Post created by Kate and Emily
Did you know that the number of babies delivered through cesarean sections is on the rise? In fact, 1/3 of babies are delivered this way in the United States. There are many appeals that c-sections provide to expectant parents when deciding their birth plan. Some benefits include the option of a set date and time of delivery, as well as a relaxed delivery without pain of contractions. However, there are risks involved. Today we will be talking about one of the risks: incisional endometriosis. Before discussing the risks involved, let us take a look at the anatomy of a uterus and what a typical cesarean section procedure looks like.
The uterus is a reproductive organ found in females. Its about the size of your fist and is located in the abdominal pelvic cavity. It is made up of simple columnar epithelial tissue. Epithelial tissues main function is to form boundaries between environments, protect, secret, absorb, and filter. In the uterus it acts as a barrier between mom’s internal environment and baby’s external environment. In a typical vaginal delivery, the uterus contracts and pushes baby out. However, in some cases a surgery called a caesarian section is required or desired.
Here is what a typical c-section procedure entails. First, anesthesia is administered to numb mom but keep her awake. Then, an initial incision is made horizontally above the pubic line through the outer layers of the skin. A second incision is then made into the uterus, in most cases a low-transverse incision is used. The amniotic sac is removed, and baby follows. The incision in the uterus is closed with absorbable stitches and the abdomen is closed with staples or stitches. Antibiotics may be given to help reduce the chance of infection. New moms can expect to spend up to 4 days in the hospital and 6 weeks recovering after the procedure.
There are typically very few complications associated with c-sections, they can include infections and abnormal bleeding. However, in some cases there can be tissue that heals improperly. Famous YouTuber, Keren Nguyen, documented her experience with her c-section and how it went wrong in her video titled “My Secondary Infertility (Finally Getting Answers).” She stated that she began to develop the symptoms of endometriosis which include infertility as well as more painful menstrual cycles. Endometriosis is a disorder where the endometrial tissue, a form of epithelial tissue, is on the outside of the uterus instead of the inside. While endometriosis is not always related to c-sections, the risk of developing the condition increases upon surgery. In normal tissue repair, there is inflammation at the site of injury and a blood clot begins to form, the clot becomes replaced with granulation tissue and the area begins to mature and contract, the epithelium thickens. Soon a fully regenerated epithelium is found underlying the scar tissue. In the case of incisional endometriosis, a cesarean scar is the cause. Rather than the endometrial tissue healing in its proper spot, the c-section causes the tissue to move from the inner lining of the uterus to the exterior. The tissue can begin to build up around the uterus causing the same symptoms expressed by Keren. Keren has gone public with her new diagnosis and has been very open about the struggles she now faces with infertility and abdominal pain.
With the number of c-sections rising, it is important for expectant parents to keep in mind not only the benefits, but also the potential risks associated with them. The risks are few to none, but nevertheless, still there. People electing to deliver through voluntary c-section should be education on both the benefits and risks to have the most successful delivery and healing process possible.
Works Cited
Donaldson-Evans, Catherine. “Having a C-Section (Cesarean Section).” What to Expect, 13 May 2019, www.whattoexpect.com/pregnancy/c-section/.
Villines, Zawn. “Endometriosis after C-Section: Symptoms, Treatment, and Scars.” Medical News Today, MediLexicon International, 13 Dec. 2018, www.medicalnewstoday.com/articles/323988.
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