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Cesearean birth : what are the risks and benefits

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Pregnancy ends with delivery which can be either vaginal delivery/ assisted vaginal delivery in the form of forceps/ ventouse or a cesearen section. Each type of delivery has its own pros and cons ie risks and benefits. Sometimes for the sake of mother or the baby or because of certain medical conditions you need go for caesarean delivery. These days the technique is such that it is very safe in good hands. Nevertheless since it’s a major operation in which we are opening the abdomen , some complications may arise.

RISKS
Pain : in a vaginal delivery with episiotomy(cut) one has pain in the episiotomy site whereas here one will have pain in the lower part of the tummy. This may sometimes take some while to subside and one may have to pain killers for some time. You are mobile immediately after a vaginal delivery but will have to be in bed for almost 24 hours before you start walking around.

Infection : of wound/womb/catheter induced urinary tract infection: Infection of the stitch line can
occur and present as pain/ redness or discharge from stitch site.in vaginal delivery the site of episiotomy can also get infected. Infection of the uterus may present as foul smelling discharge / fever or heavy bleeding. Since we put in a catheter to drain urine, one may land up with a urine infection rarely.

Bleeding : Bleeding is a bit more in a caesarean section than a vaginal birth. It is almost double in amount but most of it is in the operation theatre and is taken care of by the doctor. Very heavy bleeding is uncommon.

Adhesions : Sometimes there is a tendency of the intestines /urinary bladder to stick to the
operation site and this can lead to pain / difficulty in next operation . Rarely bowel obstruction or tubal adhesion may occur leading to problems in conceiving later.

Serious complications like injury to intestines/ urinary system/requirement for another operation/
excessive bleeding requiring removal of the uterus are very rare.

Risks associated with the type of anaesthesia are also there. Most common is a spinal headache which may occur when anaesthesia is given in the spine.

Sometimes the babies born without start of labour through cesearean may have transient breathing problems.
Having one caesarean there is a risk of having another caesarean although after the first one there are still chances of a vaginal birth(VBAC).

ADVANTAGES

There is a decreased risk of birth injuries or birth asphyxia in the newborn (mental retardation due
to lack of oxygen) . An emergency caesarean is many a times better than a traumatic vaginaldelivery by forces/ ventouse.

Caesarean can save the life of the baby in certain circumstances like breech/ transverse lie and
other abnormal presentations. When the baby passes meconium in early labour or it has fetal distress cesearean remains the only option in order to avoid future serious repercussions/ death of the baby.

In cases where the baby gets stuck in the pelvis in a labouring patient sometimes the uterus gets ruptured and this leads to loss of the baby within minutes and death of the mother if not managed in time by a cesarean.
Less chances of tears/ urinary incontinence/ prolapse/ less sexual dsfunction.In a normal delivery
there are chances of tears in the pelvic muscles which may sometimes extend to the anus. The pelvic muscles may become loose and sometimes ladies may suffer from inadvertent leakage of urine during coughing/ laughing or lifting weights(stress incontinence).

You will not have to bear labour pains in a caesarean. There is less risk of prolapse of uterus after a caesarean and less sexual dysfunction after it.
Although the term caesarean may seem intimidating but thousands are being done safely for maternal/ fetal and medical indications leading to happy mothers and healthy babies!

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