…It’s a matter of cash, monetary gain —Critics
…It’s a matter of exigency, necessity—Health professionals
Yesterday, the report focused on the attendant risks of both natural birth and delivery through C-Section, according to Dr Olusegun Adebowale and Dr Omadeli Boyo. It concludes today with the implication of having too many surgically aided deliveries and the views of pregnant women on natural birth versus CS based on their experiences.
THE truth is that the weight of the baby is determined right from conception, so it is a misconception when some pregnant women feel they should not eat certain things like soft drinks, cocoa beverage, etc. Once there are no risk factors, we only tell them to be cautious, not that they should not take at all what they want because pregnancy is not a disease.
“That you are diabetic does not mean you should not eat anything sweet but you should only take them in small quantities. I am a member of the British Society of Endocrinology and that is one of the recent trends. For us, we want people to ensure they regularly see their doctors when they are pregnant.
If they have any complaint, even in the middle of the night, they don’t have to wait until the next day, they should call the doctor immediately because an hour could be so crucial, a little delay could be dangerous. If you have been feeling your baby moving very well and suddenly it becomes quiet, get to your doctor immediately for a scan to ensure the baby is okay.
“There is also intrauterine growth restriction/retardation. Some people at a certain gestational age discover that the age of the baby is not corresponding with what they measure and that could be because the baby is not growing very well. What could have been responsible?
Intrauterine growth restriction
That has also increased the rate at which CS is being done because for someone who had been married and lost about five pregnancies and in this sixth one, it is discovered that the baby is not growing very well, of course, you know that if the pregnancy should continue to term, the baby may die, so the doctor may need to deliver via C-section.
“We had a case recently of intrauterine growth restriction and we quickly delivered the baby. At 41weeks, the baby was reading less than 2.5. This woman had been married for over 10 years and had lost about four babies in other hospitals and this was the fifth baby.
Lifestyle changes: “Yes, elderly perigravida. For some, apart from the nutrition, a woman who has tried to conceive over the years and couldn’t and maybe she went through Artificial Reproductive Technique like Invitro fertilization, IVF, and got pregnant, for such women, it is a precious baby at old age and conceived through IVF, such women will even tell you they don’t want to risk anything so, many of them request C-section.”
People’s pain threshold is lower: The doctors agree that many women have low pain threshold, hence, they prefer CS. Said Adebowale: “There is what we call grand multipara. A woman who has had four previous deliveries and is now having the fifth pregnancy is a grand multipara.
They always behave like a primigravida or a first timer because they don’t tolerate the pain very well. We have had a grand multipara here; even when she was 8cm, she was shouting that she wanted C-section but we had to tell her that at that stage, we could not give her C-section.
“You know these days, people don’t tolerate pain again. They watch so much Youtube and they don’t know those things are not true. You put someone inside water and the baby will just come; it is a lie. Another thing which we do is epidural delivery.
You will be in labour and you won’t feel any pain. Once the woman is in, we give the epidural and throughout the labour, she won’t feel any pain. When she is fully dilated, we give her another drug to reduce the pain and she delivers.
In two to three hours after that, she is fine. It is very expensive. For epidural alone, the anaesthesia is N150,000 because it is the consultant anesthesiologist that will give it and even if the labour lasts 10 hours, the consultant will wait.
In Nigeria and all over the world generally, the incidence of C-section varies from hospital to hospital; however, it has increased in recent times. There are even cases of women being forced to have C-sections. One of the few cases of forced C-section on record occurred in 1984, involving a Nigerian woman in Chicago.
Expecting triplets, she was hospitalised for the final stage of her pregnancy, the hospital implored and urged, but the woman and her husband remained steadfast in their unwillingness to consent to medically advised C-section.
As her due date approached, the hospital’s legal counsel went to court and obtained an order granting the hospital administrator temporary custody of the triplets and legal authority to carry out a C-section as soon as the woman went into labour. Unfortunately, the story ended tragically.
Documented risks: Most obstetricians declare that C-section is generally safe, but C-sections can cause significant complications, disability or death, particularly in settings that lack the facilities to conduct safe surgeries or treat potential complications.
There are well-documented risks for the woman and her infant with Caesarean section birth, both in the current pregnancy and in a subsequent pregnancy. Most mothers and babies do well afterwards, but being a major surgery, it carries more risks than a normal vaginal delivery.
Possible risks include infection of the incision or the uterus, heavy blood loss, blood clots in the mother’s legs or lungs, problems from the anaesthesia, and breathing problems in the baby if it was delivered before its due date.
Vanguard INSIGHT gathered that some risks of giving birth are more than doubled by C-sections. If she gets pregnant again, doctors say a woman with a C-section scar has a small risk of the scar tearing open during labour (uterine rupture). She also has a slightly higher risk of a problem with the placenta, such as placenta previa.
Worse still, women that undergo C-sections are less likely to breastfeed, and may be at greater risk for depression and post-traumatic stress. Babies face risks, too: they may be cut, or asphyxiate, experience respiratory distress, and asthma. It is also said that the foetus of a mother who’s already had one C-section could be at increased risk in future pregnancies.
C-section vs natural birth
On the average, a C-section is more expensive than normal vaginal birth. Cost of the procedure could range from around N50,000 in a public hospital to N250, 000 or more in a private hospital, depending on a number of factors.
Proponents of natural birth argue, too, that vaginal birth facilitates quicker, perhaps better, bonding with newborns. They say C-sections are disrupting human evolution and causing feto-pelvic disproportion increase, putting mothers and babies at risk, as women’s pelvises are not growing to keep up with larger babies being born.
Most women go home three to five days after a C-section, but it may take a month or longer to fully recover. By contrast, women who deliver vaginally usually go home in a day or two and are back to their normal activities in one to two weeks.
In the view of Professor Hannah Dahlen, a Professor of Midwifery at Western Sydney University, there is more at play about the increase in C-sections than evolution and processes, where women are potentially going to end up with more obstetric problems.
“There is nothing wrong with the capacity of women to give birth. We know that women who have babies in midwifery care, or at home, or birth centre environment, have over 85-90 per cent normal vaginal birth.”
She added that lifestyle factors like obesity and having childbirth later in life have more significant impact than the evolutionary perspective.