HEALTH: C-section delivery

When to conduct a cesarean section

Obstetrician gynecologist, Dr. Job Bosco Tezita of Mulago National Referral Hospital describes caesarean section as a delivery of a baby through incisions made in the mother’s abdomen and uterus and this normally happens when a vaginal birth is not considered a safe route.

He further notes that majority of women who go through caesarean section have it as an emergency and life saving option. The decision to conduct a cesarean section is usually made after going into labour.  In such a case, there must be indications which are classified under maternal causes (where mother is the cause) and foetal causes. This may be determined during antenatal visits where mid wives or skilled health personnel screen out high risk mothers with potential complications either to the mother or the baby. Indicators include:

• Big babies (weighing more than 4kg) and this is taken in correlation with the size of the mother’s pelvis
• Short mothers usually have a smaller pelvis
• Getting fully dilated
• Baby starting to show signs of distress
• Placenta lying low in the uterus which may cover the cervix.

“People think it’s a trend but as long as there are indications for cesarean sections, it is just what should be done,” says Dr Tezita. He says he gets a few mothers asking for C-section delivery but, he says, medical staff still base on the indications to allow it.

He says even when indications show risk, trial labour is usually given before performing caesarean section and the facility handling such cases should be facilitated to handle it. He says there is a lot to weigh before choosing to do a C-section; including availability of the specialist or skilled birth attendant.

Associated risks

Although a cesarean section is considered relatively safe, it poses a higher risk of some complications than a normal (vaginal) delivery does. The complications, according to Ndiwalana, may be to the mother or the baby. They vary from infection, heavy blood loss, blood clot in the legs or lungs, nausea, vomiting, and severe headache after the delivery (related to anesthesia and the abdominal procedure).

“The other immediate complication may be over bleeding to the extent of removing the uterus,” he says.  In facilities for paying patients, the cost involved in C-section is almost double as compared to normal delivery.

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