Cesarean Section

Up to a third of women can expect to have a cesarean section as a method of childbirth. Figures differ for various centers and certainly there is wide variation from country to country as we shall see shortly.

It can now be declared in absolute terms that cesarean section is a very safe procedure that should be carried out without hesitation in the presence of a valid indication. But this is where debate rages. Has cesarean section achieved a level of safety where it can be offered on demand? We explore this question but it is not the main focus of this section. In here, we have attempted to present broad and specific details about this everyday surgical procedure.

It is extremely important to remember that, whatever degree of technical refinement achieved in performing it, cesarean section is and will remain a major surgical procedure. Any arguments for a more liberal approach towards cesarean section should never lose sight of this fact. On the other hand, those mothers who feel that they are well informed and would like to deliver by cesarean section regardless deserve the right of a sympathetic ear, though not necessarily an affirmative nod.

Between 10 and 35 per cent of all pregnancies are delivered by cesarean section. In the UK, the average was 15.5% in the mid-1990s and now stands at just over 20%.

In 2005, the rate in the United States came in at just over 30%, close to the tail of South America with 33%. In fact in Brazil, the rate in private hospitals is around 80% (compared to 35% in the public hospitals).

In Australia, the rate hit 29% in 2004, up from 19% only ten years earlier. Cesarean section is clearly on the march globally but, can results justify the trend? We shall see.

While childbirth in developed countries is now a very safe undertaking, as far as the mother is concerned, cesarean section is a riskier delivery method in terms of both morbidity and mortality.

Although the figures are very small (a death rate of less than 0.1 per cent), vaginal delivery remains a far safer way of having a baby today. In twenty or thirty years' time, quite plausibly, this statement may belong to history.

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Transverse (horizontal) incision

Vertical incision

The ‘bikini-line’ or transverse incision is the accepted standard incision for cesarean section. In exceptional situations, an ‘up and down’ or vertical incision (below) would be used.