Cesarean Section: A valid delivery route.
One of my patients who was bleeding due to placental location refused a C-section because her mother-in-law said that “anyone that undergoes the procedure is not a woman”. What happened next? We lost the baby and narrowly saved the mother.
Anita had two previous CS scars and was told to come to the hospital at 37-completed weeks for work up. She absconded, only to reappear at 43-weeks bleeding heavily. An Emergency laporotomy was carried out and we found a ruptured uterus. But God was faithful, the baby was alive. (Nothing short of a miracle).
Chinenye was not so lucky. She had 3 previous C-sections, had all female children and was told to prepare for another C-section. Her hubby refused.
He told her that he would get a TBA (traditional birth attendant) who would take the delivery vaginally, as he still wanted her to give him two male children. Labour started, the baby came out but Chinenye bled to death.
Amaka was a first-time mum, and at the 36th week, it was discovered that the baby was too big to pass through her small pelvis. Amaka insisted that she would have her child vaginally and went to church to faith it. There she lost her baby and was rushed to the emergency unit bleeding. She was still taken to the theatre for surgery, because she had cervical lacerations.
I could go on with so many sad stories, but if only these women were brave enough to go under the knife, their stories would have been different.
Cesarean Section is an operation done to deliver one or more potentially viable foetus ( the 28th week is the week of viability in Nigeria), through the abdomen.
The Second King of Rome, Lex Caesarea (762 – 715) forbade the burial of pregnant women until the baby has been cut out. This is believed to be the origin of the name Cesarean section.
A C-section can be elective (planned with a date booked) or an emergency. Reasons for the procedure can be absolute, it can also be divided into maternal and fetal indications.
Absolute Indications
1. Mismatch of baby’s head and mother’s pelvis.
2. Placenta Previa ( when the placenta is the leading part).
3. Foetal distress.
4. Abruptio placenta with baby alive (placenta is detaching or had detached).
Maternal Indications
1. Prolonged labour.
2. Obstructed labour.
3. Severe Pre-eclampsia.
4. Cervical or Vaginal Stenosis.
5. Pelvic Tumour.
6. Classical uterine scar in the previous CS or surgery.
7. Two previous c-sections.
8. Previous c-section whose cause is permanent e.g small/contracted pelvis.
9. Maternal Choice.
Fetal Indications
1. Malpresentation ( when the part of the baby facing the pelvis is the buttocks or foot).
2. Big Baby.
3. Umblical cord prolapse.
4. Multiple pregnancy especially when the first twin is not presenting with head.
5. Gross Pre-maturity or Fetal growth restriction.
6. Bad Obstetrics history ( several miscarriages, no living child or a long delay in achieving pregnancy).
Complications are usually minimal especially when the procedure is done by an experienced hand in a good hospital.
Benefits of a C-section
1. Living Child
2. Living Mum
3. Well Child.
4. No cervical or Vaginal lacerations.
5. Intact Vagina.
Cesarean Section is a valid means of childbirth. It doesn’t make anyone less of a woman, rather it makes you more than a woman, infact a super woman I dare say, because you went under the knife to bring forth another life.
And Yes, I am a Proud C-section Mom.
I am Adaeze Stephen-Emeya (Dr BESA). I am a medical doctor and founder of the Facebook group, Mumming Intentionally group. I am a wife and mother to three lovely daughters.
Thank you.
