C-section delivery advised, when normal birth not possible or safe for mother and child

AKUH,K Signs, Symptoms and Care Programme

“Though normal delivery is the most common way to give birth, caesarean section (C-section) is often advised and performed in certain situations” said Dr Ferha Saeed, Senior Instructor and Consultant Obstetrician and Gynaecologist, Aga Khan University Hospital, Karachi (AKUH,K). She was speaking on ‘Caesarean Section' at a programme of AKUH,K's Signs, Symptoms and Care (SSC) series, held at Aga Khan University (AKU). Dr Saeed explained that this is a surgical delivery through the abdomen, rather than via normal method, using abdominal and uterine incisions. A doctor may suggest a C-section when a normal (vaginal) birth is not possible or safe for the mother or baby.  Such a birth is risky due to a number of reasons, such as a very slowly progressing labour; problems with the umbilical cord or placenta, which deprive the baby of needed oxygen during labour; the foetal heartbeat slows, speeds up, or becomes irregular during labour and  the baby is too big to fit safely through the birth canal.

Most C-sections result from complications arising during labour: however this is now usually a safe procedure, with safe anaesthesia, antibiotics and blood transfusion facilities.

Speaking on ‘Birth after Caesarean', Dr Nadeem Faiyaz Zuberi, Assistant Professor and Consultant Obstetrician and Gynaecologist at AKUH,K, said that women who have had previous caesarean delivery can later give birth in the normal manner: this is referred to as ‘Vaginal Birth after Caesarean (VBAC) Delivery'. Dr Zuberi however cautioned that though this may be a safe option for many women, it is not necessarily the right choice for all women with previous caesarean delivery. An alternate option for women in this category is the ‘Elective Repeat Caesarean Section (ERCS)'.

Latest evidence indicates that VBAC may not be as safe as originally thought, and women should therefore discuss the option of planned VBAC and the alternative of an ERCS with their obstetrician. It is especially important that women should be advised that planned VBAC should be conducted in a suitably staffed and equipped hospital, with available resources for immediate caesarean section and advanced neonatal resuscitation.