Hi Henci

I have a client who has been advised to have a cesarean for her first baby as she has a history of retinal detachment. This doens't make any sense to me. Do you have any research on this? Thanks, Nicole

I don't have any research on this, but I can suggest questions your client should be asking whomever is giving her this advice:

• What is the likelihood of retinal detachment?
• What causes it? If, for example, it is caused by the increases in blood pressure during Valsalva maneuver pushing, the solution is to engage in spontaneous pushing, which is a better idea anyway.
• If it happens, is it treatable? How likely is it that I will suffer permanent harm?

As for the other side of the equation, "What are the risks of cesarean surgery?", here is a link to a pamphlet that covers that base. As you can see, they are numerous and potentially severe so unless the risk of permanent blindness is high and unavoidable, I would stick with planned vaginal birth if I were her.

-- Henci