Cesarian section,a word very much familiar to us in the days of modern obstetrics.Cesarean section is defined as planned cutting of abdomen and uterus to extract the baby from the womb of a mother who is unable to deliver vaginally .The first cesarean section report in history dates back in 1500 but the famous news is of Julius cesar who was born via the technique.
In recent times ,we go hearing the grudges in general public regarding the increase rate of cesareans amongst the females .And, Obstetricians have tough time convincing the family members of a female that a particular female is not going to deliver vaginally for some obvious reasons(and morbidities in fetus and mother are inevitable).Mostly ,it is thought that the doctors are finding easy ways out to cut short their efforts & increase bills of patients .But very less is known to general public about the journey of fetus through the passage of maternal pelvis .
For a normal vaginal delivery of a fetus ,there are many factors involved like the size of fetal head ,the diameter of maternal pelvis ,the bony obstructions in the way, the co-morbidities associated with pregnancy(High B.P, Diabetes ,Thyroid disorder etc),the flexibility of female body & above all the tolerance threshold of female.
Previous generation was less gadget dependant & more self dependant for most of their daily chores. Home-cleaning ,cooking ,taking out water from wells, grinding & so on .So the flexibility was much better .Also ,the diet was pure, simple n home-made adding to health. Maximum females were home-makers & had less stress of managing the work-Home situation so less co-morbidities .All these factors leading to maximum vaginal deliveries .
But , the fact not to be forgotten about those days that we hear maximum cases with history of 5-6 pregnancies with 2-3 losses & also many maternal deaths for some reasons .That means ,mortality was there for sure.May be the causes for such incidents were pressurized labours with unidentified cephalopelvic disproportions leading to massive hemorrhage to which they succumbed.So there was a definite need of intervention during difficult deliveries but awareness was less.
Once the technique of Cesarian is established ,it has saved thousands of mothers for their precious lives & also prevented the morbidities in Infants & their NICU admissions .So ,its importance should not be over-looked.
The increasing rate of Cesarian sections may be attributed to the increasing age of marriage & childbirth, sedantry lifestyle ,stress because of work-Home front juggling with poor self-care ,decrease in tolerance threshold & extra knowledge from google leading to anxieties.Also right of decision making for oneself ,many females opt for cesarian sections instead of painful birth process.
Of course being learned practitioners ,we must explain them the pros & cons of both modes of delivery but we also have to take decisions according to patient-type & can’t give extensive laborious trials against patient’s wish for the fear of litigations in case of morbidities & mortalities .And general public should understand that to take a patient for any surgery is a huge risk & no doctor will take such operative risk unless it is really indicated.
Finally ,everyone must understand that mode of delivery depends on various individual factors ,but the final motto should be SAFE MOM/SAFE CHILD & SAFE DOC!
By Dr Shivangi Jahagirdar/Gynaecologist & Obstetrician,Vaishnavi Clinic,Lokmat square ,Nagpur
