C-Section brings many complications, says Dr Saloni Gupta, OB-GYN, Abhishek Hospital

Dr. Saloni Gupta is known for facilitating normal deliveries unless surgical intervention becomes mandatory to save lives. She strongly supports the global communication campaign of Devdiscourse - Mother, Not Patent! launched on October 15, 2019 aimed at minimizing sufferings of pregnant women and increasing happiness in their lives. She did her post-graduate from All India Institute of Medical Sciences (AIIMS), New Delhi and is a leading obstetrician-gynecologist in India.

I’m feeling highly blessed to be a part of this global communication campaign. I would like to thank the entire family of Bhagat Phool Singh Women University for allowing me to be a part of this campaign and awareness program that is the outcome of the rising rate of cesarean cases, a big global concern.

The concept of Devdiscourse’s campaign “Mother, Not Patient!” or in other words, labelling the expecting mothers not as patients, is very commendable. Even I believe the same and I think an expectant mother is not a patient. Rather it (pregnancy) is a state of the body and mind that prepares a woman for her next and valuable step in her life. That is motherhood. And for this, she requires tender loving care right from the beginning when she announces she is expecting a child.

The onus of welcoming the newborn to the world also lies on the obstetrician and gynecologist. The onus is also on expecting mothers who tolerate labor pain. The tolerance of expecting mothers is going low day by day and they are not ready to comply with the long delivery process. These days, a pregnant woman at the matured stage thinks the cesarean process is the safer option for her. And to some extent, the healthcare professionals are also responsible as, in many cases, the young budding obstetricians are not properly trained to handle the long delivery process. Instead, they have more expertise in cesarean delivery. This is another major reason for the rapid rise in cesarean delivery almost everywhere.

Moreover, today we all see the indications for which cesarean section are performed are mainly subjective than objective. WHO has rightly recommended the cesarean has to be between 10 to 15 percent but according to a Lancet article, the areas like Latin America and the Caribbean have already crossed the limit and rose to 44 to 45 percent. In the US, it is around 32 percent whereas in the UK it is around 26 percent. In South Asia, it is still lagging around 17 percent but the rate is rising very fast. In few areas of the African region like Central and South Africa, the rates are less than 4 percent but the healthcare facilities are not appropriate and maternal mortality is very high in this region and patients are still in need of right healthcare facilities.

Talking about India in particular, the rate is 17 percent. The southern part of India has more inclination towards the cesarean delivery than the northern parts. Telangana alone contributes more than 50 percent. In northern parts, the J&K and Punjab are the least.

So, why are we concerned about the rising rate of cesarean section? If both the mother and baby are fine with the surgical process, then why should we be concerned? Cesarean section is not just a surgery – open and close. In this case, the mother really becomes the patient. She is open to lots of complications like temporary and permanent. Permanent complications may last longer if it is not performed by the appropriate persons. Once the delivery is done by surgical method, the patient is open to next cesarean. Chances of rupture in the uterus increases, chances of hysterectomy increases including more other complications. The complications are not limited. The chances of neo-natal and maternal morbidity, the psychological and social well beings of both the mother and newborn are still not clear.

Does this mean there should be no cesarean delivery and only vaginal delivery should be continued? No, that’s not the case. If the cesarean section is performed for the medically indicated reasons, then it is savior for both the mother and newborn.

To conclude, I think, we should not strive for achieving a particular cesarean rate in any settings set by the WHO. The decision should be taken by the healthcare professions in a wiser manner. If a cesarean is done for medically indicative reasons, that would definitely reduce the maternal and neonatal mortality.

Note: Dr. Saloni Gupta is a life member of the Indian Infertility Society. She has been a gold medalist in MBBS and completed MD from India's prestigious Indian Institute of Medical Sciences (AIIMS), New Delhi. She is also a laparoscopy and infertility socialist at Kolkata's Institute of Reproductive Medicine and Delhi's Sir Ganga Ram Hospital.

Visit Live Discourse for more news, views, and interviews on the global communication campaign - Mother, Not Patient!. Please click to sign the pledge and know more about the campaign. 

(Disclaimer: The opinions expressed are the personal views of the author. The facts and opinions appearing in the article do not reflect the views of Devdiscourse and Devdiscourse does not claim any responsibility for the same.)

Also Read: I was prepared for C-section but taken for normal delivery: Prof. Ipshita Bansal