April is the Cesarean Awareness Month (CAM) which is celebrated around the world.
According to the World Health Organization Cesarean Section use continues to rise globally, now accounting for more than 1 in 5 of all childbirths
While a Cesarean Section can be an essential and life-saving surgery, it can put women and babies at unnecessary risk of short-and- long term health problems if performed where there is no medical need.
We sat down with Dr.Lorraine Muluka, who is a Gynecologist Based in Upper Hill, Landmark Plaza Opposite Nairobi Hospital
What Is Cesarean Section Delivery?
Cesarean section, also known as C-section or cesarean delivery, is the surgical procedure by which one or more babies are delivered through an incision in the mother’s abdomen, often performed because vaginal delivery would put the baby or mother at risk.
Who qualifies for a C-Section?
Ideally, if your temperature is too high you need to go for CS it could either be a function of a maternal indication or something to do with the baby.
So, usually, if you are in labor some of the things that are looked for is how well are progressive in terms of delivering because you expect that you should be able to dilate from a cervix that is completely closed to 10 cm, and there is no timeline we base this against.
Again, if a mother is not dilating as it should be and she ends up having what we call prolonged labor then we may decide that she needs to go for CS.
There are other times during the process of labor you find that the baby is not responding well to labor because it is indeed a labor process and stressful process for the baby.
So, if the baby’s heartbeat is maybe not in the right range or there are other features of the heartbeat are indicating that this baby may be in what we call distress then you find that the mother may send to the CS.
Things like bleeding in the course of the labor process and sometimes may even precede labor so you end up having a lot of bleeding then someone may then opt to take the lady for CS.
Which are the Medical Indications that one needs a CS
The indications are several some of them range from the antenatal period if a baby maybe is too small and you think the baby will not able to tolerate labor
If the mother has other complications associated with the pregnancy then you may find that some of these deliveries end up occurring in CS but by and large, women need to be educated on the possibility of these things occurring, and if the event occurs that this CS is a mode of delivery.
What are the risks associated with CS Delivery?
A serious C-section is a majors surgery and surgeries do not come without risks these are risks that we do talk to the ladies about because things such as bleeding which may require blood transfusion is a risk it may end up having infections this is at the time the wound when it is healing so the risk is high when you are having a c-section
You can also end up having different complications from having clots in the legs to having an injury to organs so it’s not something to be taken lightly and ladies must understand that even as they are choosing to opt for CS as a mode of delivery.
Despite the increasing numbers in Kenya, it has not been all rosy for women who give birth through CS as they have been shamed and viewed as less of a mother as compared to those who gave birth through vaginal birth delivery
So this perception is probably based on the fact that when you go in for a CS then at that point you have given what we call anesthesia which numbs your body, most of the time it is the spinal one whereby you are not experiencing any pain from your abdomen downwards and sometimes it’s a general one where you are sleeping but after that procedure, there are different levels of pain that women would experience during the healing process and the same with virginal delivery, there are women who experience extreme pain during the process of delivery and there are those who experience silent labor pains
Why are more women opting for CS as compared to vaginal delivery
I think there is something ladies say nowadays you don’t need to be a martyr to be a mother and they believe going through the labor process may then have these excruciating pain that they are not willing to experience.
There is also the fact that there are also ladies who have gone through the labor and prefer C-sections so there are those who are for the school of thought that I don’t want to go through any of that and I just want a simpler delivery plan so they opt to go for the c section.
There have been speculations that some doctors are recommending CS where it is not required just for them to make money
Well there have been several talks about that with full questioning of some of the indications women underwent through C-Section but that is very difficult to speak of unless an audit is done
The truth is there are indications for mothers who go for CS but if you are not prepared in advance then at the point in then you are told you need to go for a c section, you may feel it was uncalled for and you may be you would have been able to deliver through the virgina.
So it’s a space that is difficult to tell whether there is that contributing factor but definitely what I can say is that over the last decade we can say that the number of cs deliveries has exponentially increased in our country.
Here is the link to the full interview With Dr. Muluka and Women who delivered through CS