Thursday, April 29, 2004

# 82: Caesarian Sections: A Kinder Cut or a Waste of Money? • Homeopathic Tip: Childbirth

Caesarian Sections: A Kinder Cut or a Waste of Money?

The issue of elective Caesarian section was all over the media this week. Among a lot of absolute rubbish written about this important issue were a few interesting points. First let us be clear what an 'elective' Caesarian section actually is.

If a pregnant woman goes into labour and at some stage all is not going well her obstetrician may strongly recommend an emergency 'Caesar'. There is no controversy about this and it happens every day in every O&G ward in the world. However there are reasons for electing to do a Caesarian section and dispense with the process of labour altogether. These reasons fall into two categories.

1. Medical Reasons: Good examples:
  • If the baby is in a breech position and is very large. One can attempt a normal labour but a Caesarian section is often recommended as being much safer.
  • Placenta previa: the placenta is in a position that makes it vulnerable to the process of labour. Labour becomes potentially dangerous for the mother and a Caesar is highly recommended.
2. Cultural and Cosmetic Reasons:

Some women quite capable of having a normal vaginal delivery may prefer to choose to have a Caesarian section. There may be many reasons for this choice. It avoids vaginal tearing and stretching, it ensures that no episiotomy is done, and it prevents the occasional urinary problems that can follow labour. It also avoids the pain of childbirth and the fear of that pain. Thus we can see why some women would prefer a Caesar to natural childbirth.

Problems with Caesarian Sections:
The truth is that having a section is not a simple matter; it's actually quite a big operation. There are occasionally problems with anaesthesia and it takes about 6 weeks to get over the op. In addition it can sometimes reduce chances of further pregnancies. However all these risks are very, very small.

The Real Controversy about Caesarians:

It's about money. A section costs a lot more than a natural childbirth. Few obstetricians in private practice would absolutely refuse to do a Caesarian section on a women who really, really insists on one even though her reasons for having one are personal rather than medical. Thus the government and the NHS would lose millions of pounds every year if sections suddenly became very trendy. The ethics of the situation are not difficult to weigh. In a country that is apparently pro-Choice as far as elective abortion goes (118 000 a year in Britain) it is ridiculous to say that women should not be allowed to choose an elective Caesarian. The only rational question to be asked is: "Who should pay for it?" And the same question should be asked of elective abortions.

But let me end on a lighter note. Some psychologists have said that it's better for a child to be born by normal vaginal delivery. Apparently the struggle of the journey prepares us all for the struggles that lie ahead. The comedian Stephen Wright, perhaps the greatest proponent of the one-liner in comedy today, had this to say about it all: "I was Caesarian-born. You can't really tell, except sometimes when I leave my house, I go out through the window."

Homeopathic Tip of the Week: Childbirth

There are two great remedies to use after childbirth. Arnica and Bellis perennis and they are usually prescribed in 30c potency two or three times for a few days, starting immediately after giving birth. For Caesarian sections, and episiotomies, use Arnica and Staphisagria 30 also two to three times a day.

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