Caesarean Delivery

The History of Caesarean Deliveries

A caesarean delivery is a method of delivering an unborn baby through an incision made in both the abdominal and uterine walls. Historically, as the name caesarean implies, it is believed the process has its genesis in Roman times with the advent of a law called Lex Caesare. This law mandated that a postmortem operative delivery be performed on a dead pregnant woman so that she and her unborn baby could be buried separately. Caesar and caesarean both mean "to cut", derived from the Latin word caedere.

Caesarean delivery was first used as a medical practice to save an unborn baby's life, and often the mother was lost in the process. As time went on and medicine developed better techniques of surgery and treating infections, more pairs of mothers and babies survived caesarean births. It was an emergency technique - a life saving measure, but today it is also used as an elective that considers a patient's wishes and preferences. As of 2007, 32% of live births were caesarean deliveries and the issue is one that is stirring up controversy.

Risks Inherent in Caesarean Births

Outside of elective surgery, a caesarean delivery is performed because of either mother or baby issues. The leading reasons for caesarean birth are previous caesarean delivery, breech presentation, and fetal distress. 85% of all caesarean births fall into one of these categories. The balance of the surgeries are elective upon the request of the mother. The responsibility of the medical professional is to advise the mother of the potential risks and benefits of the procedure and provide the best counseling possible. A consensus conference determined that a women seeking elective caesareans should avoid them if they want several children, that the surgery should not be performed before 39 weeks and that it is verified the baby's lungs are properly matured. She needs to know the risks of potential respiratory problems for the baby, hemorrhage for the mother, and an increased risk of placenta previa and placenta accreta with each successive caesarean.

Maternal Problems that Indicate a Caesarean Delivery

There are many reasons a woman may need to have her baby delivered by caesarean delivery. Lesions in the lower genital tract, including malignant growths, and pelvic abnormalities that create difficulties in the baby's head engaging or interfere with the descent of the baby presentation in labor are possible reasons. The presence of one of a variety of diseases, such as irritable bowel syndrome, that can cause trauma and problems for the mother are other reasons. Many other maternal indications are cause for considering a caesarean birth.

When the Baby is in Trouble

Fetal indications for caesarean delivery are those considerations that surround the decrease of risk of death or harm to the baby, preventing trauma, certain congenital malformations or structural disorders, and infection. The term malrepresentation encompasses breech presentation, or presentation where there is increased risk of trauma, cord prolapse, and head entrapment. Another reason for caesarean delivery is multiples when one of the babies is in breech position. Hydrocephalus, a condition related to neural tube defect, can necessitate a caesarean delivery as the head of the baby can be too big to be delivered vaginally. When the baby is in distress, indicated by fetal monitoring, a caesarean may be necessary to ensure the baby lives. Caesarean delivery reduces the risk of HIV being passed to the baby from the mother.

There are many situations where a caesarean delivery is the best option for both mother and baby. Conversely, there are situations where a caesarean delivery could lead to death. Being informed and having a medical professional who is well informed and working for the patient is the safest way to handle this type of birth.