There is a lot of misunderstanding surrounding Caesarian section (C-section) deliveries. To shed
some light on the matter, we spoke to Dr Tony Tan, Obstetrician and Gynaecologist, Tony Tan Women and Fetal Clinic and Medical Director, Alvernia Obstetric Screening Centre.
WHEN IS A C-SECTION RECOMMENDED?
A C-section is a surgical operation where the baby or babies are delivered via an abdominal surgery. When the perceived risks of a C-section are less than the perceived risks of a vaginal delivery, a C-section is recommended.
SHOULD A C-SECTION EVER BE ‘A CHOICE’?
Dr Tan actively discourages elective or medically unnecessary C-sections, as they pose risks to the mother, to the baby, and to future pregnancies. He urges all mothers to attempt vaginal delivery so long as it is not deemed dangerous for any medical reason. That said, Dr Tan is empathetic towards nervous first-time mothers. He allays their fears of prolonged pain during labour by offering the option of epidural analgesia. While others fear the need for an emergency C-section after unsuccessfully attempting a vaginal delivery, in fact the figures are low.
Conversion to a C-Section After Attempting Vaginal Delivery
|First||Approx. 20 percent|
|Second and Subsequent||Approx. 4 percent|
In addition, some expecting mothers fear damage to the foetus during labour. However, such complications are rare, according to Dr Tan.
Increased Risks Associated with a C-Section vs. Vaginal Delivery
|For the Mother||For the Baby (especially if delivered before 39 weeks)||For the Next Pregnancy|
|• accreta, or abnormal adhesion of the placenta to the scar, with an associated risk of bleeding and infection during or after delivery
• difficulties with breastfeeding
• post-natal depression, often linked to failed attempts at breastfeeding
|• transient disorders|
• longer-term respiratory disorders
|• uterine rupture|
Dr Tan believes that when parents are fully informed, few would knowingly choose a C-section. However, if parents remained insistent on a C-section after the pros and cons had been discussed and fully understood, Dr Tan would respect their wishes.
WHAT IS THE REAL ‘COST’ OF A C-SECTION?
Dr Tan explained the increased risks posed by a C-section compared to a vaginal delivery.
Clearly, a C-section should be viewed as a medical necessity, not a personal choice. When it is needed, it can be a lifesaver. When it is not, it can be a source of unnecessary risks.
Article contributed by Dr Tony Tan, an accredited doctor of Mount Alvernia Hospital.
Tony Tan Women and Fetal Clinic & PLL Anaesthesia Clinic
Medical Centre D #07-66
Tel: 6972 4497 / 6972 4498
Alvernia Obstetric Screening Centre
Medical Centre D #05-51/52