About one in five babies are now delivered in this manner. There are obvious situations where a Caesarean section is the only choice for the obstetrician. These include a baby that is presenting side on instead of head first, a placenta that is over the birth canal, a severely ill mother, a distressed infant that may not survive the rigours of the passage through the birth canal, and the woman who has been labouring for many hours with no success. Caesarean sections may also be performed if the mother has had a previous operative birth, if she is very small, if previous children have had birth injuries or required forceps delivery, for a baby presenting bottom first, if the baby is very premature or delicate, in multiple pregnancies where the two or more babies may become entangled and a host of other combinations and permutations of circumstances that cannot be imagined in advance. The decision to undertake the operation is often difficult, but it will always have to be up to the judgment and clinical acumen of the obstetrician, in consultation with the mother if possible, to make the final decision.
The operation is extremely safe to both mother and child. A light anaesthetic is given to the mother, and the baby is usually delivered within five minutes. The anaesthetic is then deepened while the longer and more complex task of repairing the womb and abdominal muscles is undertaken. In many cases, the scar of a Caesarean can be low and horizontal, below the bikini line, to avoid any disfigurement. The latest innovation is epidural anaesthesia, where a needle is placed in the middle of the mother’s back, and through this an anaesthetic is introduced. The woman is feels nothing below the waist, and althoughsedated, is quite awake and able to participate in the birth of her baby, seeing it only seconds after it is delivered by the surgeon. Most doctors and hospitals allow husbands to be present during these deliveries. Recovery from a Caesarean is slower than for normal child birth, butmost women leave hospital witin ten days. It does not affect breast feeding, the chances of future pregnancies or increase the risk ofmiscarriage.