BENGALURU : India, over the last few years, has been witnessing a trend among women opting for Caesarean section (C-section) surgeries over normal delivery. According to a District Level Household Survey 3 (DLHS) report, there has been an increase in the rate of C-section surgery, 28.1 per cent in the private sector and 12 per cent in the public sector health facilities to be precise.
A C-section surgery is usually advised and carried out only during medical emergencies. However, of late, the rates of C-section surgery have increased in cases of non-risk pregnancies, especially among the privileged class. Factors such as fear of normal delivery, social norms, hurry to get back to work life, etc, are known to influence parents who opt for caesarean deliveries.
In C-section, babies are delivered surgically through an incision made in the abdomen and uterus. They are planned ahead based on the recommendation of the treating doctor in cases of pregnancy complications or among patients who previously underwent c-section and are not considering vaginal birth after caesarean (VBAC) or simply to follow specific date and time as auspicious. Pregnancy and birth can be unpredictable at times. Hence, a mother should be well prepared in case a C-section is required. Even though vaginal delivery is considered safest, C-section has also become quite common due to reasons such as:
Stalled Labour: It means when the labour is not progressing. This occurs when the cervix fails to open despite strong contractions. According to the Centers for Disease Control and Prevention, nearly one-third of caesarean are due to this.
Abnormal position of the baby: A baby should be positioned head first near the birth canal, otherwise it becomes challenging to undergo normal delivery. Sometimes, the feet and butt of the baby are positioned toward the canal. In such cases, a C-section is usually considered to ensure safe delivery. Baby in distress: Lack of oxygen supply to the baby and change in the heartbeat would require C-section delivery
HAVING MULTIPLE
BABIES: For mothers carrying twins, triplets, it is safe to deliver through C-section
Placenta issues: When the placenta partially or completely covers the cervix (placenta previa), normal delivery can be challenging. Sometimes, the placenta separates from the uterine lining which causes placenta abruption (losing of oxygen). In such cases, C-section is considered a safe option for delivery.
Chronic health condition: Normal delivery may pose a great threat to women with health conditions such as heart disease, high blood pressure, or gestational diabetes. C-section also allows avoiding transmission of diseases such as HIV, genital herpes, etc.
Others: Having mechanical obstruction such as large fibroids blocking the birth canal, Cephalopelvic disproportion (CPD - a condition when the mother has small pelvis or the baby has a large head to pass through the birth canal) and Cord prolapse (when the umbilical cord slips through the cervix before the baby is born) need C-section.
The author is a senior consultant and head, Obstetrics and Gynaecology, Sakra World Hospital
What to keep in mind for C-section surgeries
Most of the time, women opt for C-section with their first babies in order to avoid labour pain or possible complications of vaginal birth. However, it is advisable to avoid C-sections if you plan on having multiple children. Multiple C-sections can put you at high risk of placental problems as well as heavy bleeding, which might require surgical removal of the uterus (hysterectomy). Therefore, it is recommended to consult your doctor before planning your delivery options.