The decision of how to give birth should not be taken lightly, nor is it something that should be influenced by a trend.
Medical advisor Arturo Cardona Ospina, OB-GYN and maternal-fetal medicine specialist
It is a big decision. The choice of how to give birth depends on each person’s situation and on an analysis of conditions; it is one that is reached after discussing with family members and doctors, after becoming well-informed and after receiving the results of tests taken during the pregnancy. More importantly, it is a decision that should be made with conviction to identify what is best for mother and child.
According to a statement by the World Health Organization (WHO) issued in 2015 on C-section rates, these procedures are effective for saving the lives of mothers and infants only when medically necessary. “For 30 years, healthcare professionals from around the world consider that the ideal rate for Caesarean sections should be between 10-15%”. Despite this, as the WHO registers, C-sections are becoming more common in both developed and developing countries.
In the opinion of OB-GYN and maternal-fetal specialist Arturo Cardona Ospina, the ideal situation is to deliver vaginally. But Cardona believes that a lot of education is needed for people to understand the benefits and risks of different types of deliveries: “When patients must make a decision as patients and doctors together we can base them on what is best for their situation”.
In this vein, receiving proper prenatal care is critical. “When a woman who has been informed during her pregnancy of the two forms of delivery comes to a medical facility to have her baby, it’s not the same as when she decides based on what she heard or read on the internet,” explains Dr. Cardona, medical advisor to the WHO/PAHO on perinatal morbidity and mortality.
Other issues to consider
As the OB-GYN states, infants that come into this world with a vaginal delivery experience less respiratory and infectious diseases as well as brain bleeding disorders. This occurs because during the delivery process, the baby is in contact with bacteria that is normally present in the birth canal for a significant amount of time, and, “When the baby is exposed to these substances, their immune system produces others that help protect them and are greatly beneficial during their first months of life”.
Also with this type of delivery, the patient is less likely to hemorrhage after birth, “The patient recovers faster. Some studies have even shown that breastfeeding is easier, as babies born vaginally latch better”.
Fitting the need
Certain conditions of the fetus also determine whether a C-section will be performed: if the head is up and buttocks are down (referred to as a breach presentation); if an ultrasound determines the fetus has an approximate weight of over 4,000 grams; and if there are any fetal growths conditions. Of course, “Not all babies that do not grow enough or are underweight are delivered with a C-section. It is important to understand that when a baby is underweight, their doppler echocardiography will influence whether a C-section or vaginal birth will be performed,” the specialist indicates.
When the patient has already had two C-sections, a third birth will also have to be performed this way. “There are other types of conditions in this field that also require C-sections, such as having twins”.
When the decision is made to have a C-section, there is the added benefit that it eliminates the risk of certain injuries to the vaginal canal, which are unlikely in natural births if they take place at an adequate medical center in a correct manner,” the specialist specifies. There is also the benefit where the mother does not have to endure several hours of labor.
Unforeseen events may also cause plans to change and what was originally anticipated to be a natural birth may turn into a Caesarean. During labor, the condition of the fetus may become unstable or a placental abruption may occur (when the placenta detaches from the womb), requiring the physician to do a surgical procedure. Another possibility is for the birth to not progress and the patient may have to undergo surgery, referred to as an emergency C-section.
“C-sections happen in specific situations. But something that is happening is when people have more financial resources, they are quick to ask for a C-section because they believe that that it will be better. But this must be thoroughly analyzed”.
One of the risks of a C-section is infection at the incision. Dr. Cardona insists that certain ideas about C-sections need to be dismantled such them being better for diabetic patients or for patients with high blood pressure or heart disease. “The more diseases or risk factors a patient has, the better it is to have a vaginal birth. A C-section is also a condition we are adding to the patient; it is an added wound. And so the patient has to expend their immune system, their ability to coagulate and scar, and their energy as well, on a wound that we are creating”.
As the doctor affirms, reclaiming the vaginal delivery is a global trend and there is a need to provide education on it to the public. When it comes to making a decision, make a conscious one, keeping the health of mothers and babies in mind.
10%to 15% is the ideal rate that C-sections should be performed in the world, according to the WHO.