Adherence to best practices behooves gynecologists to prefer a vaginal delivery to any kind of surgical intervention.
Caesarean section (C-section, CS or caesarean delivery), the surgical procedure used in birth, is also employed in some cases. Often, a C-section is performed when doctors have reason to believe that normal birth will cause harm to the mother, the baby or both.
“In which case it is referred to as an emergency CS,” observes Dr Stephen Mutiso of Kenyatta National Hospital.
However, a CS can be done at the request of a couple — or the expectant woman. This kind of CS is termed elective CS.
“An elective CS is arranged and planned for in advance,” Mutiso says. “When the baby is due, the expectant woman checks into the hospital where the CS will be done.”
Some women who go for elective CS do so to avoid the pain that comes with natural labour.
“Looking back, I can understand why a woman would want an elective CS,” says Maureen Musyimi, who had a normal labour but underwent an emergency CS during the birth to her first child. “Labour is really painful. If it meant that I could skip labour, I would choose going for a CS again.” she says.
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But for Edith Mwando, an elective CS is not a good choice for a woman. “The wound from a C-section takes months to heal. I was not allowed to do heavy work for six months. I wish I could have gone through normal delivery. Recovery would have been easier,” she says.
Elective C-sections, in many hospitals, tend to cost more. This is because while emergency CS is done to save at least a life, an elective CS is not quite a life-saving venture.
However, Mutiso notes, if a mother’s first birth was via an emergency CS, and they are back to the hospital for another birth, an elective CS is advisable.
“Once a CS has been done, it is better if subsequent births are also done through CS. But if a mother has completed three years since the first CS was done, they are allowed to try normal birth, though there is always the risk of the CS cut rupturing during birth,” he says.
Dr Mutiso says the maximum advisable number of CS procedures a woman should go through is three.