One of the oft repeated questions that would-be moms in my ante-natal programs ask is: What is the chance of my having a Caesarean Section (C- Section), and will I be able to deal with it?

While this is not an easy question to answer, research, clinical studies and reported rates of C-sections in hospitals across many countries show that the most common reasons for Caesareans are:

1. Failure of labor to progress, due to improper positioning of the baby’s head, as a result of which the baby’s head appears too large to pass through the pelvis
2. Breech positioning of the baby, i.e., when the baby is positioned to come out feet, knees or buttocks first.
3. Fetal distress picked up by electronic fetal monitoring.
4. Amniotic fluid tinged with meconium (the baby’s first stools), when the bag of waters is ruptured. Under these circumstances, some obstetricians may also choose to speed up labor by using a drug called Pitocin first, and then opt for C-Section, if the labor still does not progress satisfactorily.
5. Maternal diseases such as active herpes, severe hypertension or kidney disease.

Sometimes, C- Sections are planned to avoid the pain of labor, or because they can be conveniently scheduled. While one cannot avoid C-sections done in medically necessary situations, it is important for would-be moms to know that a Caesarean is a major surgical operation. It takes at least six weeks to recover and involves cutting through abdominal muscles that tend to bulge and sag afterwards. When these muscles are then not properly strengthened after recovery, it is likely that the woman may suffer from backache at a later stage.

In the US, the most usual reason for a Caesarean is diagnosis of prolonged labor. However, many studies have found that a long labor does not necessarily mean that there is anything wrong. In fact, when women in long labors were cared for by family members and labor support persons, and when they managed contractions throughout labor with breathing, massages, and were well hydrated, they were likely to have a normal birthing experience. If everyone is patient and has confidence in the mother and her body’s ability to give birth, the mother is more likely to deliver normally, with better outcomes for both herself and her baby.

What can you do? Wellness and birthing programs such as Healthy Mother^TM are a good option to enroll in. Remain active throughout your pregnancy. Follow the exercise programs and practice the positions that are recommended and taught to you in your childbirth education program. Some of these exercises and positions, actually assist in helping the baby settle into your pelvis and moving the baby down the birth canal, once your labor starts. This in turn, facilitates labor and reduces your pain perception. Along with the breathing and relaxation techniques that you have learnt, you are then able to handle the labor pain with more confidence and ease.

Learn as much as possible about what birth is like in the hospital or health care facility that you have chosen. Pregnancy wellness and childbirth education programs such as Healthy Mother^TM, provide you information about various aspects of medical interventions during labor including Caesareans, and engage you in conversations about pain relief in labor. They empower you to talk to your obstetrician about your preferences, and to ask them about the possible advantages and disadvantages of any recommended medical procedures, including Caesareans. Let your obstetrician know, that if a Caesarean does become medically necessary, you would still like to be involved in the decisions regarding your care, as much as possible. Understand that even with the best planning and care, labor and birth do not always go as expected. Under these circumstances, a healthy baby and healthy mother become the most important outcome. Once you are mentally prepared, you will perhaps feel more in control of the circumstances surrounding the birth of your baby, and be able to celebrate the most important event in your life.

As usual, please send in your comments, questions or experiences.

Dr. Vijaya Krishnan