Dr Anita Soni, consultant obstetrician and gynaecologist at Dr L H Hiranandani Hospital, Mumbai reveals eye-opening figures, “Almost 50 per cent of women undergo C-section. With women into careers and education, late marriage, infertility problems, medically aided multiple pregnancies or medical complications, the incidence of C-section is higher.” 

Indications for a Caesarian delivery

C-section is a surgical procedure to deliver your baby through a cut in your abdomen. Some C-sections are planned because of pregnancy complications or if you have had a previous C-section. But in others, the need for a first-time C-section does not become evident until the labour has started.

“Both the mother and the child are safe in a normal delivery”, avers Mumbai-based obstetrician and gynaecologist Dr Bhavin Bhayani. “There is no need for a C-section unless there are indications such as narrow birth canal, the baby’s head is higher up, the head is blocked or the baby is feet down etc. If a woman fears pain while having a vaginal delivery, now there are options with painless labour techniques,” he opines. Dr. Soni blames it on eating habits and inactive moms. “Larger babies in particular, high incidence of diabetes in moms etc. drive women towards C-sections”, she says.

It is true that recovery from a C-section takes longer time than vaginal birth. C-sections also carry a higher risk of complications as in other surgeries. However, according to Columbia University Obstetrician and Gynaecologist Dr Mary D’Alton, chairwoman of a 2006 National Institutes of Health conference on maternal request C-sections, there’s no evidence to say that a planned C-section is, at present, riskier than a vaginal delivery; you need to know more about the individual woman to be able to assess the risks.

Times when C-section is recommended

• Your labour has stopped progressing, cervix is not opening, baby’s head is too big to pass through the birth canal
• Your baby is in an abnormal position with feet or buttocks first or your baby enters the birth canal chin up or forehead or face leading the way
• Your baby is not getting enough oxygen; there are changes in the heartbeats
• You are carrying multiple babies – twins, triplets 
• The placenta detaches from the uterus before the labour begins or the placenta covers the opening of the cervix (placenta previa)
• Medical emergencies such as umbilical cord prolapse, which cuts off the baby's oxygen
• Your baby is too large to be delivered normally
• If you have heart or lung disease or diabetes, your doctor may opt for a C-section
• For babies with developmental problems such as failure of the spine to close properly (spina bifida) or excess fluid filled in the brain (hydrocephalus)
• You have had a previous C-section, yet you may be able to try a vaginal delivery
• You have an active genital herpes infection or any other, which can pass on to your baby through the birth canal

Get a C-section only if you need it

Studies indicate that 44% of first-time moms who are induced with drugs into labour end up with a C-section while only 8% of those who go into labour spontaneously undergo a C-section. Dr Elliott Main, director of obstetric quality at Sutter Health in California, US feels anxiety slows down labour and therefore he encourages moms to stay at home in early labour. “Time your pain. If your contraction or pain occurs once every six or eight minutes, it’s time to go to the hospital. But you also have to take into account the distance from your home to the hospital”, reflects Dr. Bhayani.

Remember, some situations can be true emergencies and a C-section is necessary but elective C-sections may be needless especially with the available advanced pain-relieving technology. Of course your doctor is the best judge for you and your baby.

Pic: Benjamin Earwicker