Since the evolution of mankind, vaginal delivery (normal delivery), has been the only way of delivering a baby. So, it is considered natural and best. But, in modern era, Caesarean section (C-section) does have a place.
Why is the caesarean section rate on rise?
Caesarean deliveries are on a rise these days because of various indications like increased maternal age, precious pregnancy, IVF conception, multiple pregnancy, higher lifestyle disorders like high BP, diabetes and obesity, intolerance for pain, ease for patient as well as doctor as both don’t have to wait for too long.
Advantages & disadvantages of normal delivery over C-section?
Since normal delivery is a natural process, a mother recovers faster and has a better bonding with the baby. She can breastfeed and take care of her baby faster as compared to after caesarean. There is no scar on the body and if at all she has to undergo any uterine surgery in future, it’s easier for her.
But, all is not always hunky dory with vaginal delivery. There can be certain problems like prolonged labour, maternal exhaustion, increased chances of forceps, vacuum delivery, birth asphyxia, perineal tear or shoulder getting stuck if the baby is big in size. Women with vaginal delivery are more at risk of uterine prolapse & stress urinary incontinence in future.
Advantages & disadvantages of C-section over normal delivery?
It’s quick with less chances of trauma to the baby. It’s a relatively easy path for the patient as well as the doctor. Patient is spared labour pains. But, patients have delayed recovery with more chances of having urinary tract infection & wound infection. She has to maintain a gap of at least 3 years for next pregnancy. Also, it's difficult for her if she has to undergo any uterine surgery in future.
Is normal delivery possible without pain?
Gone are the days when women used to suffer immensely with labour pains without a respite in sight. Now, it is possible to have a normal vaginal delivery without pain by means of epidural analgesia. A woman can enjoy all the benefits of vaginal delivery minus the pain & exhaustion associated with it. One can opt for it during active labour. Here a very fine catheter is inserted through the back into a space outside the spinal cord called epidural space.
Anesthetic drugs are administered through it which block the pain sensation. The labouring woman is able to feel the contraction & relaxation of the uterus but not the pain associated with it. The woman is comfortable throughout the labour process & is spared of the exhaustion associated with the otherwise painful process.
Is it possible to have normal delivery after a previous C-section?
The statement “once a caesarean, always a caesarean” doesn’t hold true anymore. Vaginal birth after caesarean or VBAC is possible in experienced hands if following criteria are met
• At least 3 years gap between the two pregnancies.
• It was a non recurring cause for caesarean earlier like a fetal distress or meconium.
• The previous caesarean scar has adequate thickness on ultrasound.
• The cervix is favourable for a vaginal delivery.
• Delivery is at a well equipped centre with an experienced gynecologist .
Always trust your doctor to decide on the possibility of VBAC.
Important things to keep in mind during pregnancy
• Choose your doctor early.
• Choose a well equipped hospital with neonatal ICU facility & get a booking done early.
• Get all investigations & ultrasounds done in time.
• Be under regular follow up of your doctor.
• Get your BP & sugar levels checked regularly as per your doctor’s advice.
• Take your iron, calcium, vitamins & proteins supplements regularly.
• Avoid Junk & spicy food, alcohol & smoking.
• Add adequate fruits & nuts to your diet.
• Drink plenty of water.
• Wear loose & comfortable clothes.
• Avoid wearing high heels.
Eating for two- is it a myth or a fact?
Eating for two is not how a baby making math works. You do not need any additional calories during the first trimester. You may not be able to consume it either because of excess nausea & vomiting.
During the second trimester, an additional 300-350 calories are needed per day. During the third trimester you need to add 450-500 calories per day. Of course, there are exceptions to it when one is too under or overweight & when there is Gestational Diabetes.
Is exercise recommended during Pregnancy?
If you do not have any high-risk factor, then sedentary lifestyle is not at all advisable during pregnancy. Apart from your regular work which you are used to doing, you can do walks, prenatal yoga & light weight training under supervision during pregnancy. This is specially advisable for women with obesity & Gestational Diabetes.
You may be advised to restrict activity if it’s an IVF conception, placenta is low lying, blood pressure is high or there is tendency for premature delivery.
About the Author
DR. VISHAKHA MUNJAL
Mbbs, Md (Aiims), Ficog,
Dip Endoscopy (Germany)
Senior Consultant Gynecologist, Laparoscopic Surgeon & Infertility Specialist At Apollo Cradle : Spectra Hospitals,