The Women's Health Podcast with Kim and Dr. C
The Women's Health Podcast with Kim and Dr. C
Part 1 - C-Section vs Vaginal Birth , Pros, Cons & the Truth Nobody Tells You
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A Nigerian woman living abroad writes in. She's pregnant with her first baby and she's already decided she wants a planned C-section. Her family is furious. Her mother says she's bringing shame to the family. Her aunties say she's afraid.
But is she?
In this episode of the Women's Health Podcast, Dr. Leroy Campbell (Dr. C) and co-host Kimberly Hoffman Reid sit down with one of the most talked-about decisions in women's health , C-section vs vaginal birth. Not to tell you which one is right. But to give you the information you deserve so you can make that decision for yourself.
They break down the real pros and cons of both , what nobody warns you about, what gets exaggerated, and what actually matters when it comes to your body, your baby, and your recovery.
Because here's the truth: this is not about which birth is better. It's about which birth is right for you.
Low risk does not mean no risk. And fear should never be the reason you make , or avoid , any decision about your health.
🎙️ IN THIS EPISODE
00:00 , Welcome back & what's been going on
02:10 , What's Trending: C-sections now overtake vaginal births in the UK for the first time
06:30 , Why C-section rates are rising , population, patient, and physician factors
11:00 - Her Story: A Nigerian woman abroad chooses a planned C-section. Her family says no.
16:00 - Vaginal birth: the benefits nobody talks about enough
20:30 - Vaginal birth: the real risks , tears, pain, pelvic floor, shoulder dystocia
25:00 - C-section: when it's the right call and why it exists
29:30 - C-section: the real risks , surgery, bleeding, microbiome, baby's lungs
34:00 - The microbiome, respiratory health, and what the research says
36:30 - What women actually need after each birth , and what they're not getting
38:00 - Final thoughts: informed decisions over fear, culture, or convenience
39:00 - Wrap up
📌 KEY TAKEAWAYS
✔ Vaginal birth is the safest mode of delivery for uncomplicated pregnancies , that's evidence-based
✔ C-sections are a valid medical option, not a failure and not a shortcut
✔ Both have real risks and real benefits , neither is without trade-offs
✔ The microbiome difference between C-section and vaginal birth babies is real and worth knowing
✔ Low risk does NOT mean no risk
✔ Your birth plan should be based on your individual circumstances , not your culture, your family, or your fear
🔗 CONNECT WITH US
Follow us on Instagram: @drcwomenshealthdoc
Listen on Spotify & Apple Podcasts: Women's Health Podcast with Kim and Dr. C
Follow Dr C on Instagram @drc_thewomenshealthdoc.
Follow Kim on Instagram @thewomenshealthphysio
Also check out Beyond the diagnosis with Kim and Dr C. Mondays at 8pm on Nationwide90fm (Youtube)
Welcome, ladies and gentlemen, to another episode of the Women's Health Podcast with Kim and Dr. C. I'm Dr. Leroy Campbell, also known as Dr. C, the Woman's Health Doc. And as usual, I am here with my beautiful co-host, Mrs. Kimberly Hoffman Reed, the Women's Health Physio. Kim, how are you?
SPEAKER_01Hey, Dr. C. I am good. I am good. I am sure the people are wondering where we were. And I will not I will not blame Dr. C, guys. I will not say it's Dr. C who is so busy. I won't do that. But we are happy to be back and happy to be here. And I have an exciting topic for you in a doc. Like I've been waiting all week to talk to you about this. You know, remember when we started out deciding that we're going to do a podcast, it was more of just wanting other people to get in on our very exciting, entertaining, and sometimes we're going at it conversations about different women's health issues. And today I have quite the topic for you, but I know it's your favorite part. So introduce it, your favorite section.
SPEAKER_00Well, before we get into the main event, you know, I always want to hear what's trending, you know. So what's the what's trending out there in the world of social media? I need this, you know, Kim. This is my little fix because you know I can't keep up with social media most of the time. So this is where I get to hear what's going on out there.
