Apanemia Health Centre

Cesarean delivery is becoming a common resource, but, although sometimes mentioned for reasons of safety for the health of the mother or baby, in two out of five cases the reasons are not well defined.

The experience of childbirth is very personal. While for some women a vaginal delivery is a human experience deep, intense, full of emotions, which strengthens the mother-child bond, for others it may represent pain, suffering and fear.

Thus, some medical fields hold that cesarean section is both safer than vaginal delivery more advantageous: it ensures greater security for the newborn, less trauma to the mother’s pelvic floor and absence of pain and suffering during the process delivery. While not denying their disadvantages: increased risk of maternal mortality and morbidity, problems in subsequent pregnancies (uterine scar rupture, increased risk of neonatal morbidity) and adverse psychological sequelae.

Whatever the reason, the fact is that the number of Caesarean sections are performed in developed countries continues to grow, although there is no scientific evidence to support its use in all cases.

The number of caesarean sections should not exceed 15% of deliveries

Today, cesarean births represent, on average, a rate of 29% of all births in developed countries. But thirty years ago accounted for only 6% of the total. In the public sector the figure is 25%, while in the private sector, where they attend third of births, the rate is much higher: 44%. Studies seem to confirm that this trend will continue to increase steadily. Given the weight of numbers, experts from the World Health Organization recommend that C-sections do not exceed 15% of deliveries.

Causes of increased demand
It has been suggested as a cause greater demand for pregnant women, obstetricians but surveys show that most experts are reluctant to practice according to the requests of all pregnant women. What may have some weight is that, at present, these professionals operating in a context that promotes defensive practices. At the risk of problems associated with childbirth, and a possible claim for malpractice or negligence, choose the safest route for both mother and child.

A second explanation for the increase in Caesarean deliveries is the age of the mother, as the current trend is to delay the birth of the child. Other aspects that can influence you opt for this type of delivery are the problems of overweight, hypertension and diabetes. In addition, more than half of women who had their first child by caesarean section ‘relapse’ in the second and even third. Finally, it was argued as a cause of multiple pregnancies increased due to fertilization ‘in vitro’.

Another variable to consider is economic. Some private insurance companies pay for the entire cesarean delivery when, being major surgery, and do not pay anything for vaginal delivery, which could encourage some mothers to request caesarean section to give birth in private practice without cost to them. A review in USA over 10 million births shows that risk factors explain only maternal-fetal 22.7% of caesarean sections, but 40% listed under the heading ‘other causes’ not shown for reasons totally unclear.

Major surgery

The cesarean delivery is through the abdomen through an incision in the abdominal wall and another in the womb is a major surgery and, therefore, not without risks. It is also fully justified in certain circumstances and, at times, and is planned during pregnancy when diagnosed placenta previa, previous caesarean delivery, threat to life of the child, mother’s illness (heart failure, severe hypertension or diabetes , among others), herpes virus infection in the female genitalia or pelvic disproportion-head (child large or malformed or close maternal pelvis), which makes it impossible to deliver vaginally. In other cases, the indication of caesarean section was done during the same course of labor due to fetal distress, poor placement of the baby, when dilation is not progressing, extensive detachment of the placenta, severe vaginal bleeding, umbilical cord prolapse or suspected fracture the uterus, among others.

Although it is major surgery, the risks are minimal and caesarean section is considered a very safe intervention for both mother and child. Available figures indicate that the mortality risk of 0.04 per thousand for vaginal birth, is multiplied by three before a cesarean delivery. Although the numbers are negligible, it does entail serious risks such as bleeding, infection, thrombosis, pelvic or lower extremity complications for mother and from the use of anesthesia for both.

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