Pregnant women don’t dread anything more than they dread a C-section. This fear is totally understandable: the thought of possible intra-operative complications, delayed recovery, risk of scar rupture in subsequent pregnancies and limitation of family size etc… Truth is, CS is only done for a reason; sometimes more than one reasons. The goal of any obstetrician is to present a healthy baby to a healthy mother and happy father. How this is achieved does not really matter. It’s wrong to define “normal delivery” based on the mode of delivery of the baby, rather than the overall outcome for both mother and child.
There are several absolute and relative indications for CS…
*Previous CS (relative)
*Acute fetal compromise
*Failure of the cervix to dilate despite strong contractions
*Abnormal presentation of the baby: breech, transverse, etc.
*Abnormalities of the placenta: eg. Premature separation, low-lying placenta – causing severe bleeding
*Severe maternal compromise: eg severe pre-eclampsia
*Intrauterine growth restriction (relative)
*Twin pregnancy with leading twin presenting with buttocks
*Higher multiple pregnancy: triplets, quadruplets etc
*Maternal HIV (relative)
*Maternal genital herpes infection
*Previous major surgery of the uterus: eg, removal of fibroids
In centers where standards are set and regular audits are conducted, an unnecessary C-section will hardly happen, and when it does, patients have the right to file a lawsuit and appropriate disciplinary action is meted out to the erring physician. With the new advances in medical care, and availability of skillful hands, adverse events during and after CS are very rare. The popular rule of thumb: “once a CS, always a CS” has also been invalidated. It’s possible to have a successful vaginal delivery after 1 or 2 CS; but not more than that. Nowadays, the skin incision is made directly on the bikini line such that, after complete healing, the scar becomes almost invisible.
Dear women, CS is not a death sentence. It is, indeed a lifesaving procedure, with the sole purpose of protecting you and your baby. An otherwise smooth labour can become complicated even at the last minute, warranting a decision to perform CS. Vaginal delivery remains less stressful for everyone but you have to trust your doctor’s judgment and fix your eyes on a positive result rather than the route of delivery. Good luck to all expectant parents!