CESAREAN VS VAGINAL DELIVERY

The birth of a child is supernatural spiritual event. – Lailah Gifty Akita,
A miracle is really the only way to describe motherhood and giving birth. – Jennie Flnch

SYNOPSIS

A baby may be delivered by a vaginal or a cesarean delivery. But in a given situation, one procedure may be safer for the mother and the baby than the other procedure.

Advantages of the vaginal delivery are that the mother feels it is natural, the recovery period is shorter and she can breastfeed earlier. Disadvantages are that it is a gruelling event and has a higher risk of urinary incontinence; and that the baby may be injured during delivery.

A cesarean may be required in certain situations such as low-lying placenta or breech baby. Mother has longer recovery period; and risk of excessive blood loss and bowel or bladder injury. Baby may have breathing problem and childhood ashthama and obesity.

A successful. VBAC (vaginal birth after a cesarean) is possible. However, there is a small risk of rupture of the uterus. Therefore, suitable doctor and hospital are required.

INTRODUCTION

Between cesarean and vaginal delivery, choose the one which has the least chance of causing injury or morbidity to the baby and the mother. Both procedures have risks. But in a given situation, risks in one procedure are greater than in the other. Aim is to minimize the risk.

For an informed discussion with the therapist, for choosing the optimum delivery method in a given situation, and for giving an informed consent, the expecting mother and her family need to know the pros and cons of the two methods of delivery.

This paper summarizes the pros and cons of the two methods for the mother and for the baby.

INCIDENCE

According to WHO, maternal and new-born deaths decrease as the cesarean rate rises up to 10-15% of the number of deliveries. Higher cesarean rate does not further reduce maternal or neonatal mortality. We may interpret that to mean that in 10-15% cases cesarean is called for; but in 85% of the cases, that is majority of the cases, vaginal delivery is possible. In a few other studies, the death rate continues to reduce till 19% of caesarean rate.

The average caesarean rate in India is 18%. However among the 20% richest population, the rate is 30%. In the United States caesarean rate is about 32% (2017). Clearly, among the rich, more caesareans are being done than are medically needed: rich women choose caesarean rather than vaginal delivery.

VAGINAL DELIVERY

A Mother finds vaginal delivery a more natural experience, feels she is giving birth the way nature intended her to. The other advantages are:

• a shorter hospital stay (24 – 48 hours) and recovery time compared with a cesarean.
• avoid major surgery and its associated risks, such as severe bleeding, scarring, infections, reactions to anesthesia and longer-lasting pain.
• earlier contact with the new-born, hold her baby and begin breastfeeding sooner after she delivers

The disadvantages for the mother are;

• labor is a physically gruelling process and is hard work.
• a risk that the skin and tissues around the vagina can stretch and tear while the fetus moves through the birth canal. If stretching and tearing is severe, a woman may need stitches or this could cause weakness or injury to pelvic muscles that control her urine and bowel function.
• higher risk of bowel or urinary incontinence; more prone to leak urine when they cough, sneeze or laugh.
• may experience lingering pain in the perineum, the area between her vagina and anus.
• increased risk of:
o anxiety and stress during pregnancy
o sexual problems post-delivery
o increased risk of post partum depression

For the Baby the advantages are:

• muscles involved in birthing may squeeze out fluid in a new-born’s lungs, making breathing problems at birth less likely.
• good bacteria received as the new-born travels through the birth canal may boost its immune systems and protect its intestinal tracts.

For the Baby the disadvantage is that in long labor, or if the new-born is large, it may get injured during the birthing, resulting in a bruised scalp or a fractured collarbone.

CESAREAN

In certain medical situations, vaginal delivery may be too risky. Therefore a cesarean may be planned. Typical risky situations are:

• twins or other multiples
• a very large baby in a mother with a small pelvis
• baby not in a heads-down position and efforts to turn the baby into this position before birth were unsuccessful.
• medical conditions such as diabetes or high blood pressure
• an infection, such as HIV or genital herpes, that she could pass along to her baby during birth
• problems with the placenta during pregnancy

Sometimes an unplanned, or emergency cesarean, may become necessary because the health of the mother, the baby, or both, is in jeopardy. This may happen because of a problem during pregnancy; or after a woman has gone into labor: if labor is happening too slowly or if the baby is not getting enough oxygen (fetal distress).

