Deliveries by Caesareans on the increase in TN! Why?
A woman’s delivery of a baby from her womb to the world is a pleasant transition. In fact, it is believed that every woman gets her life renewed after the birth pangs and safe delivery. What is ironical is - in the past centuries, the women were able to experience normal deliveries when the so-called advancements in medical science were absent but whereas in the present century, deliveries through caesarean mode seem to be on the higher side despite a plethora of medical marvels. This is definitely a sorry state of affairs!
World Health Organization (WHO) recommends only 15% caesarean deliveries considering the healthy life of both the mother and the baby. However, the current statistical data are rather disturbing to note.
The National Family Health Survey conducted by the Central Government in the year 2015-16 has been released recently. According to that, on an average, 17.2% deliveries are through caesarean in India. This was 2.9% only in 1992-93; 7.1% in 1998-99and 8.5% in 2005-06. Similarly, at national level, nearly 40.9% caesarean births occur in private hospitals and 11.9% in Government hospitals.
As far as Tamil Nadu is concerned, caesarean deliveries account for 34.1% in which 51.3% happen in private hospitals and the balance 26.3% happen in Government hospitals. The same survey states that 32.3% happens in villages and rural areas while 36.1% occurs in urban and city areas.
While the general notion put forward by the medical authorities is that caesarean deliveries are inevitable in certain cases, the social activists opine that that some of the private hospitals have become too commercial and they do this deliberately.
However, the private hospital authorities refute this statement by stating that most of the women themselves opt for caesarean in order to undergo less pain and in certain cases the women themselves prefer caesarean in order to meet their personal expectations based on numerology and astrological requirements.
Gynaecologist Dr.Jayarani Kamaraj explains the circumstances under which caesarean is recommended. She confirms that it will be resorted to wherein there is some acute complication that may result in the danger to the life of mother and the child. She says that while normal deliveries do happen in the private hospitals,
caesarean cases have increased since recent times. She further says that virtual danger to the mother or the child was common in the olden days whereas it has now substantially reduced, thanks to the modern medical advancements. She confirms that the change in the life style of the couple, postponement of the marriage and artificial method followed by the couple for conception are equally responsible for more number of caesarean deliveries.
The doctor further shares that the modern technological developments have made the caesarean method of delivery simple and quick; moreover, it has made it possible to avoid birth-related problems for the babies. Death rate at the time of deliveries has been brought down. Further, in developed countries, the caesarean cases have become more. Though certain complications may arise after delivery, they are not dangerous to one’s life. Since the mothers are entitled to decide the course of treatment, some mothers prefer caesarean in order to reduce the pain in the process. Some people prefer particular days and time for effecting delivery based on astrological predictions. To avoid birth in the month of Adi, they are willing to go for caesarean in advance. These practices are to be discouraged. In the case of such advanced deliveries, some babies develop congenital complications and the mothers do not secrete breast milk immediately and the babies are naturally deprived of this. Another point to be noted is that it is not necessary that if the first delivery is by caesarean, the subsequent deliveries also must be of the same method. It may be normal, as confirmed by Dr.Jayarani Kamaraj.
Dr.Kamala Selvaraj elaborates the circumstances which call for caesarean method as under:-
In olden days the women were doing lot of physical exercise by default but whereas the modern women are following sedentary jobs involving no major physical exertion as a result of which the caesarean becomes necessary.
If the umbilical cord is around the neck before delivery, it would call for caesarean method.
In the case of Intrauterine growth restriction (IUGR) with no corresponding growth of the foetus and
If the baby develops breathing difficulty inside the uterus of the mother, caesarean will have to be resorted to.
Normally, the head fixing will happen in the pelvic region two weeks in advance. If the head is slightly big, it will not enter the pelvic region and the amnion will be broken. At this time, even the pain inducing drug will not act during which stage, caesarean will become unavoidable.
If delivery does not happen even after 6 – 8 hours from the time of breaking of amnion, it will warrant caesarean operation for effecting the delivery
If there is a tumour either in the uterus or the vaginal canal;
In the case of complication at the time of delivery;
In the case of high blood pressure ;
In the case of diabetic condition of the mother;
In the event of epilepsy disease on the part of the mother;
In the case of insufficient oxygen for the child;
If the lying position of the child is incorrect;
In the case of hernia and uterus is down by some earlier operation; etc.
Caesarean will become necessary
Further, in case the mother is a heart patient;
If there is cancer in the mouth of uterus;
If there is any abnormality in the position of the uterus;
In the case of artificial method being followed for conception;
In the case of frequent occurrence of ‘still-born’ deliveries,
In the event of first delivery being caesarean, the sutures may get torn
In all the above situations where the life of the mother or the child is vulnerable, caesarean will be warranted.
To conclude the transition from womanhood to motherhood is a phenomenon and divine too. The birth of a baby will bring unknown and unfathomable happiness to the entire family. It is an endurance test for the pregnant mother and not a disease to suffer. This is a process created by nature for expansion. The birth pang is true but temporary. If this reality is realized by the women, it will be good for them as well as the future generations.
It is our bounden duty to ensure that there is a perfect sync between modern technology and nature in regard to pregnancy and deliveries.
(This article written in Tamil by G Lakshmanan has been reproduced in English by P.S.Ramamurthy)