SPEAKER_01Well, I saw an article that stated that cesarean sections overtake natural vaginal births for the first time. And this article is from BBC, so they're referencing the UK. And I found the data stunning because I always thought that without adult, vaginal birth was more popular. I didn't even think that cesarean section was like catching up. But you would know more about this because you're doing this every day. Well, the data shows that in 2024 to 2025, 45% of births were by C-section compared to 44, which were spontaneous.
SPEAKER_00And then I guess a few of them were assisted with vagina delivery.
SPEAKER_01Right. Well, 11% needed extra support and interventions like forceps.
SPEAKER_00So we hear it's actually not surprising to me. It's not because that's really where it has been. So the only thing that's perhaps a bit surprising to me is that this is coming out of the UK. Because I know the United Kingdom, the bodies there, uh, such as the, you know, the Royal College of Obstetricians and Gynecologists and the National Health Services have tried for a long time to ensure that they have you know guidelines regarding which patients get caesarean sections and trying to ensure that indications are appropriate. So hearing that this is happening in the UK is probably only a surprise because the rest of the, for most of the rest of the world, certainly in the Caribbean and Latin America, for some time, we have had very, very high rates of caesarean sections in this side of the world, this side of the Atlantic. In fact, there are countries that where the Caesarean section rate at one point was as high as 80% in South America.
SPEAKER_02Wow.
SPEAKER_00Yeah, and then you know, certainly where I am in the Cayman Islands, the caesarean section rate is over 50%, right? So it's pretty high, and it's you know, similar, maybe not as high in some of the other Caribbean territories, but pretty close, somewhere between 35 to 50 percent is really what you're looking at. And I suspect that this is a trend that is only going to continue.
SPEAKER_01You know, the first thing that I thought that I thought about was is it that we're having women having more complications that's leading to emergency c-section, or are these cases of planned c-section? It didn't state it in the article, but it did make me wonder: like, are women having more complicated births? Do we have to do surgery in these cases? Are they life-saving surgeries? Or women are just saying, hey, let's just do a C-section.
SPEAKER_00Well, I think it's a little bit of both. I generally, when we look at the trends, I look at I generally divide the causes into three categories. We have population-based reasons, we have patient-based reasons, and we have physician-based reasons. And um, first of all, let us understand that in most cases the decision for cesarean section is made because it is thought that the cesarean section is safer either for mommy or the baby than vaginal delivery. Right? So that's generally the reason why a woman would be offered a caesarean section. And so if we understand that at the core, and there are exceptions, which I'll talk about, but if we understand that at the core, then you will also recognize that if we have a population of women who are coming into pregnancy with higher risks, you're gonna find that there are gonna be higher, there's gonna be a higher likelihood that these women will require cesium sexuals. So if we're looking at a population perspective, we know that there is an increase in rates of obesity, for example. Yes, we know that there are increasing rates of lifestyle-related disorders, hypertension, diabetes, heart disease. We know that there are more and more women who previously would not be conceiving, who are conceiving because of assisted reproductive therapies. And so consequently, we're looking at higher-risk women coming into pregnancy. The average pregnant woman today is certainly a higher risk pregnant woman than you would have found 20, 30 years ago. So that's where you start. And then you add to that patient factors now, so the patient's own risk profile, as well as the fact that you are having one more and more women who are saying, Well, maybe I'll choose to bypass, you know, going through vaginal delivering the rigors of labor, and just choose a cesarean section.
SPEAKER_02Yeah.
SPEAKER_00And then you have physician factors, because remember now that you're looking at, from an obstetric standpoint, a c uh one of the specialties that has the highest risk of litigation, you know, and so you're you're having physicians that ultimately are going to make a decision that is going to be safest for the mother or for the baby. And whenever there is a question, they're likely going to error to side to the side of cesarean sections. Because, of course, they're trying to reduce risk, both of adverse outcomes for mommy and baby, but also in the back of the mind, the concern about what will happen in based litigation. And so there's there, these are real risks.
