Sunday 22 May 2011

Normal delivery or caesarean section?

Obstetricians have always been taught that normal delivery was best, unless there was an indication for a caesarean section. It was assumed that every pregnant woman would want to have a normal delivery. But is normal delivery really better? The caesarean section rates have always been on the rise and now account for about 1 in 3-4 deliveries. I would say that after 25+ years of practising obstetrics, it would appear to me that a caesarean section delivery has a lot more going for it than a normal delivery. I will probably be shot down by many fellow obstetricians for this statement. However I have seen way more complications arising from a normal delivery than caesarean sections. Many pregnant women are unaware that a normal delivery has a higher risk to the baby ( this is only logical since a baby would be more prone to foetal distress having to traverse the female pelvis in its passage to this world, and a long labour may leave both mother and baby exhausted and more prone to potential hazards ). One would argue that recovery is faster with a normal delivery. This may not necessarily be true for a long labour or one with multiple vaginal tears.

Pregnant women now want to be more involved in decision making with regard to mode of delivery and this is a good thing so that a proper informed decision can be made. The obstetricians role is now more of a facilitator and educator in the antenatal care and delivery of the baby. Having weighed the pros and cons joint decisions are made, sometimes even with the input of of various family members.

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