Dear Doctor,

I’m 27 years old and pregnant with my first child.  I’ve heard so many ‘horror’ stories about natural child birth and now I’m thinking of opting for a C-section. I know it’s also not easy but after a friend of mine told me how she ripped while trying to give birth, I’ve been scared. My mum tells me she can give me local medicine to strengthen the muscles so that I won’t rip. Is this possible? Is there anything that can actually prevent tearing? I would really love to have a child the natural way but I’m terrified.

Betty

Dear Betty,

Normal child birth through labour pains and delivery is a natural process, which causes no harm to the mother or baby in any way in the majority of cases. In fact, the baby is exposed to the mother’s vaginal flora which helps him build his immunity. Pain experienced is also adjustable, depending on subjective pain perception. But of course in first child birth it is felt more. There are techniques to reduce the pain while conducting a normal delivery like spinal injection or light anesthesia. Some cases of uterine rupture complications do occur, but it is sequel to a prolonged labour. An experienced health worker can assess very well if the labour is progressing as desired or not and take appropriate decision at that moment. It is either to induce labour or do a C-section.

However a C-section, or caesarean section, is a surgical procedure where the lower belly is cut open to extract the baby. It carries all risks of a surgical procedure like postoperative bleeding, infection, and etcetera. If adjoining bladder is inadvertently damaged during C-, there can be urinary problems. One has to avoid lifting heavy weights, and excess bending for three months after a C-section, to have good healing of cut abdominal muscles. Later, risks include formation of adhesions inside the abdomen during healing. This can obstruct the bowels sometime causing severe abdominal pain, vomiting and if not treated urgently can be fatal.

Incisional hernia is also a later complication of a C-section. Due to increase in intraabdominal pressure due to any reason, there can be a weakening in the surgical scar causing bowels to protrude. This also carries risk of bowel strangulation. Hence, a C-section is reserved for cases where there is any perceived medical risk to the mother or baby. Otherwise normal delivery is always a better choice.

There is nothing to fear in a normal delivery. The pain also experienced does pass off with the child birth. It remains as a fond memory for many women.

Dr. Rachna Pande is a specialist in internal medicine.

E-mail- rachna212002@yahoo.co.uk