SPEAKER_01Yeah, further down in the article, it says that it spoke to BMI and age, but it's saying that those haven't increased significantly for the numbers, for the rate that the numbers of cesarean sections are increasing. And it also said that they're speaking to a professor from Midwifery. It's midwifery, right? Midwifery studies at the University of Manchester. And she said, part of the picture is a growing number of women who feel a cesarean is the least worse option because there is a fear they might not get the support they need for a safe, straightforward, positive label. And then she went on to say, Well, an NHS spokesperson said, all women should receive safe, personalized maternity care in line with best practice guidance and clinical evidence. The priority should always be the safety and well-being of both mothers and babies, and decisions about how a baby is born are made through informed discussions that consider individual circumstances, clinical advice, and a woman's preferences, ensuring the safest and most appropriate approach for each birth. So I know this is the tip of our iceberg in our what's trending segment, but it does segue into the conversation that I want us to have today, which is our her story segment, because I saw this email come in and I'm like, this is a conversation that I really want to have with Dr. C. And then I had to bite it down, wait for it. I did send it over to you so you can follow along, Dr. C, because it leads right into or it, yeah, it leads right into the conversation we had before, it leads right into this. And I really want to hear what you have to say about what this person sent in. So it goes, Hi, I'm writing because I need someone outside my family to answer this honestly. I'm pregnant with my first baby, and I've already decided I want a planned C-section. I know some people will roll their eyes at that, but to me it makes sense. It's controlled, it's scheduled, it feels safer. I don't understand why I would choose hours of labor, possible tearing, possible trauma when there's another option. I grew up in a Nigerian home where women talk about childbirth like it's a rite of passage, like it's something you endure to prove you're strong. My aunties tell their birth stories like war stories. My mom always said, Our bodies were made for this. We are strong women, but I also grew up educated. I live abroad now and I have access to modern health. I've read enough to know surgery is safe, managed, predictable. So I told my mom I'm planning a C-section. She didn't pause. It can just you should have told her after. You should have told her after, you know? Like after you think you know better than the woman who gave birth before you? You think you're the first woman to feel pain? That suffering will kill you. And now you want doctors to cut you open because you're scared of labor. And then she said it. Don't bring shame to this family because you're afraid. Afraid? That word has been sitting heavy on my chest ever since. I don't think I'm scared. I just don't believe pain makes me more of a woman. I don't think endurance equals worth. I don't think avoiding labor makes me weak. But now I feel like I'm standing between two worlds: the one that raised me, where strength is measured by what you survive, and the one I live in now, where I have options. I'm not trying to shame where I come from. I just want to make the smartest decision for my body. Isn't a planned C-section safer? If I can avoid labor, why wouldn't I?
SPEAKER_00Interesting.
SPEAKER_01Very interesting. It's very interesting. And you know, first of all, for listeners, this is not to say one decision for a woman is better than another because that is all based on information you have available for each individual. And that's based on that individual and their care providers, not Kim and Dr. C. What we can do right here is give you the information so that if you find yourself in such a position that you know the right questions to ask care providers, you know how to advocate for yourself, and you know how to counteract mommy or auntie or whoever else, because you're coming from a place of information, you're educated, and you know what's the best practice based on information that we're providing you and the conversations that you've had with your doctor. So, again, we're not telling you what's right or wrong, we're giving you the information. And really and truly, Dr. C, I'm sure you'll agree. There is no right or wrong in black and white. There isn't. Because this is a treatment option, and with treatment options, you have reasons that you would choose either one. And that's again up to the patient, the care providers, and their own individual and unique circumstances. So let's get into it, Dr. C. I would like the approach where we probably just go with pros and cons for each for vaginal birth versus cesarean sections. So persons can understand what they're dealing with, what are the positives and what are negatives, because both they both have that, and I think it would be lovely if we went through that. I don't know any better person who could do this than you.
