Why Caesarean sections have gone up in Kerala? A brief analysis

The history of the Caesarean section apparently goes back to as early as the ancient Roman times. The popular tale is that the mighty Roman emperor Julius Caesar was born through a C – section, thus earning the name Caesarean for the complex procedure of taking out the baby from the mother’s womb through surgery. However, there is no historical proof for this extremely popular story especially because there are documents that state that Caesar’s mother had lived for many more years after giving birth to him. It is assumed that Caesar’s mother wouldn’t have gone through a complex C- section since such procedures often resulted in the death of the mothers, at least till the end of the seventeenth century.

The mortality rate of mothers due to Caesarean was particularly high until the early decades of the twentieth century. As science and medicine developed, the C – sections too got transformed into effective surgical procedure that could save two lives. Today, Caesarean is the most common surgery that is conducted in huge numbers around the world. The writer of this article to has gone through two C – sections.

These are some of the factors that lead to a Caesarean:

» If the mother has undergone C – section earlier.

» Physiological factors that may not be conducive for a normal vaginal birth like if the mother doesn’t dilate, huge size of the baby or if the baby isn’t positioned head – down or due to the presence of any cysts or growths in the uterus or any other parts.

» Low heart beats for the baby or when the umbilical cord is wrapped around the baby’s neck.

» If the mother doesn’t show signs of labor despite trying for several hours.

» Pre mature deliveries

» If the mother is carrying more than one baby.

» In case of placenta previa or when the placenta covers the mother’s cervix.

» In case of placenta abruption or the placenta detaches from the uterus.

» If the mother is aged.

» In case of pre enclampsia.

» In case the mother has had complications in the previous delivery.

» If the mother is an AIDS patient.

» If the mother has earlier sought treatment for uterine prolapse or slipping down of uterus or for fistulas that cause urine leakage.

» For pregnant women who demand a C – section.

A cesarean section could happen either due to the above reasons or as an unprecedented emergency procedure.

Though it might seem like a simple procedure that ends in 10 – 15 minutes for the bystanders who wait outside the operation theatre, Caesarean actually involves all the procedures and steps of a major surgery. The mother, the baby, the gynecologist and the entire medical team that assists the surgery indeed go through the intensity of such a complex surgical procedure.

Though epidurals are administered in most cases for C - sections, general anesthesia too is given some times. Many people falsely believe that the woman would have to suffer from incurable back pain if the epidurals are administered on the spinal cord. However, they don’t realize that the same anesthetic is administered in many other surgeries for patients, irrespective of their gender. So, if they don’t have back pain, then it wouldn’t particularly happen for a woman who has undergone a C – section. Women should realize that over weight and the subsequent back pain are the results of the high calorie food, continuous rest by lying down and lack of exercise during the post delivery days.

There are lots of people in our society who have an aversion towards Caesarean. They believe that this procedure is harmful for the mother and the baby. They also have the misconception that the doctors unnecessarily opt for the surgery for their monetary benefits.

It is indeed true that the mother and the baby cannot enjoy certain benefits of the normal vaginal birth. Many studies have revealed that babies born through C- sections have less immunity power or are prone to asthma attacks. However, for such minor and curable benefits, it is not right to deny Caesarean that could save the lives of both the mother and the baby. An unreasonable preference for vaginal birth too isn’t advisable as it could put lives in jeopardy. You could definitely seek a second opinion or read and learn more about it. But, stubbornly refusing C –section in the cases where the doctors decide an emergency procedure may even lead to loss of life.

There is a minor section among the doctors who suggest C – sections for their patients, just for their own monetary benefits. If it is found that a doctor does a C- section without any valid reason, then strict action should be taken against him/her.

Here are some of the reasons why the number of Caesareans has gone up:

» The numbers of women who have undergone Caesarean for delivering their first babies have gone up.

» Staying away from complex labour procedures that involve forceps and vacuum.

» When the baby isn’t in the head – down position and the doctors do not take risk, waiting for a vaginal birth.

» There are modern equipments that could monitor the heart beats and movements of the baby.

» The complexities or other issues could be diagnosed at an early stage as the mother visits hospitals for the monthly checkups and scanning.

» The number of pregnancies through IVF treatments has gone up.

» Doctors are often worried that they might land in a legal soup if the mother or child is harmed while waiting for a normal delivery.

» When the pregnant woman and her family demand a C – section.

Most people have the doubt whether the mother can have a normal vaginal birth for the second baby if she has had a C – section for the first child. If the mother hadn’t dilated enough in the first delivery, then it not possible that she could dilate during the second delivery as well. Because of such unchangeable factors, it is not possible for a woman to have a normal delivery for the second baby.

However, if the woman has undergone Caesarean, the first time due to reasons such as wrapping of umbilical cord around the baby’s neck or premature babies that are unlikely to repeat, she could think about a vaginal birth next time. Vaginal birth after Cesarean or VBAC is quite risky. If the previous Cesarean wound splits open, it could put the mother’s life in danger. Before taking such risks, make sure that the doctors are well experienced and the hospital has all the facilities for emergency surgical procedures.

The relatives and doctors should realize that their decisions should not put the mother and child under duress or in life threatening situations. A mother carries a baby in her womb for ten long months and it always gives happiness for the entire family only when both the mother and baby are ‘separated’ safely and are healthy.

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