Lesotho Times

Caesarean effects

DOCTOR’S CORNER

 

AN increasing number of women nowadays are subscribing to the view that there is no need to bother going through the process of giving birth through the vagina when you can have a planned caesarean section.

One of the biggest advantages of a caesarean section is that it can be scheduled and most families find this very important.

Another reason is that it is quick and pain-free because it is done under an anaesthetic and therefore there are no pains of labour to be endured.

The “wake me up when it’s all over” scenario appeals to many women.

A caesarean section avoids the need for a baby to make the journey through the normal birth canal.

Many women worry about how something as large as a baby could possibly fit through such a small opening.

Some women fear the baby may be “squashed”and damaged in the process.

A caesarean is clean.

The antiseptic nature of the operating theatre is very different from the physical exertion of labour. No sweat and tears.

The mess of amniotic fluids and blood is dealt with out of sight. Urine is catheterised. There are no lumps of stool emerging from the rectum, pushed out by the baby’s head as it journeys down the vagina.

Planned caesarean birth avoids the necessity of the many probings of the vagina, which have become routine during what is termed “normal” birth today.

A woman can more easily maintain a degree of professionalism and detachment in her relationship with her carers since the private areas of her body are left unmolested and unsullied.

With these advantages in mind, does caesarean delivery not fit rather well with the ethos of our society in this new millennium?

The problem is, however quick, clean and convenient caesarean delivery may be considered, it also has its disadvantages, the most obvious being the post-operative recovery period.

Contrary to popular perception, delivery by caesarean section is far from an “easy” option. Caesarean mothers are never able to jump off the operating table and get straight back to normal.

The operation itself may be completely pain free but the post-operative recovery period rarely continues to be so.

There is, of course, a range of pain-killers to help mothers through the first few days, but even so moving around, handling the baby and going to the toilet, all present their own difficulties and have to be tackled slowly and carefully.

The mother also has to go on for the rest of her life with a scar, which may be itchy and painful at times especially the next few winters.

Scar tissue or adhesions may cause long-term pain, bowel obstruction, infertility or miscarriage and may make repeat surgery more difficult.

Some unlucky caesarean mothers suffer post-operative infections and this can be quite distressing.

And then of course there are the risks. Caesarean section is major surgery and complications can occur. Mothers die very rarely these days, but the risk of maternal death is higher with caesarean section than with vaginal birth. Caesarean mothers are also at increased risk of ectopic pregnancy (the baby growing outside the womb) and complications of the placenta in subsequent pregnancies

A caesarean is not without risk to the baby either.

Babies are occasionally cut by the surgeon’s scalpel.

Babies who are born by caesarean section have a higher incidence of respiratory problems both at birth and in adult life. Perhaps a caesarean is not quite as practical a solution to the problem of bringing a baby into the world as it might at first seem.

But even women who are well informed of the realities of caesarean birth maintain a preference for this form of delivery.

Why have we reached the point where women are prepared to face the risks and inconveniences of major abdominal surgery in order to avoid giving birth to their own babies? Maybe recent decades have not given “normal” birth a good press.

Another reason may be that vaginal birth has changed.

It may no longer be a private time where women give birth to their babies themselves, supported and cared for by a few known, trusted, and accepted attendants in a familiar atmosphere.

The reasons women are opting for caesareans have more to do with the unacceptability of what happens during what passes as “normal” labour and birth, than the appeal of major surgery.

The realities of what women experience in our maternity wards today is hardly inspiring.

Vaginal birth today usually takes place in front of strangers.

Trying to form a formal, business-like relationship with a professional whilst semi-naked and trying to go with the flow of a primal natural process can be difficult, embarrassing and demeaning.

Many women feel that there is an invasion of privacy with all the vaginal examinations which may be frequent and may be carried out by different people, none of whom may be known to the woman and some of whom may not even introduce themselves.

Vaginal birth today is portrayed as being dangerous for the baby.

Women sometimes have difficulty in believing that an experience that can be so awful for them, can be any better for their baby.

The emphasis on electronic fetal monitoring adds substantially to the impression that the baby is in great danger.

Vaginal birth is generally painful often to a point where women can no longer cope without painkillers and this is the biggest deterrent from vaginal delivery but there are options to make labour bearable such as strong painkillers like the use of a nitric oxide mask.

A simple back rub can drastically reduce labour pain.

There are also other options for completely getting rid of the labour pain that you can discuss with your doctor.

Despite all this, the vast majority of women would still prefer to have a normal, straightforward vaginal birth.

However, the sad fact is the majority of modern mothers look back on their birthing experience negatively

The ever-diminishing numbers of women who do achieve a straightforward, intervention-free birth are well aware of the benefits, both for their babies and for themselves, and are usually able to approach subsequent births with excitement and eager anticipation that they will be privileged to go through the process again.

Normal, straightforward, intervention-free, healthy, natural birth is still the safest, most practical and advantageous way for a baby to be born.

Babies born vaginally have a lower risk of respiratory problems.

It is widely accepted that the contractions of labour help prepare the baby’s lungs to breathe air.

Babies born by caesarean section have a higher risk of respiratory distress syndrome than babies born vaginally.

Adults with asthma are more likely to have been delivered by caesarean section compared with adults without asthma.

It is also widely acknowledged that the baby plays a part in deciding when the time is right to be born.

It has been commented that babies born by elective caesarean section can show signs of being angry and do not appreciate being delivered before they are ready.

The passage down the birth canal also gives a baby a wonderful all-over massage that wakes up various systems in the body.

Mothers who feel safe, confident and well supported rarely find the level of pain reaches the point where it becomes unbearable.

Their hormonal state supports the process rather than fighting against it.

Labour is not perceived as being a trial, the pain is more like that experienced by athletes when they are giving their all and trying their hardest.

Labour and birth are often the hardest physical work a modern woman ever has to do, but can also be the most rewarding.

A mother who has experienced a natural birth can generally walk unaided after the birth and can begin caring for her baby straightaway.

A mother who has experienced a natural birth is usually able to become involved in family life within hours of the birth and can get back to normal daily life within just a few days.

When the birth has gone well, the baby is often peaceful, quiet and relaxed.

When the birth has gone well mothers feel stronger, both physically and emotionally.

There is a wonderful sense of achievement and peace, of strength and control, of health and completeness, of being able to cope and get on with life in general.

It is a very positive life-changing experience.

In conclusion, there are many very good reasons for having a caesarean section and with a little forethought and planning the operation can indeed be a wonderful experience.

There is also no denying that a positive caesarean section is infinitely preferable to a traumatic vaginal delivery.

But what too many have lost sight of, is that even the best caesarean can never hold a candle to a good experience of giving birth to your baby yourself.

Lesotho Times

Lesotho's widely read newspaper, published every Thursday and distributed throughout the country and in some parts of South Africa.

Contact us today: News: editor@lestimes.co.ls Advertising: marketing@lestimes.co.ls Telephone: +266 2231 5356

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