It is undeniable that giving birth is an extremely daunting act for many women. As such, it is important that women feel as comfortable and as prepared as possible for this. Therefore, it is imperative that a pre-labour discussion outlining options for mode of delivery, along with the risks and benefits of such, should be had. This is even more imperative when the woman has a multiple pregnancy (e.g., twins, triplets, etc.) with the national recommendation being that this discussion takes place by 32 weeks gestation.
Caesarean sections are generally based on a risk-benefit analysis that takes into account all clinical information and this analysis must determine whether delivery through the maternal abdomen rather than vaginal delivery is in the best interests of the mother and foetus – hence the importance of the aforementioned discussions. Pre-labour risks which indicate the need for a caesarean section include foetal breech presentation, placenta praevia and certain infections in pregnancy. In some cases, women request elective caesarean section delivery, despite there being no concerns. Again, in this instance, a pre-delivery discussion regarding the risks and benefits is imperative so the woman can make an informed decision.
The discussion for caesarean section should include the long-term benefits such as a lower chance of developing urinary incontinence and a slightly reduced chance of pelvic organ prolapse. This discussion should also include short-term benefits such as a lower chance of perineal trauma, avoidance of labour associated pain, and reduced risk of shoulder dystocia.
Thus, in summary, it is extremely important to outline the risks and benefits regarding a caesarean section so as to ensure the patient feels as calm as they can before labour and to ensure informed consent is given to whatever mode of delivery they opt for.