Sometimes a mother may request for an elective cesarean because she wants to plan her delivery; or because she previously had a complicated vaginal delivery.

In certain situations cesarean is lifesaving. But opening up a woman’s abdomen and removing the baby from her uterus is a major surgery. The risks are:

• often leads to repeat C-sections in future pregnancies,
• longer hospital-stay, two to four days on average.
• longer recovery period, often at least two months; more pain and discomfort in the abdomen as the skin and nerves surrounding the surgical scar need time to heal.
• increased physical complaints such as pain or infection at the site of the incision and longer-lasting soreness.
• increased risk of:
o blood loss and a greater risk of infection, bowel or bladder injury or a blood clot forming during the operation.
o future pregnancy complications, such as placental abnormalities and uterine rupture, which is when the uterus tears along the scar line from a previous cesarean. The risk for placenta problems increases with every cesarean a woman undergoes.
o death during surgery: three time more likely in a cesarean than in a vaginal birth, due mostly to blood clots, infections and complications from anesthesia.
o miscarriage and stillbirth in pregnancy after cesarean.

Baby born by cesarean is at a higher risk of:

• stillbirth
• higher mortality rate than vaginal delivery baby
• more likely to be admitted to the NICU for breathing problems
• higher rate of childhood (up to the age of 12) asthama
• a greater risk of becoming obese as children and as adults (perhaps because women who are obese or have pregnancy-related diabetes are more likely to have a C-section)
• lesser immune system

VBAC

VBAC (vaginal birth after cesarean) is possible under certain conditions. But VBAC is not safe for every woman and can even be life threatening to her. Before attempting a trial of labor after cesarean (TOLAC), remember that the following are contraindications:

• obesity (body mass index 30 or higher; weight over 200 pounds)
• pre-eclampsia (high blood pressure during pregnancy)
• age (usually older than 35)
• previous caesarean was in the last 19 months
• fetus is very large
• the reason for the initial caesarean is recurrent (for example, very small maternal pelvic dimensions). In this case, TOLAC may be dangerous to both mother and baby.
• more than two previous caesareans
• scar is a vertical cut, that is, it goes from top to bottom (high risk it will rupture and harm the baby and the mother and will call for a cesarean)
• additional uterine scars, anomalies, or ruptures

If scar is low and a transverse cut, that is, goes from side to side, then TOLAC may be attempted.

According to ACOG (The American College of Obstetricians and Gynecologists):

• 3-4 out of 5, ie, 60-80% women can have successful VBAC
• transverse cut, risk of rupture, is 0.2 to 1.5%, ie 1 in 500
• VBAC is safer than repeat caesarean
• more than one previous caesarean does not pose any additional risk in VBAC
• genital herpes is acceptable, unless a visible lesion
• no evidence that a large baby requires cesarean. Squatting increases outlet of the pelvis by 10%

Rupture of the uterus is the principal risk of VBAC. The risk is small: less than 1% VBAAC result in rupture. But it is dangerous if it happens. Go for VBAC only if you are prepared to take that risk.

Also be sure to choose a pregnancy doctor in delhi and a hospital who can handle the rupture and do a cesarean if needed.

You may wish to attempt a VBAC because if it is successful, you will avoid the disadvantages of a Cesarean.

History

The second Mauryan Samrat (emperor) of India, Bindusara, was born c. 320 BCE by caesarean. His mother accidentally consumed poison and died when she was close to delivering him. Chanakya, his father Chandragupta’s teacher and adviser, cut open the belly of the queen and took out the baby Bindusara, thus saving the baby’s life.

That Julius Caesar was born by caesarean, hence the name caesarean for the procedure, is a myth. Though caesareans were performed in Roman times and Jewish woman are said to have survived such operation. But caesareans usually led to the death of the mother and were usually performed only when woman was dead or supposed to be beyond help. In Great Britain and Ireland, the caesarean-mortality rate in 1865 was 85%.

