Elective cesarean delivery, also known as social factor cesarean delivery, is what ordinary people call a “cesarean” that they don’t want to give birth on their own, that is, they want to open. So is it better to give birth by yourself or by cesarean section? Here we will first look at when the doctor will recommend a cesarean section, that is, the medical indications for a cesarean section. In the chapter of “abnormal delivery” written by Prof. Li Li, it is mentioned in the textbook of Obstetrics and Gynecology (8th edition) of the medical school that there is a rupture of the uterus with aura, obvious pelvic stenosis or obvious deformity, shoulder first, posterior chin position, high straight posterior position, uneven front tilting position, mixed breech or full position in primigravida, breech position with pelvic stenosis, huge fetus, united fetus, etc. Cesarean section should be considered for all cases. The first is that “the old people say that the buttocks are small and cannot be born by themselves.” Generally speaking, if you have a big buttock, your pelvis is relatively bigger, but you can’t tell the real size of your pelvis from the appearance alone. Those who have had a maternity checkup should know that the doctor will do an external measurement of the pelvis during the initial consultation to determine the possibility of a vaginal birth in the future. If this result indicates a narrow pelvis, the doctor will definitely talk to you. Secondly, “A breech delivery must be a cesarean section.” There are 4 types of breech positions: mixed breech (both buttocks and feet at the opening of the uterus), single breech (both legs straight and both feet on the side of the head), single foot (one leg straight and one foot at the opening of the uterus), and double foot (both legs straight and both feet at the opening of the uterus). Combining the indications mentioned above, we can understand that women with no pelvic stenosis, first-time mothers who have their first child are usually considered for cesarean delivery, and if they are in single breech position, they can have a vaginal trial of labor; for a breech position with a second child, they can have a vaginal trial of labor. Moreover, for breech position in the middle and late stages, if it is not accompanied by risk factors such as cord winding and short umbilical cord, we can also start chest and knee position with external inversion after 30 weeks of pregnancy to help turn the fetus into head position. Say three, “The most afraid of pain, do not give birth by yourself, firmly request a cesarean section!” It is undeniable that labor pain is the highest level of human pain. But the reason why it is called “paroxysm” is that the pain is not continuous, there is a painless interval between pain and pain, this interval is to give the mother and baby time to recover their strength and relieve the state of ischemia and hypoxia, so the process is not so scary. Ask your mother or mother-in-law or friends or relatives who have already given birth, the memories of labor pains are not so clear compared to the joy of seeing the baby and the joy of family afterwards. What I can share with you is my own birth experience: I had my first baby after working for 5 or 6 years, with a solid foundation in obstetrics, diligent work and training, plus assisting President Yu in translating and publishing the book “A New Model of Obstetrics: Family-Centered Obstetric Monitoring” when I was pregnant, and working with the author of the original book, a famous American I also had a face-to-face meeting with the author of the book, a famous midwife and obstetrician-gynecologist in the United States, to fully understand the recent trend of childbirth and midwifery methods. The only difference was that I was standing by the delivery bed to encourage and help others, but this time I was lying on the bed myself. The labor progressed as I expected and within my control (thanks to my husband for reminding me and doing “Lamaze breathing” with me), but when my mouth was fully opened and the pains came again and again, seemingly endlessly, I couldn’t help but complain to my husband who was with me. “Why isn’t it out yet? I’m running out of energy.” However, nature has endowed mothers with infinite strength, and the baby came out without a lateral incision or laceration. Besides, a cesarean delivery can avoid the pain of the baby’s delivery, but the wound in the abdomen still hurts after the operation, the contraction of the uterus still hurts, and the wound makes it more difficult to hold the baby and breastfeed. The cesarean section that must be performed, there is no way, the cesarean section that you requested, is not asking for trouble? The fourth statement, “The baby is too big, the doctor recommended the cesarean section.” Huge babies, undeniably, should be considered for cesarean delivery. But what should be discussed is how the baby will grow so big and how the weight control during pregnancy was not done properly. With a huge baby, neonatal hypoglycemia and hypocalcemia may occur after birth. That’s why weight monitoring is also important during routine maternity checkups during pregnancy. Pregnancy is a normal physiological process that does not require excessive supplementation of sugar, fat, protein and other nutrients. A proper diet should be carried out under the guidance of a doctor to avoid the occurrence of a huge baby. Statement 5, “Vaginal delivery will result in loosening of the vaginal wall and later sexual life will be unsatisfactory and should be delivered by cesarean section.” Statistics show that the incidence of pelvic floor dysfunction disorders will be higher in women who deliver vaginally than in those who deliver by cesarean section, but with the increasing attention and research on pelvic floor dysfunction disorders, postpartum pelvic floor function has become a routine 42-day postpartum examination and guidance on pelvic floor function exercises to help recover as soon as possible after delivery. The etiology of pelvic organ prolapse in women after cesarean section is also under further study and may be related to genetics and genes as well. Therefore, cesarean delivery should not be pursued in a single way. What is so bad about cesarean delivery? The technology of cesarean delivery is getting better and better, and the surgeon’s surgical skills are getting better, and the operation time is getting shorter and shorter, and the fastest surgeon can end the operation in 20 minutes. But there are also more and more problems after the cesarean section. To name a few: i. Endometriosis of the abdominal wall scar, symptoms usually start 1-2 years after surgery, menstrual period, “belly pain”, a lump or even many lumps will bulge around the scar, which will improve and shrink after the end of menstruation. The next menstrual period, there is the beginning, and finally it is the end of the period, the mass is also there, and the abdominal wall is also painful. Such a case requires surgical removal of endometriosis foci from the abdominal wall. Second, the uterine incision diverticulum, symptoms for a long period, often a small amount of vaginal bleeding dripping, the hospital repeatedly check the cervix, and even do segmental scraping of the uterus, can not find the cause, careful ultrasound or MRI examination can find a gap where the cesarean incision, menstrual blood accumulation in the inside, outflow is not smooth. Surgical repair is required. Third, uterine incision pregnancy, which is also considered a newly created disease, with the rise in the rate of cesarean delivery, the incidence of this disease is also rising, also due to belong to a kind of ectopic pregnancy. In the diverticulum mentioned earlier, the gestational sac is laid there, and because the myometrium there is very thin, with the increase of the gestational sac, uterine rupture may occur, so emergency treatment is needed. Fourth, pelvic adhesions after cesarean delivery. Many women undergo surgery again after cesarean delivery and because of other diseases. The picture in front is the picture of the pelvic cavity of two patients, the top is a patient with uterine fibroids who has not undergone surgery, and the bottom is a patient with a history of cesarean delivery with pelvic adhesions, which has an impact on the second surgery, and the doctor must first decompose these adhesions and then perform the surgical operation booked. The process of decomposing the adhesions increases the incidence of complications considerably, such as serious adhesions with the intestines, and the decomposition may result in intestinal perforation and rupture, which requires repair. Therefore, the mother and her family should actively adjust their mindset, provide the mother with a reasonable diet, control the rate of weight gain, encourage reasonable exercise, attend a school for pregnant women to learn some breathing techniques that distract from pain (Lamaze breathing), etc. Giving the woman the opportunity to have a vaginal trial of labor if the doctor does not object, and trying to avoid unnecessary cesarean sections. Let’s say “No!” to elective cesarean delivery.