Cesarean section or natural birth, who should make the choice?
Recently, there was a doctor-patient incident in China. A maternal family member beat the doctor twice because of the 44-year-old woman who had a caesarean section.
So, what needs a cesarean section? Just to clarify the concept.
Natural labor is a “normal” mode of delivery. Once upon a time, not so long ago, our grandparents were able to do this in their own homes. The development of modern medicine, to better solve the delivery process of disinfection, neonatal health care, complications and other issues, so the maternal and neonatal survival rate has been greatly improved.
Natural labor is not a medical person to help you give birth, is the mother’s own delivery, but the medical staff and hospital environment can make the process more smooth, safer and more comfortable.
Cesarean section is usually a treatment of “dystocia”, is not effective with other methods, or other methods of greater risk only to consider the use of treatment. Dystocia is a condition in which a natural birth is problematic and is not good for the baby or for the mother if it is necessary to insist on a natural birth.
Why should natural delivery be preferred?
Natural birth is a natural process, doctors in fact most want to “go with the flow”, only when they have to choose C-section. For example, most colds do not require medication, which we should already know.
Cesarean section to “open”, that is, to open the anatomical structure.
Although this is a relatively simple operation for obstetricians (the baby can be produced in 10 to 20 minutes after successful anesthesia), after all, it is necessary to open and restore the body, and there is no guarantee that the normal anatomical structure will not be affected in the process. Causing future problems.
For example, can not determine how long the suture of the uterus can be completely healed, cesarean section if not careful pregnancy caused scar pregnancy, which is a kind of ectopic pregnancy.
Cesarean section must be anesthetized, and anesthesia is a traumatic operation, there will be anesthesia-related risks.
For example, how many hours before anesthesia can not eat, so as to avoid the process of anesthesia vomiting asphyxia; anesthesia and can not eat immediately after the resumption of intestinal activity to eat again, to avoid intestinal obstruction.
All of this creates additional risks for the natural process of childbirth.
Who will choose a caesarean section or a natural birth?
Doctor, of course.
Unfortunately, the information asymmetry between doctors and patients is a gap.
People who have not studied medicine know very little about their bodies, have no idea of the stages of the birth process, and have a dark eye about the risks and precautions of surgery. Nor is it possible for a doctor to explain all the steps and possibilities to the average patient in a short period of time.
Doctors through the collection of medical history and a variety of tests to understand the situation of patients, combined their own experience and available resources (including when the operating room) to provide programs, and according to the changes in the situation to adjust the program, do a good record.
So in the real operation, the conversion between caesarean section and natural labor is likely to take place.
Below I will list some of the common situation had to cesarean section, that is, the so-called “indications”, let you have a basic concept.
But this is not a clinical professional article, and does not cover the full range of clinical situations, or the complex details of each situation. Just because you want to share a little bit of information with clinicians doesn’t mean you can use that knowledge to negotiate with your doctor.
Like a narrow pelvic entrance. This includes relative and absolute stenosis, also called cephalopelvic disproportion.
Absolute narrowness is common in petite parturients. Relative stenosis is often due to the fetus is too large, especially the fetal head is too large. Although the fetal skull still has some room to be squeezed, but this “room” is ultimately limited.
The fetal head is also a bone, the pelvis is a three-dimensional structure, the fetal head is not straight up straight down. Absolutely narrow case, the baby is unable to pass through the pelvis normal childbirth, is the vagina this natural childbirth exit, the baby simply can not walk.
In addition to the narrow pelvic entrance, pelvic factors also include other plane stenosis and deformity.
The abnormality of soft birth canal.
For example, there is a history of cesarean section within 1 year, doctors will worry about in the trial labor process, uterine contraction intensity is too large, resulting in uterine rupture. If you want to try it in this case, you can try it, but you won’t be allowed to try it for too long, and you won’t normally use a drug like oxytocin.
Pregnancy complication, selective operation is safer.
The most common is gestational hypertension. If the pregnant woman’s blood pressure is well controlled, it is also possible to try natural childbirth.
But if the blood pressure control is not good, we should quickly dissect it when the blood pressure control is satisfactory, because the fetus is a big burden to the pregnant woman, the delivery process is also a stimulation, if causes the blood pressure to elevate, the puerpera eclampsia, that is troublesome.
The same is true of other complications, including high myopia.
Placenta previa or placental abruption.
Placenta previa is when the placenta is too low and gets in the way of the fetal head descending. On the one hand, this will cause the fetus can not successfully reduce output, on the other hand, it will cause the placenta in the process of natural delivery exfoliation and affect uterine contraction, resulting in massive bleeding.
Placental abruption is common in pregnant women when subjected to external forces, such as falls and bruises. Normally the placenta should be delivered about half an hour after the fetus is born. Because all the oxygen and nutrients of the fetus come from the placenta attached to the wall of the womb of the mother, once the placenta falls off, it means that the fetus can no longer get oxygen and nutrition. So cesarean section is also needed in this case.
The baby’s cause.
The most common is fetal distress.
To put it bluntly, the baby is anoxic in the mother’s stomach.
The cause of this hypoxia may not be predictable, but the hypoxia can be detected with the fetal heart rate recorder.
Fetal heart rate is too low or too high, or the lack of normal waveform, we should consider the existence of hypoxia. If hypoxia is not improved, there will be irreversible damage to the brain.
So as soon as the presence of fetal distress is observed, oxygen inhalation to the mother or other medical measures cannot be improved, and it is impossible to deliver the fetus through natural delivery in a short period of time, it is necessary to immediately give birth by cesarean section.
Normal labor process stagnation.
This is a very embarrassing situation.
Sometimes because the birth process is weak, no matter how pregnant women eat and drink, family members how to encourage, medical staff how to help, are unable to complete natural labor.
To avoid anoxia during labor-and to avoid maternal fatigue and postpartum bleeding-the only option is to switch to a C-section.
- The rarity of the fetus: for example, there has been a history of multiple miscarriages before, or the fetus was acquired by IVF (test-tube baby).
- First birth at an advanced age: it may be difficult and risky to have a natural birth.
- Multiple pregnancy: multiple pregnancy can be carried out naturally depends on the position of the baby. If the mother wants to try, of course, she can try to give birth naturally.
- Overdue pregnancy: medical term pregnancy defined as 37 weeks to 42 weeks, generally we will not let the mother more than 42 weeks, or worry about the occurrence of placental aging, fetal death and other intrauterine problems. Therefore, if more than the specified time, will no longer wait, and the end of the pregnancy by cesarean section.
Can you ask for a cesarean section for fear of pain?
In this case, the more appropriate way to deal with the pain problem is to give birth without pain.
Cesarean section can not completely avoid the problem of pain. After cesarean section, the pain of contractions and incisions of many parturients is sometimes no less than that of natural labor. To relieve the pain, you also need to be treated by a professional physician.
Whether from the perspective of pain relief, or from the perspective of maternal recovery, painless delivery is better than cesarean section.
In addition, enrich their knowledge, know the general process of childbirth, eliminate the fear of the unknown, will increase your natural childbirth confidence, reduce your anxiety.
Modern medicine is used to solve problems, not to create them. All decisions made by a doctor are made after weighing the pros and cons. Please solve the problem together with the doctor, do not become the doctor’s problem, otherwise everybody will encounter the question in the future to be in trouble.