Saturday, September 5, 2009

Rising caesarean section rate

Doc,please do something.please,I want a c-section.I can't tolerate labour pains............
your baby's heart rate is going down,you need a c-section.
you haven't progressed well in labour can't deliver vaginally.need to do a c-section.
baby is upside down(Breech) need to do a c-section.
Your baby has passed stool inside the womb.
List is unending for why we end up with a c-section.
WHO recommends a c-section rate of no more than 15%;for an optimal care for both mother and baby.But are we maintaing that rate?I do remember how it used to be a Panic situation at my hospital in UK the moment we crossed 20% of the deliveries as C-section.And it used to be an exhausting exercise for Mr Banfield,our Labour Room in charge to go through all the c-section files.And most often then not, we were able to maintain the c-section rate within 20% despite the fact we were a referral centre with high risk cases.And no,we didn't gave compromised babies in return.
Today ,when I look back,I do feel thankful to all my bosses at NHS,who made me realise that conducting delivery is more of an art than skill.Taught me the nuances of instrumental delivery.Thanks my dear teachers,you have helped me in a big way in maintaing my c section rate still within the WHO approved rate.I know it means spending a little more time with the patient,being little more patient but at the end of a vaginal delivery(be it normal or instrumental)I feel on the top of the world and believe me I thank you all,every time................

A link below which is related and I found it interesting


ananya said...

I believe if all practising obstetricians stay faithful to what they were taught, reducing the C-section rate is not difficult. Perhaps more and more a more commercial and less dedicated approach is also contributing to it.
Natural deliveries are the way nature intended it to be.....c-sections should be done only if there is truly no other way.
One must appreciate it if your obstetrician has made an all out effort to achieve a normal delivery

Jimmy said...

Now a days almost everyone are opting for caesarean section. Some years ago, it has been said that ‘Once a caesarean, always a caesarean’. Later on it was found that Vaginal Birth After Caesarean was proven to be safe and effective. Also all post-caesarean pregnancies do not need repeat CS and most of them could have unfussy vaginal delivery.

Dr Kaushiki Dwivedee said...

Very rightly said Jimmy,infact 60 to 80% of womaen who had a caesarean section can achieve vaginal delivery(VBAC)if the c-section was for a non recurrent reason.yup,after two c-section one should ideally go for a c-section as the evidence is that after 2 sections a scarred uterus might not be able to take the brunt of uterine contractions and pop off.