Grow Your Understanding With Doctor For Timely Results

It ought to be a matter of genuine delight for you to bring forth a kid. In spite of the fact that it looks exceptionally basic on paper, you need to confront different wellbeing issues, even before you get to be pregnant. You need to locate your accomplished doctor, in the event that you are occupied with turning into a mother. You need to experience different tests and you need to take required pharmaceuticals, on the off chance that they are required for your wellbeing. Your doctor knows everything about your conceptive framework and you need not to get stressed. In the meantime, you need to counsel a obstetrician doctor or a gynecologist in Delhi, who is extremely experienced in managing pregnancy. You ought to understand that it is vital for you to deal with you and your tyke, which is developing inside you. You need to visit your doctor routinely, once your pregnancy is affirmed.

There is a plausibility of contaminated with yeast disease and your doctor may analyze this issue, when you visit her. You can feel a few changes in your body, when you are pregnant and you may not feel extremely great with your general exercises. You may feel overwhelming with your bosoms, now and again. These early signs may affirm your pregnancy and once your pregnancy is affirmed by your doctor, you ought to take extra care of your wellbeing. You need to eat just recommended nourishment things, which are required for your wellbeing.

When you visit your doctor surprisingly, you ought to have complete examination for your pregnancy and you ought to dependably counsel your best gynecologist in Greater Kailash consistently, until you convey your infant. At the point when your specialist settles the date of conveyance, you ought not to miss to visit your specialist, since you may need to experience the surgical technique, if the conveyance is not typical conveyance. Just your specialist can choose about the conveyance of your child. You and your child ought to have flawless wellbeing condition, after the conveyance and this is the main point of your doctor.

Welcome To the Best Gynecologist in Lajpat Nagar

Gynecologists are also known as the obstetricians, which deal with the health of the female reproductive systems including vagina, uterus, ovaries and the breasts.

There are many situations, where a woman needs to visit a gynecologist. Women health issues are very private and cannot be discussed with anyone, so an expert gynecologist can guide her in the right direction and can suggest the best treatment.

Dr Sadhana Kala’s clinic is Delhi’s one of the best gynecology clinics dedicated to women’ health and newborn babies. We offer an excellent health care system, a vast pool of competent medical expertise for women’s. We have world-class availability of state-of-art diagnostic and therapeutic facilities.

We have a whole range of maternity and gynecological treatment. Patients receive the most advance treatment delivered by regions leading medical professionals. If you are in search of the best gynecologist in Lajpat Nagar, then always contact Dr. Sadhana Kala. She has vast experience and through experience high risk pregnancies and women health. She has always kept the benefit of the patient as the top priority.

These are the conditions or issues, where a gynecologist can help a woman:-

• Cancer and pre-cancerous diseases of the reproductive organs
• Incontinence of urine
• Amenorrhoea
• Dysmenorrhoea
• Infertility
• Menorrhagia
• Prolapse of pelvic organs
• Infections of the vagina (vaginitis), cervix and uterus (including fungal, bacterial, viral, and protozoal)

Over the course of many years, there are many doctors in Delhi which has expertise in the fields of gynecology, obstetrics, infertility, and sexual health. In many hospitals, you can see male doctors too for dealing with genecology problems. However, in most of the cases, it has seen that a woman sometimes does not open all her problems. She finds it difficult to open up about her personal health issues, to overcome these kinds of situations, a female doctor is suitable and reliable.

If you have any of these issues or multiple issues at a time, you must visit the best gynecologist in Delhi.

Services Offered by OB/gynecologist?

An OB/Gyn is a branch of physiology and medicine who combines two medical specialties, Obstetrics and Gynecology. It deals with the function and disease specific women and girls, it also provide comprehensive care for problems involving the reproductive systems of women prior to pregnancy, the pregnancy cycle of trimesters and after pregnancy. The two specialties are as follow:

Obstetrics

Obstetrics is the medical specialty that provides care for women and childbirth during the three trimesters of pregnancy and continuing for the initially few weeks after b childbirth. The obstetrician attends to the woman during labor and delivery and is trained to handle all complications that would endanger and jeopardize the safety and health of the mother and fetus.

