Our Summary

This research paper discusses the rising number of caesarean section births and the corresponding increase in health risks for both mother and baby, especially when the operation is performed in the second stage of labor. The study analyzed data from the Patan Academy of Health Sciences and found that out of 40,860 births between April 1, 2013, and March 30, 2017, 18,011 (44%) were caesarean sections with 1.9% of these performed in the second stage of labor. The common reason for a c-section was cephalopelvic disproportion, a condition where the baby’s head or body is too large to pass through the mother’s pelvis.

Most of these surgeries (92.4%) were performed without first trying an instrumental delivery (using forceps or a vacuum). The study also noted several maternal complications, such as postpartum hemorrhage (excessive bleeding), postoperative fever, and wound infection. The baby also faced potential risks, including meconium-stained amniotic fluid (which can cause breathing problems), neonatal hyperbilirubinemia (a condition that can cause jaundice), increased nursery admission, and a small number (1.3%) of perinatal deaths.

In conclusion, the study warns that caesarean sections, especially when done in the second stage of labor, come with significant risks for both the mother and the baby.

FAQs

  1. What percentage of births were cesarean sections according to the study conducted by the Patan Academy of Health Sciences?
  2. What are some of the health risks associated with cesarean sections, particularly those performed in the second stage of labor?
  3. What is the most common reason for a cesarean section as found in this study?

Doctor’s Tip

A doctor might advise a patient considering a cesarean section to discuss all possible risks and benefits with their healthcare provider and to carefully consider alternative options before proceeding with the surgery. They may also recommend taking steps to prepare for a c-section, such as attending childbirth education classes, maintaining a healthy lifestyle, and discussing pain management options with their healthcare team. Additionally, following post-operative instructions and attending follow-up appointments are essential for a successful recovery.

Suitable For

Therefore, it is important for healthcare providers to carefully consider the indications for a c-section and only recommend the procedure when medically necessary. Patients who may be recommended for a cesarean section include those with:

  1. Cephalopelvic disproportion: When the baby’s head or body is too large to pass through the mother’s pelvis.
  2. Fetal distress: When the baby is not getting enough oxygen or nutrients during labor.
  3. Placenta previa: When the placenta is covering the opening of the cervix.
  4. Umbilical cord prolapse: When the umbilical cord slips through the cervix before the baby, cutting off the baby’s oxygen supply.
  5. Multiple pregnancies: When a woman is carrying more than one baby.
  6. Previous c-section: If a woman has had a previous c-section, she may be recommended to have another c-section for subsequent deliveries.
  7. Maternal health conditions: Such as high blood pressure, diabetes, or certain infections that may pose risks during vaginal delivery.
  8. Malpresentation: When the baby is not positioned head-down in the womb.

Overall, it is important for healthcare providers to carefully assess each individual case and weigh the risks and benefits of a c-section to ensure the safety and well-being of both the mother and the baby.

Timeline

Before a cesarean section, a patient may experience prolonged labor, failure to progress, fetal distress, or other complications that necessitate the need for the surgery. The patient would typically undergo preoperative preparations, including consent forms, blood tests, and anesthesia discussions. During the procedure, the patient would be given anesthesia, and a surgical team would perform the operation to deliver the baby.

After a cesarean section, the patient would typically spend some time in the recovery room before being transferred to a postpartum room. The patient may experience pain, discomfort, and difficulty moving in the days following the surgery. They would also need to monitor their incision site for signs of infection and follow up with their healthcare provider for postoperative care. The patient may also face challenges with breastfeeding and bonding with their newborn if they are unable to have skin-to-skin contact immediately after birth. Overall, the recovery process for a cesarean section can be longer and more challenging compared to a vaginal delivery.

What to Ask Your Doctor

Some questions a patient should ask their doctor about cesarean section include:

  1. Why is a cesarean section being recommended in my case?
  2. What are the potential risks and complications associated with having a cesarean section?
  3. Are there any alternative options to a cesarean section that could be considered?
  4. How will the surgery be performed and what can I expect during the procedure?
  5. What is the recovery process like after a cesarean section?
  6. How will a cesarean section impact future pregnancies and deliveries?
  7. Are there any long-term effects or implications of having a cesarean section?
  8. What measures will be taken to ensure the safety and well-being of both myself and my baby during and after the surgery?
  9. How often do you perform cesarean sections and what is your experience with this procedure?
  10. Are there any specific guidelines or recommendations I should follow before and after the surgery to promote a successful recovery?

Reference

Authors: Gurung P, Malla S, Lama S, Malla A, Singh A. Journal: J Nepal Health Res Counc. 2017 Sep 8;15(2):178-181. doi: 10.3126/jnhrc.v15i2.18210. PMID: 29016591