SPEAKER_00All right, Kim. Yeah, flattery, flattery is everything, right? But uh, yeah, I mean, I I like, you know, first of all, thanks to you know, uh listener who sent that in because it's actually quite a real situation that many women experience in terms of making decisions about their health care. And quite often we must admit that our decisions are influenced by the people we love, people around us. And in this particular case, she's deciding that she wants a cesarean section, and her family is saying otherwise. Now, as you rightly said, Kim, cesarean section is just a therapeutic option, it's just something that uh that is designed to help women, and it's important to understand from historical context how we ended up with cesarean sections as a mode of delivery.
SPEAKER_02Right.
SPEAKER_00We understand that for thousands of years, women have been having babies with very little help. Uh it's just, you know, in fact, I tell most patients you really don't need somebody like me to have a baby. Women have been doing this for thousands of years.
SPEAKER_01In the bushes, in the forests.
SPEAKER_00Exactly, in caves, and with minimal help, the average a healthy woman with minimal help will go through pregnancy and have a safe delivery. What we must understand though is that there are a subset of women who will develop complications. And it's that subset of women who need people like myself, right? Because we have to be able to identify those who are at the highest risk, put measures in place to mitigate those risks or eliminate those risks. So if we understand that, then you can see where cesarean sections came from. Because there are a subset of women for whom that baby might either be too big for the passage, right? Well we call we call that cephalopelvic disproportion. Uh, you know, whether it's the pelvis or the outer or the vagina, goes through significant changes during labor and delivery, but sometimes it just can't facilitate the passage of the fetus. And in can you imagine how that would have been in the past? That would have led to obstructed labor. And so you're gonna have a woman now who's having a baby, her labor is obstructed, and that baby is sitting in that birth passage, and sometimes for days, there are cases, horrific cases, Kim, of babies not being able to pass, women have died from infections, the ones who survived the baby died, or if the baby survived a severe handicap, or cases where the baby's head, for example, may have been down in pelvis for so long that it compromised the blood flow to the organs there, and you end up with what we call fistillas, which is where you get these abnormal communications between the vagina and the rectum and the vagina and the bladder. And so you have women leaking stools through the vagina, and you know, it's really these are really serious problems, which we forget about because of the fact that modern science has provided alternatives, and that's how cesarean sections initially came about, finding another means of delivering the baby whenever the vaginal route was unsafe. Now, over time that has evolved to the point now where we've moved from just doing cesarean sections primarily for concerns about the safety of mother of the baby, to where we have what we call you know patient request or maternal request, where women like this patient that you're that you're sharing can say to her physician, I want a cesarean section. And the reason for this, there are two reasons for this. The first reason is that cesarean sections have become so safe. You know, so nowadays the risk related to a cissare insection is quite low. It's estimated that the morbidity, the risk of mortality is no different between cesarean sections and vaginal delivery. So a woman understanding that risk is so small, is so small, feels more and more comfortable. But that being said, not because there is the risk of mortality is low, does it mean that there isn't morbidity, meaning that there can't be complications, there can't be problems. Uh and I say to patients all the time, I said, well, cesarean section is a fairly low-risk surgery, but it doesn't mean it's a no-risk surgery. You know, there is a difference between low risk and no risk. And that's important to understand.
SPEAKER_01You can tell again, yeah, right? Low risk. There's not equal no risk to put it on a shirt.
SPEAKER_00Right. So now when we combine all of these factors of one, the general population being at higher risk than in the past, two, you're having a surgery that is safer, and so more and more women are willing to request it. And then the third thing is that a lot of, you know, and certainly when I was coming up in residency, what was one of the popular reasons for women requesting a cesarean delivery was because they wanted to protect their pelvic flora and protect the perineum, the vagina from being damaged, you know, during labor and delivery. And those are real concerns that they had because they saw women with prolapse, they saw women with incontinence of stool, incontinence of urine, and they didn't want to experience that. And so that's kind of that that drove this increased rate of women requesting caesarean deliveries. So just to give some perspective on that, and yeah, and if you want, like we can talk a little bit about the pros and cons of each.
