Over the years the number of caesarean sections that are performed has increased, what is the reason and what criteria are used to schedule it?
The C – section is a technique that is performed in cases where there are possible complications during pregnancy or natural delivery. It is a surgical operation, in which the fetus and placenta are removed through the abdomen.
In its beginnings, it was only practiced in those cases in which the mother died and the child was still alive. Currently, its use is very frequent, especially in Western societies, due to the safety of the procedure to maintain the well-being of both the mother and the fetus. We can see that today the number of cesarean sections is increasing , this is due to advances in science that allow risk reduction during the process, in addition to the fact that the first cesarean section implies that subsequent deliveries have to be also by cesarean section.
However, the WHO (World Health Organization) recommends that the rate on the number of caesarean sections should range between 10 and 15% , warning that this practice is increasing more and more.
IN WHAT SITUATIONS OR CASES SHOULD A CESAREAN SECTION BE PERFORMED?
The reasons for cesarean delivery may affect the mother or the baby. Sometimes, this practice is the only option that arises during the last period of pregnancy , because it is considered unfeasible for a natural vaginal delivery to be practiced, while other times, the reasons are only risk factors that indicate the doctors that the most convenient is to perform a cesarean section.
Next, the most frequent circumstances that imply the execution of the cesarean section will be pointed out.
1. Low birth weight:
If the baby weighs 1.5 kg or less, it is probably not necessarily strong enough to overcome natural vaginal delivery.
2. A previous cesarean section:
In one out of four cases in which the mother has undergone a cesarean section in a previous delivery, doctors decide to perform this surgery again. However, it is possible to attempt a vaginal delivery, unless the complications to which the mother and fetus may be exposed are very clear. For example, if the previous cesarean section was horizontal, the mother is not at risk of having a natural delivery . But if the previous C-section was vertical cut or you had more than one C-section, the risk that the uterus may rupture during natural delivery is greatly increased.
3. Multiple gestation:
In this case, what is most taken into account is the position of the babies and the maturity of each fetus. It is up to the gynecologist and the mother to decide whether to perform a cesarean section.
4. Possible abnormalities in the cervix, vagina, or vulva:
Such as tumors, fibroids, etc.
5. Loss of well-being of the fetus:
If the baby does not get enough oxygen and nutrients, the uterus feels unsafe and uncomfortable.
6. Inappropriate fetal position in the uterus:
The baby may be in two inappropriate positions, either the transverse one that undoubtedly implies a cesarean section, or when the baby comes from the breech (breech position) that can make vaginal delivery difficult, although it is the decision of both the doctor and the mother perform a cesarean section, because if the baby has a good weight and is healthy, it can cope with natural delivery perfectly.
7. Possible maternal illnesses that make delivery difficult:
Such as vaginal infections, HIV in the active phase or the human papillomavirus , heart disease or any disease that endangers the health of the mother and the fetus during the process of childbirth.
8. Macrosomia fetal:
The excess size of a fetus during pregnancy can complicate vaginal delivery, especially in those cases in which the mother suffers from a disease, such as diabetes .
9. Placenta previa:
In this case, the placenta is located in the uterus so that it covers the cervix and prevents the fetus from leaving the vaginal canal. This is usually diagnosed in the last period of pregnancy and can be accompanied by blood loss.
10. Fetal malformation or previous fetal death:
Either of these two circumstances is detected through ultrasound. If the detected malformation of the fetus indicates that it may complicate and put the mother at risk during natural childbirth, a cesarean section is recommended.
ARE EMERGENCY CESAREAN SECTIONS PERFORMED?
There are cases in which complications appear, while regular contractions or water breaks occur, which mean that vaginal delivery is risky. For instance:
– Prolapsed umbilical cord : that is, the umbilical cord is located in the birth canal before the baby. In this way, the cord can cut off the oxygen supply to the fetus.
– Premature detachment of the placenta: the placenta detaches from the uterine wall, causing a reduction in oxygen.
– Increase or decrease in the baby’s heart rate
– When the baby stops going down the vaginal canal or when the cervix does not continue to dilate. In these cases, it is a question of stimulating contractions and resuming the process, but if this is not effective, a cesarean section should be performed.
These examples are not common, but if they occur early in labor, cesarean section is the only option for the baby to be delivered.
In the case of cesarean section, recovery takes longer and is more complex, and emotional recovery can be, in some cases, more delicate. Although it is a safe surgery, it is only recommended to use in those cases in which natural vaginal delivery is impossible, since the practice of cesarean section presents more risks than vaginal delivery, it also implies a longer stay in the hospital because the recovery, as noted above, is longer.
In any case, do not hesitate to ask your doctor for more detailed information and advice if you have any doubts, providing you with information about the benefits and risks of cesarean section for you and your baby.
Dr. Tabriella Perivolaris, Sara's mother and fan of fashion, beauty, motherhood, among others, about the female universe. Since 2018 she has been working as a copywriter, always bringing to her articles a little of her experience and experience as a mother and woman.