Cesarean surgery and VBAC risks listed in a printable informed consent document

 

About The Risks of Cesarean Section:
A Checklist For Expectant Mothers To Read During Pregnancy

Birth is a normal, natural, process and the vast majority of women can have safe, normal, vaginal births. There are health conditions where a cesarean birth is necessary for the well being of the mother or her baby. However, more and more mothers these days are giving birth by cesarean section for non-medical reasons. A cesarean poses risks as well as benefits for mother and baby, and should not be undertaken lightly.

This educational material is provided by the Coalition for Improving Maternity Services (CIMS) to help all expectant parents become better informed about the risks of cesarean section.To give the expectant mother time to reflect on this information and consider the impact of cesarean surgery on her health and the health of her baby, care providers are encouraged to introduce and discuss this evidence- based information throughout pregnancy and no later than at 32-34 weeks.

The expectant mother is encouraged to take the form home, read and initial the statements, discuss the information with her partner, and raise any questions or concerns she may have with her care provider.

The text of following form should be copied WORD document and then printed, signed and
placed in the mother-to-be’s pre-operative chart.

Expectant Mother’s Name: _________________________________________________

Care Provider’s Name: ____________________________________________________

A cesarean section is an operation by which a baby is born by making a cut in the mother’s lower abdominal wall (abdominal incision) and a cut in her uterus (uterine incision). I understand that a cesarean operation may be more dangerous than a vaginal birth for my baby and me.

POSSIBLE PROBLEMS FOR ME WITH A CESAREAN AS COMPARED TO A VAGINAL BIRTH:

1._____ I am more likely to have more blood loss and a longer recovery time.

2._____ I am more likely to have accidental surgical cuts to my bladder, bowel, or gastrointestinal tract.

3._____ I am more likely to have a serious infection in my incision, uterus, or bladder.

4._____ I am more likely to have thick scarring (adhesions) inside my abdomen that may cause chronic pain years after my cesarean. This scarring can make any future abdominal operation I may need more difficult.

5._____ I may have uncontrolled bleeding and need an emergency hysterectomy (removal of the uterus) if the bleeding cannot be stopped.

6._____ I am more likely to have complications from anesthesia.

7._____ I am more likely to develop serious and life-threatening blood clots that can travel to my lungs (pulmonary embolism) or my brain (stroke).

8._____ I am more likely to be admitted to intensive care.
9._____ I am more likely to need to return to the hospital for complications from the cesarean operation.

10._____ I am more likely to feel pain and/or numbness at the site of the operation for several months after my surgery.

11._____ I am less likely to breastfeed successfully. I may lose out on the health benefits of breastfeeding for myself, including: weight loss, reduced risks of cancers, heart disease, diabetes, and osteoporosis.

12._____ I am less likely to have a satisfactory birth experience. I am more likely to have emotional problems such as post-partum depression and post-traumatic stress. Many women experience a profound sense of happiness after a normal birth that flows naturally into bonding with the baby and breastfeeding.

13._____ I am more likely to die.

© 2010 Coalition for Improving Maternity Services. Permission granted to freely reproduce with attribution. 1500 Sunday Dr Ste 102, Raleigh, NC 27607 | Tel: 919-863-9482 | www.motherfriendly.org

Coalition for Improving Maternity Services (CIMS) Fact Sheet February 2010

 

 

POSSIBLE PROBLEMS WITH A CESAREAN FOR ME WITH A FUTURE PREGNANCY AS COMPARED TO A VAGINAL BIRTH:

14._____ I am more likely to have trouble becoming pregnant again.

15._____ I am more likely to have complications in a future pregnancy due to the scar in my uterus. If the new placenta attaches over my previous scar, it is more likely to cause serious problems, including: serious bleeding, placenta coming in front of the baby (placenta previa), placenta growing into or even through the wall of the womb (placenta accreta), miscarriage, or pre-term birth.

16._____ I am more likely to have a baby with a congenital malformation, central nervous system injury, or low birth weight due to problems with the placenta.

17._____ I am more likely to have a stillbirth.

18._____ I am more likely to require major surgery to remove cells from the lining of my uterus that may grow outside my womb (endometriosis).

19._____ Since it is difficult to find a physician or hospital supportive of a vaginal birth after a cesarean (VBAC), I am more likely to have a repeat cesarean for the birth of all my future children, although a vaginal birth after a cesarean birth is usually safe. Each additional operation I have increases the odds for complications.

20._____ Research shows that having a cesarean will not protect me from urine, gas, or stool incontinence in the future, or from future sexual problems.

21._____ I may not be able to get healthcare coverage since some insurance providers consider a cesarean to be a pre-existing condition.

POSSIBLE PROBLEMS FOR MY BABY:

1._____ My baby is more likely to be born prematurely if the cesarean surgery is performed anytime before labor begins. A premature baby is more likely to experience the following:

• -admission to the intensive care nursery
• -trouble breastfeeding, digesting food, and regulating body temperature
• -developing jaundice
• -brain development problems and difficulties in learning in school2._____ My baby is more likely to face complications from anesthesia and postpartum pain medication.3._____ My baby is more likely to be accidentally cut during surgery.4._____ My baby is more likely to have breathing difficulties since labor contractions clear the lungs.5._____ If I agree to a scheduled cesarean, it is normally best to wait for labor to begin before performing the operation.6._____ My baby is more likely to have difficulty breastfeeding. My baby is less likely to benefit from skin-to- skin contact with me and is less likely to get the health benefits from breastfeeding including: reduced risk for asthma, allergies, respiratory infections, Type 1 diabetes, childhood leukemia, and SIDS (sudden infant death syndrome). If I do have a cesarean, I can request special care to help me and my baby breastfeed successfully before I am discharged from the hospital.I have read and discussed this information with my care provider.
  Expectant Mother’s Signature: _______________________________ Date: ________________ Care Provider’s Signature: __________________________________ Date: ________________This information is provided for expectant mothers and their care providers by the Coalition for Improving Maternity Services (CIMS). CIMS strongly recommends that cesarean surgery be reserved for situations when potential health benefits clearly outweigh the risks. Please see the The Risks of Cesarean Section, a CIMS Fact Sheet for the references that support this form, available as a free download from www.motherfriendly.org.

© 2010 Coalition for Improving Maternity Services. Permission granted to freely reproduce with attribution.