SPEAKER_01I absolutely want you to talk to the about the pros and the cons of each because I had a conversation with a colleague recently, similar conversation, and she was saying that she don't she was also on the the side of C-sections being safer and better. And she was saying that one of the reasons she was telling me, Kimberly Hoffman, the pelvic birth therapist, that did do you know that there's some women who they have vaginal birth and they're incontinent beyond repair? And I'm like, yes, incontinent and vaginal birth. That is a risk of vaginal birth. However, the chances of being incontinent beyond repair after vaginal birth is very low. That is not a common thing that happens. You can have temporary incontinence that resolves in about at least two to four weeks, and with physiotherapy for those who have take a longer time to recover. So I'm like, you know, so I just feel like there are lots of miscommunications out there and a lot of information and a lot of fear-mongering. And we don't want fear-mongering for either sides, for vaginal birth or c-section. We want to be clear on what the risks are, we want to be clear on what the benefits of each procedure, of each technique of delivery, what those are as well, so that you're leaning on information and not perception or preconceived notions. So if we could, let's start with the vaginal birth, because you know, what do you call that one, Dr. C? The default way.
SPEAKER_00Really, I mean, yeah, it's the default mode of delivery. That's how the good law designed for us to be born. In fact, that's how most of us came into this world, right? Yeah, so vaginal delivery is the let me repeat this, is the safest mode of delivery. It's the safest mode of delivery for a woman who has an uncomplicated pregnancy, who's generally well, and there are no concerns about mother or baby, it is the safest. There's significant admirations.
SPEAKER_01You can say that with your chest, your full chest, Dr. C.
SPEAKER_00Absolutely, absolutely. Think about it. After you have a vaginal delivery, you get up, you know, barring any complications, you know, you you recover much more quickly. You're able to get up, you get walk around. Literally, after having a baby, you can walk around within a few hours, you literally can go home if you deliver at a hospital. You know, certainly most hospitals would keep women for no more than 48 hours after vaginal delivery, if it is that all is well, you know. So the benefits, first of all, in terms of short hospitals to faster recovery, quicker return to physical activity, there is certainly no comparison. And then, of course, we talk about the risks related to the surgery that you're avoiding. Because regardless of whether we want to admit, you know, whether you recognize it or not, Cesarean section is a major abdominal surgery. It's major surgery. Not because it's safe doesn't mean that it's not, doesn't carry risks, and so vaginal delivery avoids those risks. Uh, because you're moving around and you're more active, it's also associated with a lower risk of blood clots, which is one of the more feared complications of that postpartum period. So there are benefits there for mummy, and in in the present, and there's also benefit in the future because you know that if you had a cesarean section, then you're gonna have a higher risk of needing one in the future. Not that you have to have a cesarean section once you've had one, right? But the chance of you requiring a repeat. Section is going to be higher. And there are certain complications that are peculiar and are particularly increased in women who have had previous caesarean sections. You know, I had a patient just recently we had to do a major multidisciplinary procedure for because she had a low-line placenta and that was that had implanted into the previous caesarean section site and had started the placenta had eaten through her uterine wall and you know almost into the base of the bladder. What we call placenta percreto, right? So in that particular case, and that it and the main risk factor for that is repeat is repeated cesare and sections. So so there are significant risks that you can avoid having a vagina delivery. And for the baby, then you also have benefits, uh significant benefits for the baby, because for example, we find that the respiratory, there are certain respiratory conditions that our style increases with the caesarean section. Like sometimes after the baby is born, they may find that they tend to be a little bit more distressed, especially if the baby is born before 39 weeks, what we call transient tachytney of the newborn. Generally babies do well, but we see that rate higher in cesarean sections rather than vaginal delivery. And part of the reason for that we postulate is that two reasons. One is that the labor process itself, that compression as the baby passes through the birth canal helps to expel some of the fluid from the baby's lungs. So the lungs are a lot not as wet as they would be compared to when they're delivered by a caesarean section. And also the stress of labor. I mean, Kim, you know, you think mommy goes through stress, baby.
SPEAKER_01You know, when you see these babies come out, you know that sometimes with the head, you know, the head shape, like a little cool.
