FEATURES, VIEWS, ANALYSIS - Caesarian Section

Sanjoy's views on the rising trend of cesarean delivery -Indian scenario
My opinion about where the doctors at fault:
1. Many doctors posted as resident doctors in Labour Rooms don’t know how to deliver
normally.
2. More revenue for the institution, so fat salary.
3. Administration of pituitary hormone at wrong time causing fetal distress.
4. Use of prostaglandins for cervical dilatation in inexperienced hands causing more
complication
5. Lack of technical knowledge of staff nurses.
6. Bending down to relatives/ patient’s pressure for CS at an auspicious time.
7. Plan delivery by CS at night when the OT’s are under-utilized.
8. No advice is given before and after pregnancy to the lady on how to strengthen
pelvic-floor muscles and have a normal delivery.
9. Too much extra calories advised to the pregnant lady resulting in CS for large
babies.
10.Worried about court cases.

Fault with the patient

1. obesity
2. lack of effort to do some exercise
3. Cs will be less painful(but in reality other way round)
4. Child will be safe.
5. birth canal will be too laxer(if delivered vaginally)
6. sleeps most of the time to escape work
7. Eats too many tonics and food (advertisements)
8. Associated diabetes and hypertension due to late marriage.
9. wants to have a baby at fixed time
10. Has a very low threshold for pain.
11. A status symbol

How to avoid CS?

1.No doctor in India really tells their patients how to perform exercise and how dangerous it’s to have a child by CS.
2.Like patient education programs ,all newly married ladies , who like to have a child should be asked to perform certain Yogic exercise or physiotherapy
3.The mother in laws should not feed too much to the d in law(old beliefs, ghee and honey)
4. Doctors should be discouraged to go for CS unless otherwise there is danger to the life of the mother. Many times to save the baby the mother dies due to post CS complications.
5.The hospital and NGO authorities should have a weekly review of all CS done in the city.
6.CS and normal delivery should have the same billing.

7.The hospital authority should bear the expense for complication following CS.

8.Australia has implemented no extra pay for Cs(to doctors) after which the CS rate has drastically come down.

9.Public education

10.Punishment for unnecessary CS

But hold your breath; nothing is going to happen for another decade unless our supreme court intervenes. Female feticides continue, abortions are bread and butter of gynecologist and obstetricians. Who cares the poor lady suffers. The women association must take up this very important issue urgently. If you want to know more about unnecessary CS read recent article in BMJ.


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Dr. Sanjoy kumar Satpathy MD (medicine) FCCP, Dip. Yoga, Diabetologist, Malariologist Faculty member of WHO for SARC countries on Malaria