March 18, 2019

Why Cesarian? Why not Normal!

Why Caesarian?

Cesarian Section is a life saving surgery,, done when the life of the baby or the mother is threatened. It is done to overcome a unexpected problem in normal vaginal delivery but many a time, it is  done electively to prevent a complication!

Non Progression of Labor

Normal delivery should progress by dilatation of cervix/ brith canal to accomodate the baby. This is achieved by uterine contractions. In some women good contractions do not happen for reasons unknown!

cesarian delivery

Narrow Birth Canal

Baby has to pass through a birth canal that is bounded by bony prominences. If the pelvis is narrow it cannot allow the fetal head which is almost 9.8 cm wide. Some women and short women have a narrow pelvis.

cesarian delivery

Placenta Previa

Placenta, which supplies nutrition to the baby is normally away from the birth canal. In some women, it is abnormally placed close or on the cervical os, preventing the baby to come out through the vagina.

cesarian delivery

Breech position

Baby normally comes out, head first. But in some women it is the rear that attempts to come first. Such deliveries can be difficult and hence elective cesarian section is done!

cesarian delivery

Poor General Health

Women who had prior cesarian section are candidates for cesarian, as the scar of previous surgery can rupture due to uterine contractions causing an emergency.

Fetal Distress

If the baby's blood supply is comprimised either due to cord coming out first or cord around neck of the baby, it is prudent not allow normal delivery.

Cesarian Section

Aka, as C- Section.

Baby is delivered through a surgical incision. There are specific situations where this method is resorted abandoning the natural birth.

If you are pregnant, knowing what to expect during C-Section helps you prepare.

Indications for Cesarian Section

Placental Abruption
Uterine Rupture
Birth Defects
Multiple Births- Twins
Cephalo Pelvic Disproportion
Active Genital Herpes Infection
Previous Cesarian Sections
Baby in Distress
Abnormal Location of Placenta
Labour not progressing normally
Blockage of birth Canal - Fibroid
Cesarian Section Babitha Maturi

Assesment of Birth Canal for Trail Normal Delivery

Assesment of adequacy of pelvis for normal vaginal delivery is done by your doctor.

A rough estimate is made around 38 weeks , when the baby is fully formed and the head would have descended into the pelvis by then allowing a comparison of its dimensions with the birth canal.

Assessment is more realistic and practical, when the labour sets in and your doctor through repeated internal examinations and by noting baby’s progression (descent into pelvis), decides if delivery can be safely continued through normal vaginal route. Any relative inadequacy of pelvis or failure of the baby to descend sequentially inspite of good uterine contractions or if baby goes into distress, your doctor may decide to go ahead  with Caesarean Section.

VIDEO: Inadequate size of the birth canal due to narrow bony pelvis, shoulders couldnt be delivered and traction resulted in injury to nerves of arm causing paralysis in the baby!


Monitoring the progression of labour involves noting the intensity of contractions, frequency of contractions, assesment of formation(dilatation) of birthcanal to accomodate the baby. Also important is to monitor the health of the baby and it is done by Fetal heart monitor which calculates the heart rate.

CTG- Cardio Toco Graph This instrument is used to monitor the quality of uterine contractions and fetal health and the information is given out in a graph form. 

NST – Non Stress Test – This monitors the baby and its heart rate in relation to baby’s movement when uterus is relaxed. Often done around 37-38 weeks to asses  the health of baby.

CST – Contraction stress test – This monitors the baby’s heart rate in relation to uterine contractions during active labour. It is done to monitor the health of baby and detioration on this graph is an indication for Caesarian Section.

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