Understanding C-Sections: A Necessary Overview

A C-section involves delivering a baby through incisions in the abdomen and uterus. Dr. Anuradha Panda, Senior Consultant Obstetrician and Gynaecologist, explains:

A C-section is a surgical procedure where the baby is delivered through incisions made in the abdomen and uterus. We usually classify them as either elective, where the surgery is scheduled in advance, or emergency, when we need to act quickly due to complications during labor.
Dr. Anuradha Panda, Senior Consultant Obstetrician and Gynaecologist

Elective C-Sections: Planning for Delivery

Elective C-sections, also known as planned C-sections [1][2], are scheduled in advance for specific medical or obstetric reasons [3].Common reasons include:

• Malpresentation: Such as a breech or transverse baby.
• Twin pregnancies.
• Placental Conditions: Like placenta previa.
• Fetal Growth Restriction.
• Maternal Health Issues: Such as heart disease or severe preeclampsia.
• Previous Caesarean: Women with a history of lower segment caesarean section (LSCS) may opt for a repeat procedure, depending on the condition of the uterine scar.

Increasingly, maternal request plays a role in the decision to have an elective C-section. Dr.Panda notes:

More and more women are asking for planned C-sections, frequently enough due to fear of labour pain or the desire to plan the date. But I always ensure they understand that this is still major surgery.The pros and cons need to be discussed thoroughly before going under the knife.
Dr. Anuradha Panda, Senior Consultant Obstetrician and Gynaecologist

Emergency C-Sections: When Time is of the Essence

Emergency C-sections are performed when unexpected complications arise during labor. These situations require immediate action to protect the health of both the mother and the baby.

Common triggers for emergency C-sections include:

• Fetal Distress: Detected through the baby’s heart rate.
• Labor that Isn’t Progressing.
• Placental Abruption.
• Cord Prolapse.
• Uterine Rupture: Particularly in women with a prior uterine scar.

In these critical moments, the priority is clear:

as obstetricians, we sometimes have to make snap decisions in the labour room. There isn’t time for debate. We act to protect lives.
Dr.Anuradha Panda, senior consultant Obstetrician and Gynaecologist

Challenging Common misconceptions

Several myths surround caesarean delivery, and it’s important to address them with accurate data.

Myth 1: A C-section is an easier option than vaginal birth.

Reality: While it allows for planning, it is still major surgery with a potentially slow recovery. Dr. Panda clarifies:

One big misconception is that a C-section is an easier option than vaginal birth. Yes,it allows for planning and avoids the uncertainties of labour—but it’s still a major operation. Recovery can be slow, and mothers need time to heal, manage pain, and care for the incision.
Dr.Anuradha Panda, senior consultant Obstetrician and gynaecologist

Myth 2: C-sections are safer for babies.

Reality: While life-saving in emergencies, vaginal delivery remains the gold standard for healthy pregnancies with no complications.It carries fewer risks and ensures quicker recovery for the mother.Dr. Panda emphasizes:

They are certainly life-saving in many emergency cases. But for healthy pregnancies with no complications, vaginal delivery remains the gold standard.It carries fewer risks overall and ensures quicker recovery for the mother.
Dr. Anuradha Panda, Senior Consultant Obstetrician and Gynaecologist

Future Pregnancies After a C-Section

A previous C-section can influence future pregnancies. The uterine scar can led to complications such as placenta previa. Although rare, uterine rupture is a risk if the scar is not strong enough.

Careful management of subsequent pregnancies is essential.Vaginal birth after caesarean (VBAC) is an option for some women, but it is indeed not suitable for everyone. Dr. Panda advises:

VBAC—vaginal birth after caesarean—is an option in selected cases. But it’s not suitable for everyone. We assess the risks and counsel the mother accordingly.
Dr. Anuradha Panda, Senior Consultant Obstetrician and Gynaecologist

The Rising Trend of C-Sections

C-section rates have increased, particularly in private hospitals. Dr. Panda notes:

Between 2016 and 2021, we saw the national average go from 17.2% to 21.5%, and in urban private sectors, nearly one in two deliveries is now by caesarean.
Dr. Anuradha Panda, Senior Consultant Obstetrician and Gynaecologist

This trend is attributed to factors such as older maternal age, IVF pregnancies, increased referrals of high-risk cases, and more cautious medical practices.Additionally, more educated women are actively involved in the decision-making process.

Making an Informed Choice

Ultimately, the decision of how to give birth should be an informed one, made in consultation with medical professionals. Dr. Panda believes:

Every woman, every pregnancy is diffrent. Fear of labour pain should not be the reason to avoid vaginal delivery—especially when epidural analgesia is available.
Dr. Anuradha Panda, Senior Consultant Obstetrician and Gynaecologist

Open interaction between patients and doctors is crucial. Women should ask questions, share concerns, and actively participate in the planning process. dr. panda concludes:

Women should ask questions, share concerns, and be involved in the planning. C-section isn’t something to fear,but it also shouldn’t be chosen lightly.
Dr.anuradha Panda, Senior Consultant Obstetrician and Gynaecologist

Childbirth is a deeply personal and complex experience. with the right information and guidance, women can make empowered choices that prioritize thier health and the health of their baby.