SPEAKER_00You had to mold to get through there, you might have a little capot, you know, babies, you know, looking all like, listen, I'm glad that was over. Thanks for putting me out, Doc.
SPEAKER_01You know, I'm just they're so happy, that's why they're crying. They cry.
SPEAKER_00Listen, we don't want to do that again, you know. So uh that stress, you know, release of cortisol is believed to help just speed up the lung maturity at birth. So there are benefits, significant benefits to vaginal delivery. Also for the baby, one important thing to mention is the microbiome. And increasingly, we're seeing more information in indicating to us that there is significance of the microbiome. And the microbiome for our listeners is really the germs that are present within our body. We we understand that we have germs in and on our bodies, and most of these germs are necessary for our overall health. So now we get taught that germs are bad, but not germs are not always bad, you know. Um, we need them in terms of our immune function and so forth. So you'll find that the baby who is born vaginally has as it passes through the birth canal would inherit some of mommy's normal flora, that microbiome, which seemingly has a benefit in terms of immune function. So, yeah, so therefore, we see some significant benefits there.
SPEAKER_01You know what just came to me, remember in the article, um one of the reasons they were saying is that uh we just said that with virginal birth, you literally can, in most cases, when it's uncomplicated, you can just get up, walk around, you can go home. But one of the reasons that they're saying women are choosing cesarean section is because they fear they might not get the support they need for a straightforward positive label. And uh, as we're going to start talking about like the C-section aspect, I fear that women don't get the support they need after a C section as compared to well, they would more likely need that as compared to needing that type of care after vaginal birth. You know, it's just like there's a disconnect between what's actually how women feel and what they actually do need and what's available to support them. It's like a disconnect between the two.
SPEAKER_00Yeah, you're right. But I think both can be true, to be honest. Yeah, it both can be true because it's all about perception and understanding what's needed at the moment. Because remember that the labor process sometimes can be quite long. You know, you're going in and it's unpredictable. Some women labor very quickly, some will take a long time. And while you're going through that process, you know, most of the modern health facilities don't necessarily offer the option of having somebody with you all through the time. I mean, you may have a midwife, but they don't have enough staff for the midwife literally to be assigned to you. Uh, you may not have the benefit of a dollar who is going to be there sitting with you through the whole process. Uh, you know, so so many women they would may feel that that support isn't necessarily there. There's a lot of it that they have to do on their own. And even if the partner is there, obviously there's a limit to which they can help. They can help, especially if they haven't had training, you know, if they haven't gone through any kind of classes or education on how to support their partner in labor. So you can see that. And I think from your perspective, you're looking at what you know as a physiotherapist.
SPEAKER_02Yes.
SPEAKER_00And you're, you know, so your perspective is going to be different. But it's true, it can be true on both sides. One of the things that I wanted to touch on are the risks related to vaginal delivery, because as you said, we want patients and our listeners to have a very balanced educational experience. That we're understanding that, oh, yes, I'm saying vaginal delivery is the safest, but notice I'm saying it's conditional. If it is that you're well and you're not having any, there are not any uh complications that might put you at risk.
SPEAKER_02Right.
SPEAKER_00And it's also important to understand that vaginal delivery is associated with the risk of having perennial tears or tears in involving the vagina, the pelvic floor muscles, and you can have tears even extending as far as involving the anal sphincter, which is what maintains fecal continence, and even the rectum. So you it can be a very traumatic experience to go through vaginal delivery. And for some women and their partners, the fear of affecting vaginal function and the ability to maintain, just like your friend said, incontinence and all these things which are which do happen, these are real things that we'll have patients, not every patient, but sometimes after delivery can't maintain the urine. It after a while it comes back, especially if you have the physiotherapy and the support. But these are things that can happen, and many women are afraid of, and their partners are afraid of. Uh especially in this world, in you know, in this day and age of awareness. And the question is, how is my sexual function gonna be like afterwards? How is this gonna be? So these are some of the concerns that women, the genuine concerns that women have, you know, relating to vaginal delivery.
