Is a C-Section on the Table? Mom-to-be, Here Are 3 Questions to Ask Before You Consent to a Caesarean Section by Dr. Alan Lindemann

The World Health Organization (WHO) reports caesarean section (C-section) use continues to rise globally, now accounting for more than 1 in 5 (21 percent) of all childbirths. In a June 2021 article, the WHO predicts nearly a third of all births are likely to be by C-section by 2030. The article continues to say that while a caesarean section can be an essential and life-saving surgery, it can put women and babies at unnecessary risk of short- and long-term health problems if performed when there is no medical need.

Patients often assume surgeons do C-sections exactly alike. In reality, each surgeon develops their own preferred way of doing a C-section, and some techniques are better than others. It is important for patients to know what’s involved in a C-section surgery, and to know what questions to ask before they undergo the procedure.

Here are my suggested questions women can discuss with their doctors beforehand:

How many C-sections have you done?

The time to ask your physician about C-sections is not just before the surgery – often decided upon at the last minute. Instead, ask the questions about C-sections on the first visit to your obstetrician. Note: Find out how many C-sections are done at your hospital, separate from your doctor. The number of C-sections varies quite a bit from hospital to hospital. I have performed more than a thousand C-sections in my career, and I recommend choosing a hospital with a low C-section rate compared to other area hospitals.

Have you ever done a caesarean/hysterectomy?

When obstetricians do C-sections, they are sometimes unable to stop the bleeding. When this happens, the physician may remove the uterus to stop the bleeding. This is called a C-hysterectomy. If your obstetrician has done one in his career, it should be considered a red flag, I have never done one of these in my career, even though I've delivered thousands of babies.

Have you had any maternal deaths?

It's estimated that 60 percent of maternal deaths are preventable. You may want to know how many maternal deaths your obstetrician has had on your first visit. You then have time to decide if you want to interview some other physicians who may have had no maternal deaths.

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