesarean section
Among the most frequent long-term emotional consequences in women undergoing a cesarean section, and even more so in the event that this is not completely indicated, and can be called "unnecessary", we find high sadness, which sometimes responds to a process of mourning for the lost, and sometimes stolen, birth. Difficulties in establishing the link; Sometimes mother and baby separations are prolonged, giving rise to a feeling of strangeness in front of that baby that some initially say they do not recognize.
The sensations of feeling violated, wounded, mutilated are also frequent, with the scar being a constant reminder of what has been experienced.
Another consequence that may occur is called tocophobia, or excessive fear with avoidance of childbirth and all aspects related to it.
In the couple there are also a series of consequences, since we must not forget that cesarean sections are usually situations in which the accompaniment of the couple at the birth is not always allowed, which can generate feelings of doubt and uncertainty and even fear about the development of the intervention and the life of mother and baby. Regarding the relationship between the members of the couple, they tend to feel more dissatisfied with the birth of their baby, sometimes there are discordant points of view, which leads to a lack of understanding between them.
Consequences of a cesarean section for the baby
Finally, it is necessary to talk about the consequences for the baby. We know that early separation can significantly hinder the bond and attachment behavior with the child, in addition to creating greater stress in the newborn from which it is more difficult to recover; Caesarean sections scheduled before the 40th week of gestation seem to increase the risks of having special educational needs than those born after this week.
In any case, it must be considered that a cesarean section is a major surgical operation, not without risks, and that it represents a stressful situation for the mother that can worsen in the long term when it is performed routinely and unnecessarily, generating feelings of loss, grief, pain, disappointment, uselessness, and even leading to post-traumatic stress disorders or postpartum depression; For this, adequate support during the cesarean section with information about the process, not separating from the baby, promoting early breastfeeding and bonding, as well as being in a space where they can talk about what they experienced, what happened, their feelings and sensations, will help the mother to achieve the best physical and emotional recovery.
Article written by Jesica Rodríguez Czaplicki is a psychologist at GEA Perinatal Care and Psychology and president of the Perinatal Psychology Association of Spain
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