SPEAKER_01Pain. Let's talk about pain, up front labor.
SPEAKER_00There you go. How could I forget that? That's probably the and I qualify why I didn't bring it up. But the truth is, yes, pain is the most significant concern that many women that women will have. And like fortunately, I'll never been in labor and I cannot be in labor.
SPEAKER_01Do you want me to tell you? Do you want me to tell you?
SPEAKER_00Well, I've heard that you can tell me if it's true. I've heard that is the worst pain that you'll ever experience in your life is labor pain.
SPEAKER_01Oh, yes. I have not experienced anything that I can compare. Oh no, tooth, like it's pretty close up there. I'm gonna lie to you, it's pretty close. But the thing with labor pain is that just like you know, you have the labor pain, and then in like a moment I catch my breath, and boom, it's back. And like I saw stars, like the stars, like literal stars just blinking, and you're like, I cannot wait for this to be over. Like, I remember calling my mom and saying, There has there have to be another way, like, there's just no way, there's just no way I can do this. There just has to be another way, and yeah, painful. And I had no help, no medication.
SPEAKER_00Listen, not just and that's sad, you know. We nearly didn't have any help. They're fortunately today. We live in a world where we do have options, we really have very effective options of pain management, but if you're laboring without any kind of pain management, effective pain management, it can be quite intense. I mean, I've seen calm, sedate, composure, and transform, you know. Transform into villains. So, you know, but labor-induced psychosis, you know.
SPEAKER_01Oh man, oh man, oh yes, it's it's really it's it's really intense.
SPEAKER_00Um, but fortunately nowadays you have you know options for pain management, medications that we can give, gases, um, epidurals that can help a little bit.
SPEAKER_01So, yeah, yeah, yeah, that's that's lovely. And um yeah, what else? What else do we miss for risk?
SPEAKER_00Yeah, so we spoke about the potential advantages of vagina delivery, and of course, we spoke about the risks for the mother, but they're also risks for the baby, too, because yeah, um, you know, as baby's going through the birth canal, we spoke about issues that may arise if there is a discrepancy or discordance between the baby's size and the mother's size, and baby's stuck. And that can be if the head is too large, the baby may not come down, or even more concerning is a case where the head comes out and the body is stuck. We call shoulder dystosia, which is a major, one of the more fair complications of vaginal delivery, because you know, once that head comes out, there's only you're on the clock, you only have a few minutes with which to be able to get the body out before that the baby begins to have severe oxygen deprivation to the brain. So, so there are significant concerns, and because of these concerns, now that's the reason why you know you're finding that some women uh are increasingly wanting to try just doing a cesarean section to one, ensure that their baby has a good outcome, two to reduce the risk of injury to their to the vagina and the perennial the perineum on their pelvic floor, and of course, three, convenience, right, because you can schedule, you can manage your time, you know exactly when you can everything around it because you know exactly the time while labor we know is unpredictable, yeah. It can happen at any time, right? And then some women are saying, Well, I'd much prefer to have an elective caesarean section when it's controlled than, for example, to go through labor and then end up with an emergency because something happens in labor. So when you think about those four reasons, you can understand why women are increasingly choosing the route of an elective cesarean section.
SPEAKER_01Fair, and another thing that my colleague said was with African traditions, after vaginal birth, they have this process where they have the elimination. I guess it's part of like the bleeding, the clots and the afterbirth that they have their own herbs and their process of elimination. But when they have a c-section, that they can skip that part. So that part where the whole aunties and mummies and everybody's around them, they can skip that part if they choose to do the C-section.
SPEAKER_00If they choose to do so, yeah.
SPEAKER_02Yeah.
