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Tuesday, November 1, 2011

Caesarian Sections

A Caesarian section is a major abdominal surgery involving 2 incisions (cuts): One is an incision through the abdominal wall and the second is an incision involving the uterus to deliver the baby. While at times absolutely necessary, especially in emergencies or for the safety of the mother or the baby, caesarean childbirth is not a procedure to be undertaken lightly by the physician or the mother. It should be performed medically necessary and definitely not for the convenience of women and surgeons.
History has it that the Roman leader Julius Caesar was delivered by this operation and the procedure was named after him. Shrewd historians, however, doubt the truth of this.  Julius Caesar seems unlikely to be the first since his mother Aurelia is reputed to have lived to hear of her son's invasion of Britain. C-sections were reserved for the dead.  So during that time the procedure was performed only when the mother was dead or dying, as an attempt to save the child, so that means that Julius Caesar could not have been the first caesarisn section. Roman law under Caesar decreed that all women who were so fated by childbirth must be cut open; hence, caesarian.
Latin language has many explanations for this. Other possible Latin origins include the verb "caedare," meaning to cut, and the term "caesones" that was applied to infants born by postmortem operations. Ultimately, though, we cannot be sure of where or when the term caesarean was derived. Until the sixteenth and seventeenth centuries the procedure was known as caesarean operation. This began to change following the publication in 1598 of Jacques Guillimeau's book on midwifery in which he introduced the term “section.” Increasingly thereafter "section" replaced “operation.” Caesarian sections remained rare before anaesthesia, which came along in the mid-1800.
History told us that sections took of around the turn of the 20th century when rickets began to plague malnourished families in crowded cities. The deficiency led to malformed bones, including the pelvis that could make normal childbirth impossible. Until today the term small pelvis is grossly overused to justify the reason for the alarming high caesarian section rates in the world. Almost every OB/GYN will tell a woman that they have a small pelvis and the fun part is that women actually believe that. Imagine if we as women all have a small pelvis, no woman would give birth via the vagina.
In Africa, which is the cradle of mankind, history told us that British Dr Robert Felkin observed a caesarian section performed by an traditional healer in Kahura, Uganda in 1879 by giving the woman banana wine, with a couple of men holding her tight. The traditional healer cleaned his hands and made a vertical cut through the skin and a second through the uterus. The wound was cauterized with a red-hot iron. How they know that is indeed very impressive. The baby was lifted out and the placenta removed. The woman was rolled over so the fluid could drain out of her abdomen, and then the abdominal wall, but not the uterus, was sutured with bark cloth and sharp skewers. A paste made of chewed roots was slathered over the incision and covered with a banana leaf and a cloth bandage. The skewers were removed after a week. Dr. Felkin, reported that both mother and baby “were doing fine, “when he left the village.
In the last 3 decades, the number of sections worldwide has doubled to more than 30 percent of all birth. The World Health Organization says that the c-section rate should be around 10% and no more than 15%. The section rates have been rising in the world and are a growing concern in many countries. The United States rate is now over 32% - and rising - and the maternal mortality rate is rising right along with it. Evidence shows that caesareans place women and babies at increased risk for morbidity and mortality immediately and long term. In the South Africa it is at 98% in private hospitals. It has become the most common surgical procedure in private hospitals in South Africa and women dont see to question that at all. 

The year I graduated from nursing school was a time for normal birth-- when C-sections accounted for 1.9 percent of all births. Caesareans were the prerogative of the obstetrician, not the mother, and were performed only when the physician thought that it was a matter of safety for both mother and child. That is all change now because every woman wants surgery.
A woman’s body basically is having her internal organs cut, clamp, moved around and then put back again, with the possible risk of infection. It isn't worth it unless it is medically needed. I can't believe the women who will go through it, and the risks, so they won't have to go through labour. I think women need to be educated about the choices. There are countries in the world where this operation is a desperate need and in my own country it is hitting an all-time high. It is so wrong!
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