6 C-Section myths and misconceptions

By Dr. Aruna Muralidhar

Caesarean section is the most common surgery performed in the world. About 25% of babies are delivered by caesarean section in general. Planned caesarean section is performed in certain cases where vaginal delivery is likely to cause more harm to either the mother or baby. Caesarean sections done on an emergency basis are usually for complications that are an immediate danger to the mother or baby such as bleeding, scar rupture or prolapse of the cord etc.

Also, an emergency CS may be deemed necessary in situations where the baby is distressed or tired during labour or if the
progress of labour is not satisfactory. Caesarean section, no doubt, is a life-saving procedure in many clinical situations. However, there are many myths associated with this surgery.

Myth 1: Caesarean section is a minor surgery

Despite having the reputation of being the world’s most common surgery, it is certainly not a minor surgery. It is a major abdominal surgery requiring to enter the abdomen and the uterus in order to deliver the baby. Any surgery, no matter how routine, has risks involved to the mother and in this case to the baby as well. Vaginal delivery, on the other hand, is a much safer procedure.

Myth 2: Caesarean delivery is associated with a delayed recovery

Although caesarean section has a slightly longer duration of recovery of 4-6 weeks, unlike in the past, enhanced recovery is now possible and women are usually mobile within 6-12 hours of surgery. Adequate pain relief, early oral intake and early ambulation can help the new mother recover faster.

Myth 3: The doctors decide which way to deliver well in advance during antenatal care

Especially with respect to first-time pregnant women, obstetricians do not decide the mode of delivery in advance. In almost all cases, we would encourage a normal vaginal delivery. However, in certain situations, close to the due date, we may have to discuss the option of caesarean delivery for the safety of the mother or baby. These situations include a breech presentation (bottom down, head up position) or placenta praevia (low lying placenta obstructing the birth canal increasing the risk of heavy bleeding). A single loop of cord round the neck per se is not an indication for caesarean delivery.

Myth 4: Spinal or epidural anaesthesia causes back ache

This is a common myth. For a caesarean section, the best anaesthesia is a regional one. Here, only the torso and lower limbs are anaesthetised instead of putting the woman to sleep as in the case of general anaesthesia. For this, a very thin spinal needle is inserted in the back, into a fluid surrounding the spinal cord to inject the anaesthetic drug. It is a quick, safe and effective procedure for providing anaesthesia and pain relief during and after this major surgery. The effect lasts for 4
hours. Long term back pain is certainly not due to this procedure. The more common reasons for back pain in new mothers are poor back muscle tone and core strength, loosening of the abdominal muscles, ligamental loosening due to the pregnancy hormones compounded by back strain and poor posture during breastfeeding and baby care. Bending the back whilst changing nappies, slouching on bed during breastfeeding contribute to long term back issues.

Myth 5: Once a caesarean section, always a caesarean section

No. Caesarean delivery involves cutting of the muscular uterine wall to deliver the baby. This cut takes about 18-24 months to build up strength. Hence, we emphasise on a two-year interpregnancy interval after a caesarean delivery. Following this interval, in an otherwise normal pregnancy, a vaginal delivery can be attempted and may be successful in certain selected cases. The labour and delivery however, have to be monitored carefully throughout.

Myth 6: Skin-to-skin contact is not possible

It is certainly possible. Following delivery, the baby is dried on the mother’s tummy. The umbilical cord is cut after 1-3 minutes if the baby is active and crying. Thereafter, the mother can have skin-to-skin contact (SSC) if the baby doctor has no concerns with the baby. However, in certain situations like when the delivery is an emergency or if the baby is not crying very well, the baby may need immediate care and hence SSC may not be possible. Having a baby is a wonderful event of one’s life. Caesarean section in many situations comes in handy as a lifesaving procedure. It is important to get the right guidance about the type of delivery and tips for a better and faster recovery after a caesarean section.

(The author is a Senior Consultant Obstetrician and Gynaecologist, Fortis Hospital, Richmond Road, Bangalore. The article is for informational purposes only. Please consult medical experts and health professionals before starting any therapy, medication and/or remedy. Views expressed are personal and do not reflect the official position or policy of the FinancialExpress.com.)