SPEAKER_00So maybe let's talk a little bit about the sugarian section now, isn't it? Um, and then we we can can give some additional perspective there. So the advantage, of course, if we think back, is that the cigarine section is essentially the backup plan, right? It's the uh alternative whenever vaginal delivery is not necessarily ideal or maybe considered unsafe. And in if it is that there, let's look at the maternal side first of all, if there are underlying factors for which that would cause a woman to have be at high risk of complications from vaginal delivery, then the seizure insection is advantageous. So let's take, for example, heart disease, which is you know as a high risk obstetrician, that's one of the main one of the main chronic issues that we deal with. If the woman is coming in with severe cardiac disease, then she may not be able to handle the stress of labor, you know, because labor is very taxing on the body physiologically. The blood flow changes, the changes in blood pressure with pain, with contractions, all of these things can lead to cardiac decompensation. And a woman who is at risk can end up in heart failure or even dying. And so, in cases where there are maternal conditions that put them at risk during labor, then a cesarean section may be advantageous. Or at minimum, sometimes we will allow labor and then try and help the labor process using like an assisted vaginal delivery to avoid the woman having to push and to go through that stress. And then, you know, then we talk about where there are conditions that may cause the labor process to be obstructed. So, for example, if the placenta or the afterbirth is low-lying, right? The reason we call it the afterbirth is because it's supposed to come after the baby. But there are times when the placenta is sitting lower in the pelvis, in the birth canal than the baby, and in those cases can obstruct labor or can begin to separate before the baby comes, leading to massive hemorrhage. So, in those cases, the cesarean section is ideal. And you have other things as well that, you know, for example, previous, a previous caesarean section or previous uterine surgery from like a myomectomy to treat fibroids, where we are concerned that there's a weakness in the uterine wall that may cause it to rupture or tear during the process of labor. And then, of course, you have the fetal or the baby issues, such as in cases where a baby may not be able to handle the stress of labor because the placenta isn't giving enough oxygen and the baby isn't growing well, or there are other concerns. So, in you know, for example, multiple pregnancies, twins, triplets, quadruplets, those kinds of things where labor may not be necessarily safe for both babies or or the others in the case of a triplet quadruplate. So you realize now that there are many different factors that in cases in which a cesarean section may actually be ideal, right?
SPEAKER_01Um be the safer option.
SPEAKER_00And be the safer option, right? Right. So that's very important to understand. You know, the when we talk about the risks related to a caesarean section, the first thing we must understand is that this is a major abdominal surgery. I said it again, I'm gonna say it again. Said it before, I'm gonna say it again. It's a major abdominal surgery, and because it's a major surgery, we must understand that there are significant risks involved. So, for example, once you cut tissue, it bleeds. Is you know, you know, obviously you lose blood during labor as well, vaginal delivery, but the risk of hemorrhage from a cesarean section is certainly greater than the risk of hemorrhage from vaginal delivery. And you also have to understand that while we're operating, even though we're operating and removing the baby from the uterus, there are other structures around there, Kim. You have the blood in front of the uterus, you have the tubes that carry urine from the kidney to the blood on either side, you have the intestines here. These are all structures that can be injured doing surgery. Even the baby, even though we say it's safer food, baby can potentially be injured too. You can, you know, be there are cases where a baby has been accidentally nicked while by the blade, the scalpel, doing surgery, it can happen. The risk is low, but it can happen. Yeah, yeah, it can happen. Yeah, and there are cases well documented, and babies generally are fine, but you know, these are things that can happen. Then you have to also consider the risk of infections, right? After surgery, risk of blood clots in the legs, blood clots in the lungs, because of course you're not moving around as much as you would if you had a vaginal delivery. You know, so there are significant risks involved. That and I mentioned before about the respiratory issue for the baby, the potential that the lungs, the respiratory issues in terms of transient tachymia and also the microbiome-related things. In fact, interestingly, based on the microbiome theory, we one of the things that we the studies have suggested is that babies born to women, mothers by cesarean sexual have a higher risk of certain types of respiratory disorders and allergic disorders. So, you know, asthma, for example, and eczema, these are higher, and certain types of immune-related issues are higher in babies born by cesarean sexual and vaginal delivery. And the theory is that maybe it's because the microbiome issue that we spoke about.
SPEAKER_01Yeah. So you see now, what we're really trying to establish is that both sides of the coin have benefits and they have risk. And at the end of the day, it's about making the informed decision.