Medicos debate need for caesarean births

Concerned over the ‘epidemic’ of caesarean sections globally, the World Health Organisation (WHO) has advised that the procedure should only be performed when medically necessary as surgical intervention can have harmful effects on the mother and child. The number of caesarean sections births has increased notably in several metros in India.
FPJ spoke to medical professionals to find out the scenario. Dr Shreekant Chorghade, eminent Paediatrician who has authored several books on neo-natal and child care, said, “The number of caesarean section might have increased. But since the investigative facilities have increased danger to the life of foetus can be detected and, caesarean section can be advised if the life of the foetus is in danger. As medical professionals Obstetricians and Paediatricians always strive to ensure that the mother and the baby are safe and it is a safe delivery. Waiting too long for a normal delivery in several cases can endanger the life of the foetus. If the new born baby suddenly goes in distress, timely help may save the life but further outcome due to the distress cannot be predicted.”
“Long wait for normal delivery can lead to diminish supply of oxygen to the brain of the foetus leading to damage to the brain cells and can lead to neurological problems in future as the child grows older,” added Dr Chorghade.
Dr Varsha Dhawale, practising Obstetrician and Gynaecologist, who is member of The Federation of Obstetric and Gynaecological Societies of India (FOGSI), said, “With women postponing motherhood till late 30s, with conditions like obesity, diabetics and hypertension becoming common, chances for normal delivery were becoming less.”
“Planned caesarean is advised when the mother has health problems like diabetes or blood pressure or defective bony pelvis which does not allow normal delivery to occur. Sometimes if the baby is too big and the mother has a small frame caesarean section is must. Sometimes some undiagnosed causes lead to distress of the baby leading to passing of stool in the womb which compels the treating gynaecologist to go in for a caeserean section,” said Dr Dhawale.
“Sometimes the pregnant woman is unable to bear pain which is essential for a safe normal delivery. Due to various reasons they are not able to exert sufficient pressure needed for a normal delivery. And due to late marriages couples plan parenthood bit late, in their mid-thirties so they avoid taking any risks in the child birth this making it a precious pregnancy,” added Dr Dhawale.
“Consumer Protection Act has definitely affected the decisions for a caesarean section birth because many times a doctor is blamed for the mortality and the morbidity of the children in majority of cases.”
“The would-be parents and their family members should take due care before choosing an obstetricians. And they select a particular doctor then they should show full faith in the advice and decisions of the selected obstetrician. Many times lack of trust towards the doctors makes them consult other doctors for second opinion where they may get a different advice leading to confusion and distrust towards the treating obstetrics,” stated Dr Chorghade.
“For those who cannot endure labour pains for a longer time can go for painless delivery. They can relax and enjoy the experience,” added Dr Dhawale.
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