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Health News of Wednesday, 6 April 2016


The Caesarean Section: To have or not to have?

Agyeeeeiiiii, Agyeeeiiiii, eeeeeeei eeeeeeiii eeeeeeiii, mmmmmmmmmmmhhh, mmmmmmh!

Then silence, after about 10 mins the pain recurred.

These were the cries from Maame Shikpenkpe on the eve of the 6th March 2014. She had been in labour for over a day.

When she was 36 weeks pregnant (almost 9 months), her midwife and doctor had suggested that she has a planned caesarean section (C/S) because her baby was very big and was coming with his buttocks (breech). The C/S would help prevent harm to her baby and herself during the delivery.

She was, however, scared by the mere thought of having an operation. Her response to her doctor was, “I am a child of God, and I will deliver like a Hebrew woman (the vaginal/natural way)”. As a result, she decided not to even attend the antenatal clinic anymore but to show up in labour, deliver naturally and surprise everyone.

There she was in labour. Midwives did another vaginal exam to check the opening of her womb to see if the baby could come out. After so many hours she remained at 8cm and not reaching the 10cm that is required for the baby to be delivered

The midwife checked the baby's heartbeat, only to realize that the heartbeat has become abnormal.

Her doctor was called in to repeat the examination and take a decision.

The doctor concluded that she needed to have an emergency CS to deliver her baby else baby could die or have brain damage.

He counselled her further but she still refused to have the CS. She spoke with her mother, husband and “prophet” who after a word of prayer, advised her against surgery as that was not the will of God for her life and that God would intervene.

Another hour down the line, baby's heartbeat had become very faint and mother was getting weaker. Husband finally convinced her to have the CS.

The doctor quickly mobilized his team and performed the CS for her. The baby was finally delivered, but came out looking bluish and could not cry.

Resuscitation was started immediately and baby admitted to the neonatal intensive care unit (NICU). Baby remained on admission at the hospital’s neonatal intensive care unit (NICU) for about 2 weeks before he started sucking breastmilk himself and started crying.

The child turned 2 years on the 6th of March 2016, but he is unable to sit, walk or talk.

The same “prophet” now says it is her in-laws who are bewitching the child.

Let’s now take a look at Caesarean Sections.
The myths:

'It is an artificial mode of delivery'.

'You are not a strong woman once you do not achieve vaginal delivery'.

'You will not be well enough to take care of your baby afterwards'.

'Surgery is the work of the devil'.

'Doctors give you medication during pregnancy so that the baby becomes very big so that you cannot deliver vaginally'.

Caesarean section defined:

It is a mode of delivery in which the baby is delivered through an opening made in the abdomen and the womb. Every pregnancy will end in delivery either through vaginal (natural route) or caesarean section (surgical means).

Having a Caesarean Section does not mean that the woman is weak or a failure. It takes a strong woman to carry a pregnancy and reach the stage of delivery. Any baby is blessed to be delivered by either mean.

Sometimes, the CS is the only means to guarantee that the baby will be born healthy and not blue.

The CS may be elective (planned) or done as an emergency.

Some reasons why a Caesarean Section may be recommended to you:

When the pregnant woman is carrying two or more babies.

When the mother is bleeding prior to delivery of the baby

When artificial means of inducing labour has failed.

When mother has severe medical complication during the pregnancy, such as hypertension, diabetes, heart disease, etc

When a mother has had major surgery on the womb such as for the removal of a fibroid.

When the mother has had two previous Caesarean sections.

Fetal complications such as;

- when the baby is a very small baby or very big.

- when baby has difficulty breathing in the womb (foetal distress).

- when the baby is breech( the baby is coming with the buttocks)

There may, however, be other reasons for which your doctor may recommend a CS for your delivery.

Implications of refusing or delaying an emergency Caesarean Section:

The baby could be born blue (asphyxiated) and develop subsequent brain damage of varying severity which may be irreversible.

A very big baby could also be born with birth injuries like fractures and nerve injury.

Depending on the reason for the surgery, the mother may even lose her life.

Care of the mother post surgery:

The mother may be in the hospital for some days before going home whilst receiving treatment.

She will be given medications to reduce the pain from the surgery.
Once she gets better and the doctor certifies that she is fit to go home, she is discharged home.

At home, she continues the pain relief and antibiotics for a few more days.
She should not lift very heavy loads for a few weeks after the delivery.
She is, however, fit to do some chores at home and take care of her baby.

Caesarean Section and breastfeeding:

Breastmilk may not flow immediately after the delivery. This may also happen even in mothers who have had the vaginal delivery.

Sucking at the breast by the baby helps to establish breastfeeding.
In Conclusion, the Caesarean section is an acceptable way of delivering a baby which may be the only way to save the baby from brain damage, physical injury or even death.

Women should therefore not refuse or delay the decision to have a CS delivery when it is recommended.