Enigma of Caesarean Birthing Trends

Increasing worldwide rates of caesarean section are of global concern, especially on maternal request have become a hotly debated issue. A Caesarean delivery (C-section/CS) is used to deliver a baby through surgical incisions made in the abdomen and uterus. It is a lifesaving procedure for mothers and newborns in certain circumstances. While the need for a first-time C-section of a primigravida woman isn’t' clear until after labour starts. Planning for a C-section might be necessary if women who have had a C-section earlier or had other systemic diseases like heart or brain diseases. When not strictly necessary, caesarean section cause unnecessary national expenditure and place a strain on scarce public health resources in lower- and middle-income countries. The consequences on adverse health outcomes, due to CS include i) babies born are more likely to develop transient tachypnoea & get accidental surgical injuries to the baby. Though the mother won't feel much pain during the surgery, recovering from a CS is more painful & takes a longer time than from a natural birth. There is a payment wedge for C-sections relative to vaginal deliveries under fee-for-service and an information asymmetry between obstetricians and patients as most illiterate or Less-informed patients or their families cannot reduce the asymmetry by seeking an independent second opinion during labour and are possibly exploited. Materials & Methods: This article is based on author’s experience of two deliveries by caesarean section in September and November 2024. CS in September was of a poorly built young lady of 28 years, Primigravida, a precious pregnancy as it was successful after a long-term consultation, hormonal and other efforts (D&C) for 2 years after marriage. The woman was clearly influenced during ANC itself in Bengaluru and during labour in Raichur a district head quarter both private obstetric facilities. The delivery in November was second gravida of twin girls, diagnosed by scanning in Australia, previous delivery also CS, a justifiable cause for CS. Literature search adds value for argument for justifiable reasons of CS & unnecessary caesarean sections. Outcomes: Both mothers are doing well now but the process of recovery from surgery has taken about 3 weeks. However, the baby of avoidable CS is suffering from frequent upper respiratory infections in the first 3 months of life. The cost involved was around INR 300,000 each and the young infants URIs costing another INR 100,000 so far. The twins of 2.2 kg and 1.8 kg are needing special care where two aunts have taken of for a month each to take care of them an indirect cost of INR 50,000 each month.