Delivering a baby is a primal and unassisted event for the viviparous community. We humans are slightly different, as matriarchs have passed down their skills and experiences which are used for assisting vaginal deliveries. Thus, rather than being left all alone to accomplish this task, there is usually someone around with requisite skills to assist, although a few deliveries continue to occur unassisted. However, armed with the recent knowledge acquired in the past few decades, vaginal delivery is being made out into an extremely painful, outdated, formidable and complicated event which needs to be shunned in favor of a better alternative – the cesarean delivery. Albeit, vaginal deliveries are still considered handy for the mothers who do not have requisite means as also for the simple folks from countryside, as cesarean deliveries are costlier and everyone can’t afford it. Cesarean delivery is often being made out to be a privilege and is becoming a trend amongst the well-to-do and upwardly mobile and this trend is more or less a global phenomenon. Is it really a privilege, and at what cost? What about the risks and later consequences? Is cesarean delivery really so safe after all?

Improvements are fundamental otherwise we would have remained hunter- gatherers and cave dwellers. For improving outcomes of delivery, planned vaginal delivery and cesarean delivery have been two such improvements. Cesarean method was developed to overcome certain complications which could be detrimental either to the mother or her baby. Based on evidence, certain indications were developed for cesarean delivery, which ought to be respected and followed. When planned home births with certified professional midwives are safe[3], surely the planned vaginal deliveries in hospital would be safer still. We also know that women in the planned vaginal birth group who had spontaneous or instrumental vaginal delivery were less likely to experience death or serious morbidity than were those who delivered by emergency cesarean birth. Notwithstanding, the indications for cesarean delivery have now perhaps been overtaken by an ‘educated choice’, convenience, and ‘on request’ for being fashionable and trendy these days. Whose convenience and preference are we talking about? Once the pains start, graduating from the first stage to the second takes time and then there always would be the third stage to follow and would require careful monitoring all throughout. It also requires patience and perhaps it may also be remotely associated with missing out on quick bucks. On the other hand we have cesarean experts who have clocked 10 minutes or even less and this process gives enough freedom and choice so that one can plan to have a baby during a weekend, sharp at 0911 hours GMT for example, if that is the preference.

In Canada alone, the rate of cesarean births has increased from 5.2% in 1969 to 25.6% in 2003, and from 19.7% of all cesarean deliveries in 1994 to 28.3% in 2001 in USA. Consider the overall workload when these figures would reach 75% or more. If the general consensus still remains in favor of elective caesarian deliveries, we should then get prepared for 30 to 100 or more deliveries by elective caesarian sections daily that would have to be done in every busy urban or sub-urban hospital. The responsibility shall be over and above the normal commitment towards health of the society that every hospital provides. This fashion has all the potentials of becoming a trend setter, with a global fall-out. Does the developed world (ignoring the developing countries at this stage of reasoning) have sufficient experts, hospital beds, paramedical staff, etc, to take on this additional responsibility which will be colossal? Once the trend is established, are we still to imagine that the post caesarian outcomes will continue to remain at its present best levels. More importantly, would we be able to switch the tide back towards planned vaginal deliveries thereafter when, sooner or later, we may want it to be restituted? Then, why must we push vaginal deliveries to oblivion? [1]

Reference:

1. Chauhan R et al. Pushing vaginal deliveries into oblivion. CMAJ 19 Feb 2007. http://www.cmaj.ca/cgi/eletters/176/4/475#7451