Gratuitous caesarean sections: why should they not exceed 10% of deliveries

 

Gratuitous caesarean sections: why should they not exceed 10% of deliveries.

Key words: Cesarean section history, C-section risks and benefits, Cesarean section procedure

Almost half of the births in Chile are caesarean sections, simple surgeries, yes, but definitely with side effects. These are the reasons why the WHO (and many others) recommend undergoing this surgery ONLY when necessary.

Did anyone ever believe that we would refer to caesarean sections as a “global epidemic”? One that is considered to have to be stopped. One that has consequences and side effects in the long and short term, and although in some cases the procedure can be crucial, it has been shown that many times it is completely unnecessary.

But why? What is wrong with this surgery that is performed in almost half (48%) of deliveries in Chile?

It may interest you: For more respectful births: the Chilean public hospital that sets the example

Natural and normal childbirth: weren't they synonymous?

If you missed out on the classification of normal birth and natural birth, here we go back briefly to show the differences. In natural childbirth little or no technology is used and drugs are not used either.

“It is every birth that begins, develops and ends spontaneously, where there has been no intervention in between,” Andrea Torres, a midwife at the University of Chile, told El Definido.

Normal or vaginal delivery is not necessarily a natural delivery, but can start spontaneously, or through induction, and end with the expulsion of the fetus through the vagina, explained the midwife.

 

Cesarean section is the surgery in which the fetal extraction is performed abdominally. When carried out for medical reasons, a caesarean section is a surgical surgery that can save both the mother and her unborn child's lives. However, many caesarean sections are performed unnecessarily, which can put the lives and well-being of women and their babies at risk, both in the short and long term.

When cesarean section is unnecessary

Nobody denies that cesarean section is a procedure that helps a lot in some cases. Surgery that saves lives is great when it is necessary, but it also has a lot of negative side effects.

And the problem is that cesarean section rates have been increasing, above the levels that are considered necessary. There has even been talk of a global epidemic of surgery. In fact, if used only when medically recommended, the procedure would not be performed in more than 10-15% of deliveries. But as of right now, everything has changed drastically.

Studies estimate that 21% of births in the world were caesarean sections in 2015, which was almost twice as much as in 2000. In Latin America and the Caribbean, the figures worsen, since surgery was applied in 44% of the cases. And in Chile, 48% of births are performed through cesarean sections, of which 62% occur in the private sector.

In addition, there is evidence that this surgery can carry serious risks in both the short and long term. According to the WHO, there are more chances of requiring blood transfusions, having risks with anesthesia, organ damage, infections and neonatal respiratory distress for the baby, among other short-term complications.

And in the long term, it has been associated with an increased risk of asthma, obesity in children and complications in subsequent pregnancies. Thus generating some problems such as uterine rupture, placenta accreta, placenta previa, ectopic pregnancy, hysterectomy, among others.

Unfortunately, there seems to be an international tendency to intervene in births, which is seen especially in an excess of medications, as explained in La Tercera.

Contrary to the global recommendations of the WHO, a woman who is about to give birth is typically seen as a sick person who requires a lot of technology.

an instinctive act

As Andrea told us, in normal situations, with a healthy pregnancy, the most normal thing is to give birth without help or intervention.

The act of giving birth is quite instinctive and involuntary. Absolutely, a woman is made to give birth. Women behave during childbirth precisely like any non-human mammal, the midwife said. We as a society are continually told that childbirth is an emergency circumstance even when it is not.

It is a natural and everyday situation that does not necessarily require interventions. Of course, sometimes there is no choice, and many have no choice but to undergo surgery. First of all, the priority must be that everyone comes out healthy. But if surgery is not necessary, it should be avoided.

An atomic bomb of oxytocin

And although the type of delivery is important, the entire process is essential for those involved, as well as the one that originates after childbirth, indicated the midwife.

Hormones are released, and their only function is to make the mother fall head over heels for her child. Oxytocin is a major hormone that triggers spontaneous delivery. a hormone that is present whenever we experience romantic encounters.

Formerly it was thought that it only influenced contractions and the release of milk, but as Andrea says, the great purpose is to generate the bond.

The hour after delivery is especially important. Torres exemplifies this by saying that if kissing is like fireworks of oxytocin, childbirth is an atomic bomb of the hormone.

More than a medical procedure

From the WHO they also emphasize the importance of the process in general and how, in part, it has been left aside.

While much is known about the clinical care of labor, less focus is placed on what else needs to be done to ensure that women have a good, safe, and fulfilling experience. The physiological process of childbirth is becoming more medicalized as we gain understanding on how to initiate, quicken, complete, regulate, or oversee the process.

It is now recognized that this strategy can compromise a woman's capacity to give birth and may adversely impact her experience of what ordinarily would be a happy, life-changing event.

And for midwife Andrea Torres, this experience is extremely important, regardless of the type of delivery.

The procedure is without a doubt the most crucial factor, as a woman may give birth vaginally or naturally but yet have a very negative memory of the experience. Possibly because she thought her rights had been infringed or her requests had not been honored. What exactly do I mean by that? That a woman can have a caesarean section that may have been highly warranted, extremely essential, well informed, and have a wonderful birth experience vs a vaginal delivery with a really awful experience that will mark her for life.

Pain is not the same as suffering

Not because the natural way can be painful, it means that it should be avoided at all costs. For Torres, pain has a role, and it is a signal sent by the body of what is being experienced.

“Natural childbirth is painful; it would be a lie to say that it doesn't hurt. It is intense, but that is not synonymous with suffering, and that is the key. It is not a permanent pain either, it is not a pain that is telling you that there is damage. It is a pain that rather tells you that something very cool is happening in your body, it is power, it is not suffering. The woman's body is prepared for that intensity, ”she emphasized.

Every experience is unique

It is always important to find out what you are going to experience and find the healthiest way to face this unique event. From the WHO they deliver recommendations, such as going to training workshops, relaxation training programs and different mechanisms to have support and reduce unnecessary caesarean sections.

In the end, the main thing is that everyone comes out healthy. Each childbirth is different, each experience unique and processes that vary greatly are experienced. But you have to know the options and not get carried away at such an important moment just by an opinion that may be wrong.