WHY WHOSE AND WHEN : CESARIAN SECTION

From the very beginning of pregnancy diagnosis, women is curious whether she will be delivering her baby in normal way or she will have a c section.Both procedures are equally challenging .In older days women used to perform normal delivery and they were even confident too. But today, either it is new technologies or health services, women generally prefer cesarian surgery which has become their own choice. The reason behind prefering cesarian is it has no risk of pain, the labour pain is so tough that they do not want to go through that situation. The other reason might be the lack of care in a labour room for normal delivery. Women are left screaming and crying inside labour room .On the other hand, cesarian is performed by experienced doctors and anesthesia's that ensures the good delivery leaving no risk for both mother and baby.

Smart Aamaa interviewed Doctor Dilip Koju, working at labour Department of Burtibang health center at Baglung.He has performed several successful cesarian sections .

1)In present days, cesarian surgery is becoming more prevalent in comparison to normal delivery, why is it so? In context of Nepal, it becoming even more happening.

The number of Caesarean section is increasing in today’s practice. The optimal number of C section is arounf 10-15 percentage of total deliveries but the percentage is more higher now a days. Reasons could be:

Easy availability of the health facility

Patients’ and health professionals’ wish to deliver via C section for their individual benefits.

C section being done more often for relative indication for which vaginal delivery could be tried.

2)What are the pros and cons of a cesarian delivery?

Pros of C section:

Less pain during labour,

Baby delivered in less time period,

Life saving surgery for both mother and fetus if they are in distress.

Cons of C section:

Larger recovery time after surgery for mother

Possibilities of surgery related immediate and long term complications.

Babies born by C section are porn to respiratory illness and other illness as they cannot combat the diseases as those born by vaginal deliveries

Chance of C section in next delivery increased

3)Nowadays, doctors themselves ask a pregnant lady for an options of c section over normal delivery looking at complications during delivery. Is it good to keep it as an option .

For both mother and baby C section is the life saving surgery. In my view, it is neither necessary nor good to give C section as option to normal delivery without any genuine indication of C section. Normal vaginal delivery is natural process as it helps both mother and child endure the stress.

4)Is it true that a women who had cesarian surgery has lots of physical problems in later days ?why is it so?

Women with C section can have various problems in later part of life after CS. Immediately after surgery, the recovery time extends to weeks. The complications related to surgery such as bleeding, injuries to other organs, surgical sit infection can occur. Later some patients complain of surgical site pain. There is increased risk during future pregnancy and delivery.

5)It is studied that an anesthesia given during section at the mid spinal cord is not so good anesthesia, please elaborate about this.

Spinal anesthesia is given by placing a needle in the sub arachnoid space and delivering the anesthetic drug there. As all other procedures, spinal anesthesia has also side affects and complications such as headache, spinal cord injuries and infection. As such spinal anaesthesia is not that bad.

6)In older days, most women infact all women give birth by normal delivery. Hadnot there been any complications during delivery.?? If there were complications, would they still prefer normal delivery at any cost?

In older days, there was not facility of CS for all mothers. There are many mothers not having the facility of CS in remote areas now a days also. When a live baby cant be borne by a mother without keeping the mother at risk, complications occur. If people are informed about the possible life threatening complications properly, they will definitely opt for CS.

7) How many times cesarian can be performed in women"s body?

After first CS, adhesions occur in the abdominal cavity during healing in many cases. This makes second CS difficult. Generally, two to three C Sections can be performed in an individual but even that is with increased risk. Vaginal delivery can be tried in women with previous CS , that also has increased risk.

8) It is believed that a women who has delivered her first baby by cesarian, her second baby should also be operated by cesarian surgery, what do you say about this?

After first CS, the uterus is never as strong as before. So during second child birth, there is risk of scar dehiscence and uterine rupture. Vaginal delivery can be tried with increased risk. Many professionals prefer CS for previous CS.

9) In nepalese society, normally a new mother is fed with lots of calories like ghee chaakoo meat, can a mother who had cesarian can take these sort of food .

Yes , after immediate post operative stage women can and should have high calorie and high protein diet such as ghee , meat , chaaku for the recovery from surgery.