Gynecology

Gynecology is the medical specialty that handles women reproductive organ disorders. The most common disorders are menopause, fertility, infections, tumor, menstruation and endocrine disorders. Mostly gynecologists provide counseling to all birth control related issues and prescribe appropriate method during on pregnancy and after childbirth.

The most important thing is that, how to choose the OB/Gyn specialist?

There are several ways, you can choose the best OB/Gyn sin your area:-

• Ask family doctor. He or she is in contact with all types of health care professionals and will be able to point you in the right direction.
• Ask friends, neighbor, and co-worker.
• Search the best gynecologist according to their qualification and experience by internet.

Gynecologist in Delhi provide all types of services from pregnancy to childbirth, you just have to registration and take appointment to consult with gynecologist specialty.

Finding the best gynecologist in Delhi is not tough there are very hospitals that have world class facilities and all kind of services. These hospitals and clinics have complete team of doctors and nursing staff that care of their patient very well.

Problem in Finding a Gynecologist in Delhi

Are you a woman? Are suffering from a reproductive system disease? If YES then this blog is for you! You are not alone; there are many people all over the world that are suffering from gyno problems. These people suffering from such problems look for gynecologist that can help them provide quality treatment and solutions to their problems.

Gynecologist or obstetrician is doctor, who is commonly referred to as OB/GYNs, provide care for a variety of women's concerns, most notably issues relating to menstruation, menopause, pregnancy, childbirth, hormonal therapies and diseases of the reproductive system.

Finding the best gynecologist or obstetrician for an individual is a hectic task nowadays. This is happening because, today, there are many clinics, who boast as a best gynecologist in Delhi.

Finding an obstetrician or gynecologist is a process that should be approached with careful consideration. You need not worry, as through the internet, you can find out many obstetrician and gynecologist and make prior research. Look for an obstetrician or gynecologist, to which you will feel comfortable.

It is suggested to women, that when you find out a gynecologist in Delhi, look for a lady doctor, so that you can share all your problems and get effective treatment for it. Some women feel very strongly that they would be uncomfortable with a male doctor.

Dr. Sadhana Kala is known to offer services to women with variety of services. Her clinic is located in Greater Kailash and Lajpat Nagar, Delhi. If you are looking for the best gynecologist in South Delhi, book an appointment with her and get quality medical services.

Select The Best Class Medicinal Services For Good Health

This zone in pharmaceutical incorporates an extensive variety of issues a standout amongst the most well-known is vaginitis. There are three primary driver of this issue; bacterial, candidiasis and Trichomoniasis. Few of these patients have bacterial contaminations, few has candidiasis and a little parcel are experiencing Trichomoniasis.

These issues typically have unusual release, tingling and blazing of the vagina. Now and again there is an unsavory scent. They are some of the time somewhat dubious to analyze and various ladies are not determined to have this dissention. This is the reason it is critical to locate the best Gynecologist in Delhi, Lajpat Nagar, Chittranjan Park. In the event that left untreated this minor issue can advance into more significant issues like Pelvic incendiary sickness and diminished sexual capacities, because of scarring from ceaseless diseases.

In some cases a pap smear can be taken as business as usual exam. In the event that this is anomalous further examinations will be taken. One of these indicative strategies is a Colposcopy. This is the point at which an instrument is embedded into the vagina which has a light toward the end. This methodology will empower the specialist to see where to take a tissue biopsy and now and then they can identify unusual development around there which may show a major issue.

There are various healing facilities that offer across the nation benefits and in addition giving a Gynecologist in Delhi, Lajpat Nagar, Chittranjan Park. India and its urban communities have developing populaces, with more individuals needing medicinal administrations. This is the reason Delhi and the encompassing regions have turn into the inside for therapeutic offices in India.

There are various huge healing facilities in the territory adjusting the needs of the occupants furthermore giving consideration to remote towns and individuals who can't bear the cost of good restorative consideration. This implies that numerous ladies can get treated for their issues that may somehow have been denied treatment.