CAESAREAN SECTION

CAESAREAN SECTION

A caesarean section or c-section, is a form of assisted childbirth in which a surgical incision is made through a mother’s abdomen and uterus to deliver one or more babies. It is usually performed when a normal delivery would put the baby’s or mother’s life or health at risk. In recent times it is being performed upon request or sometimes indiscriminately for births that would otherwise have been normal.

The word caesarean comes from Roman word “Lex Caesarea” meaning to cut open the mother abdomen to deliver the baby.

Indications: Doctors have different opinions about the necessity of caesarean. Some of the indications are: having high blood pressure, having had a previous caesarean, having twins or triplets, slow progress during labour, and having a very large baby or an abnormal positioning of the baby. The indication viewed in the mother’s condition are- unable to push the baby out and placenta placed lower down in the uterus.
Contraindications: C-section is contraindicated when the mother’s medical condition does not permit her to undergo any surgery. A caesarean delivery may not be recommended if the fetus has abnormality or known anomaly that may lead to death.

Anaesthesia: The operation is done under either a general anaesthetic or, a spinal anaesthetic.
Risk factors: A C-section birth involves major abdominal surgery, so the benefits need to be weighed against the risks in each case.
Risks for the mother:

 Women may land up in problems such as: infections, haemorrhage, blood clots, damage to the bowel or bladder, fallopian tubes with possible effects on fertility.
 A C-section will usually: require a hospital stay, standing and walking around, getting out of bed is difficult and painful.

Risks for the baby:

 The major risk for the baby is breathing difficulties.
Cost factor: Normal deliveries is four times safer to the mother as well as for the child than in C-section.
Complications: As with any major operation there is a risk for complications related to your heart or your lungs, or an injury to spinal cord. Aches and twinges may be felt in the wound. It may result in numb patches in the skin around the wound.

he complications of babies delivered through caesarean section include scratches or cuts, fractures of the skull or long bones and serious brain or nerve damage.
Disadvantage of C-section: One woman in 2,500 who has a caesarean section may die, compared to a rate of one in 10,000 for a vaginal delivery.

Alternative for C-section: The decision to deliver your baby/babies by C-section has been made by your obstetrician and yourself. If you are unhappy with this decision, then you should speak to your family doctor or take a second opinion from another obstetrician.
Avoiding C-section: There are ways which may help to reduce the likelihood of a C-section:
 If your baby is breech, having the baby turned.
 In the later part of pregnancy, using upright, forward positions to help the baby get into a good position for labour.
 During labour, keeping upright and mobile so that labour progresses well.
Precautions:
 C-section is a major surgery. Hence adequate rest and post operative care must be taken by the woman.
 Start walking soon as it will prevent blood clots from forming.
 Avoid subsequent pregnancies or give adequate spacing before becoming pregnant again.

Conclusion: There is an increasing tendency to go for C-section delivery in the private hospitals and nursing homes. In some private maternity homes C-section delivery is as high as 75%.This is done in order to escape from pain which is a bad precedence. Subjecting a lady for C- section for monitory gain is unethical. It should be strongly condemned. Alternative methods of delivery must be viewed or considered before taking up for C-section. Mother should wait or bear the pain in order to undergo the normal delivery.
The large difference in the rates of C-sections in women in the Govt and private hospitals is due to more unwanted caesarean sections among private hospitals rather than a real medical indication for surgery.