Introduction
Cesarean Section (C-section) is a surgical procedure to help a mother deliver her baby if normal delivery is not possible (C-Section, 2006). A surgical incision is done from the abdomen of the mother through the abdomen where the baby would be taken out from the mother’s womb.
History of Cesarean Section
The history of cesarean section was not really traced as to when it started, who discovered the procedure and what way is the procedure performed. But it was believed to have existed in the ancient times. Traces of the history of the cesarean section are reflected in the ancient Hindu, Egyptian, Grecian, Roman, and other European folklore (Cesarean Section, 1998). “Cesarean” Section was believed to have been derived from the birth of Julius Cesar, who was thought to have been delivered in this manner.
But this was very doubtful as Julius Cesar’s mother survived his birth and was alive until he was at the age of 48 which was incompatible with the maternal mortality that was almost a hundred percent at the time Julius Cesar was born and that cesarean section was done only when the mother is dead or dying at that time (Murphy, 2008).
However and whenever cesarean section started, the concept of giving birth through opening the abdomen was the same as before and today, the difference are only presented in the techniques. Let us then see how the same and how different techniques of cesarean birth from before as compared to the techniques used nowadays. In previous practices of cesarean birth method, the woman who cannot give birth by normal delivery would be held by 4-5 men down on a kitchen table and the surgeon would cut the woman’s abdomen by a dirty kitchen knife, a pocket knife or even a razor blade. The knife the surgeon would use may be caked with blood or grime and his hands may even be dirtier than the knife he used.
Their criterion for a good surgeon was through how fast the surgeon performs the cesarean section. There was no safe and effective anesthetic that was used (Murphy, 2008). The surgeons before were walking from one patient to another or from corpses to another patient to perform the operation with their bloody clothes and without washing their hands. The blood on their suits was the indication of their status as surgeons (Murphy, 2008).
Early in the 19th century, the procedure somewhat had an advancement. The surgeon now would cut from the abdominal wall through the abdomen, and then he pulls the baby out and sews the skin incision but leave all the underlying tissues open including the incision in the uterus. Women at this time may bleed to death or if they survive they would have an overwhelming infection as antibiotics were only available in the 1930s (Murphy, 2008).
Since the maternal outcome was very poor, the procedure was usually performed after the death of the mother or when the mother is dying and the Rex Regia law was enacted by Numa Pompilius, the second King of Rome, in the Roman Empire wherein it states that it is prohibited to bury a pregnant woman before the fetus has been removed (Murphy, 2008).
In the present times, almost all cesarean sections are the same except for some minor differences as to the style f the cut whether up and down or side to side. The surgeons nowadays follow the layer to layer cut until they reach the abdominal muscles, then the surgeon would push the bladder to a safe position to prevent accidental injury. Then the in the lower segment of the uterus a cut will be made where the baby would pass out from the uterus, the umbilical cord would be cut and the placenta would be taken out.
Then a layer to layer suturing of the incision would be done and the patient is given Oxytocin and the antibiotics to prevent post-operative complications such as infection and bleeding. The operation nowadays is painless as they are with the aid of an Anesthesia given by separate doctor who specializes on anesthesia, an Anesthesiologist (Murphy, 2008).
It is not just the techniques that changed when it comes to the cesarean section procedure but also the place where it has to be done. A mother before undergoes a cesarean section on a kitchen table, nowadays, it has to be performed in an operating room in a hospital where strict aseptic techniques must be employed before an operation is begun. This practice includes ensuring that the hands of the surgeon are washed before the sterilized gown and the sterilized gloves are used.
Another thing that differentiates the cesarean section procedure from before and today is that the main reason and the goal of the said procedure. Before it was mainly done to save the life of the baby inside the mother’s womb even it would mean the mother’s death because either way, the mother would still die (Murphy, 2008). Nowadays, the mother can give through the cesarean section with a very good prognosis. With the advancement of the medical technologies, the emergence of the different type of antibiotics and other medicines, cesarean section procedures can be done safely (Cesarean Fact Sheet).
The survival rate is also one big difference after a cesarean birth. If before, almost all cesarean sections were done with almost a hundred percent mortality rate, nowadays it is almost having a 100% survival rate after the operation is done (Murphy).
Indications of Cesarean Section
Cesarean section was done to save the mother and the baby. In what cases then is cesarean section indicated? C-sections are indicated to mothers who had previous c-sections and are giving birth to another baby. Another is that, the mother is having a baby which is too big to be delivered normally via a vaginal delivery. The baby’s position is another indication for a c-section if ever the baby is in a breech or transverse position.
Another is the placenta problems which may pose a risk to the baby such as placenta previa. When labor stops or is too slow, a cesarean section is also indicated. When there is an umbilical prolapse, it also needs a direct cesarean section as it the cord may be squeezed if a vaginal delivery is done and may compromise the oxygen supply of the baby. Another indication is if the mother has HIV or genital herpes, or if the mother is having twins, triplets or more, or if the fetus is already in distress.
The mother may also deliver via a cesarean section delivery if she has a serious medical condition that needs intensive or emergency treatment such as high blood pressure or diabetes or if the baby has a certain type of birth defect (Cesarean Birth, 2006).
Advantages and Disadvantages (Risks, complications and number of Births)
Cesarean section may be helpful especially if the baby is in distress; it is only through this way that the baby may live. It is only through c-section that a mother may be saved if she is in an emergency situation that calls for the operation. The baby will then be delivered promptly and thus avoiding any complications arising from the emergency. However c-section is not without risks, one disadvantage is that it has the risks of having infection, blood loss and injury to the organs just like any other surgery has (Is there a possibility). Another risk is suffering from the potential side effects of the anesthesia used during the delivery which may include spinal headache, nerve damage, high block, hematoma and many others (Murphy, 2008).
Summary
Cesarean section in delivering a baby has actually no limits, but the type of c-section done with the previous c-section may affect the following cesarean sections (Repeat Cesareans, 2008).
Cesarean section delivery is a major operation that may pose a risk to the mother and the baby. However, oftentimes, c-sections are necessary to save their lives as well. In deciding whether the person must have a c-section or a normal vaginal delivery should be determined by the Obstetrician so that the mother may be guided in the choice of delivery that she makes or she would be prepared as to the method that she will undergo in giving birth.
References
Murphy, M. (2008).Choosing Cesarean Birth: An alternative to today’s Crisis in Natural Childbirth? Web.
C-Section: Medical Reasons. (2006). Web.
Cesarean Section – A Brief History. (1998). Web.
Cesarean Fact Sheet. (1998). Web.
Is There A Possibility That You May Need A Cesarean Section? Web.
Repeat Cesareans. (2008). Web.