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Nowadays, more and more deliveries are being done by Caesarean Section worldwide. As women have only one or two children nowadays, each delivery becomes an important one and each child extremely precious. Focus is not on the number of children but the quality of each child- making sure that the child has no injury, no distress, no slowing down of the heart rate, no asphyxia (less oxygen going to the brain), does not pass meconium or aspirate it (passing stool inside the womb). All these problems, if they happen, can cause major or subtle disability to the child later. Even a few minutes of delay in the baby crying after birth can have some effect on its development later.
Not only the child but the mother's health is of extreme importance. Difficult normal deliveries with tears in the vagina, forceps deliveries or prolonged labour can cause damage and result in loss of urine control later (stress urinary incontinence) or looseness of vagina and prolapse (womb coming down). In addition, there is a high risk of severe bleeding post-delivery in these cases.
Some of the common causes of planned caesarean section are breech presentation or transverse lie (baby is upside down or lying across in the womb), baby being IUGR (intrauterine growth retardation), or the amniotic fluid around the baby has dried up.
Sometimes the mothers' pelvis is narrow, and the baby's head does not enter inside. In many twin pregnancies, patients with placenta Bravia (lying low down in the womb) are risky to deliver vaginally.
Sometimes the patient is in labour, but during that time, the baby's heartbeat starts to fall, the baby passes stools inside the womb, or the labour does not progress at the required pace. These may result in an emergency caesarean section.
Nowadays, most caesareans are done under spinal anaesthesia (very thin needle in the back) where the lower part of the body is numbed; this is safer for mother and child. Usually, a bikini scar should be given, and good quality self-dissolving stitches used. A paediatrician should be available at hand to immediately look after the baby post-delivery. There should be enough staff around to handle any emergency immediately.
Normal delivery, if possible easily and without trauma to mother and child, is still the best option, but a well done caesarean section in chosen patients saves lives and ensures a healthy baby to a healthy mother.
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