Caesarean section

It's not only because it's a scar on your body, but all of the emotions and the feelings and the energy is also held in that area.

And because your C-section was difficult, challenging or traumatic, your brain thinks it's doing you a favour by making you avoid the area.

those feelings, they're all stored in that part of your body.

That's why it's really important that we get the opportunity to process what we've been through so that you can talk about your birth experience, think about your birth experience without it having to bring you to a point where you feel like you're breaking down or you just avoid talking about your birth altogether because of the feelings that it brings up.

The chapters on politics in Rome in the year which succeeded the Gracchan Revolution, and again after the consulship of Pompey and Crassus in BC 70, can hardly be too highly praised, especially when we consider how soon after the events narrated they were written.

Sallust indeed, except when speaking of the dictator himself, never allowed his Caesarean sympathies to carry him away, and it is difficult to understand how Professor Mommsen could permit himself to speak of the Catiline and Jugurtha as partisan pamphlets.

If Sallust was a party writer, then Defoe himself must yield him the palm for cleverness in concealing his real object, and one could almost wish Mommsen's theory correct, for the ingenuity of the elaborate contrast which Sallust draws between Caesar and Marcus Cato, the one man for whom the dictator entertained an uneasy hate, would then be without a parallel.

But the whole tone of Sallust's two essays forbids the idea that he was writing for any immediate purpose.

So even though they didn't have Tumas Leda, but still, it is, it can have Rizpila on day eight.

What's an example of a baby boy who does not bring Tumas Leda to the mother? A Caesarean section, a Yotidofan.

So it's a Machlokas Amorim in the Gemara.

A Yotidofan is born on Shabbos.

A woman has a Caesarean C-section on Shabbos.

When's the Rizpila? When's the Machlokas? Is it day one or is it day eight? That's the Machlokas Amorim.

If you say it's not Tali and Tumas Leda, then you should do it day one.

Can adding azithromycin at unscheduled cesarean delivery reduce postpartum infections? For patients with severe asymptomatic carotid stenosis, does revascularization improve cognition? And what are some ways to make IUD placement more tolerable? This and much more on today's JAMA Editor's Summary.

Thank you so much for having me.

Today, I'm joined by Dr. Preeti Malani.

Let's take a look at some of the latest research published this week in JAMA.

Postpartum infection remains a major source of maternal morbidity, and cesarean delivery is an important risk factor.

In an original investigation, Dr. Ferreret and colleagues asked whether trial evidence published in 2016 increased perioperative azithromycin for patients undergoing unscheduled cesarean delivery in the United States.

This was a difference-in-difference analysis using Epic Cosmos data from more than 1.6 million deliveries of live-born, singleton infants between 2013 and 2024.

Among cesarean births, perioperative azithromycin use increased from 2.2% before the trial to 39.6% afterward.

It was good.

Cesarean recovery is pretty brutal, [laughs] so we made it through that, but breastfeeding's going well.

I've been exclusively nursing on demand for eight-ish months now, 'cause she just turned eight months, so that has been a journey.

So, um, but it's been good.

There is this association.

Notice I said association or link, okay? But we can't say causation here, but there's an association between general anesthesia for cesarean delivery and an increased risk of postpartum depression, and even in some studies, suicidality, right? We're gonna get into this.

So yes, that is a thing, and you c- we can't doubt that anymore.

What I am not saying is that that is the sole factor contributing to postpartum depression.

No, no s- no, uh, association with overall." That's overall, all of them thrown into the bucket.

But if you do a sub-analysis, as they did, and take a look at severe postpartum depression requiring hospitalization and suicidality, you're like, uh, "Oh my goodness." Uh, there was actually, uh, the highest association, even though it, it did not cross two.

This was published in Anesthesia & Analgesia, September 2025, and the title was "Association of General Anesthesia for Cesarean Delivery With Postpartum Depression and Suicidality." So even though it wasn't a big association, meaning the hazard ratio was under two, there, there was still something there.

So no overall relationship with all types of postpartum, uh, m- uh, mood disorder/depression.