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Under what circumstances should one go in for a caesarean delivery?

Q: I would know what do people think about caesarean cases happening nowadays in India. I totally agree that most of the caesarean cases the doctors perform are for their own personal profit. I would also like to know under what circumstance one should go in for a caesarean delivery? What are the symptoms or reasons looking at which doctors should advise the patient for caesarean? My sister has recently undergone a caesarean delivery. Her pregnancy was 40 weeks. All the medical reports were normal but the doctor still suggested for a caesarean stating that the due date had passed so there was an element of risk in a normal delivery. Is this true? How can one determine that what a doctor has done is for the good?

A:Caesarean Section (CS) is never performed nor suggested by any doctor for earning money. You may think so - but it is totally wrong. That is why, some doctors and hospitals are beginning to charge the same rate for CS and a normal delivery, which I think, is totally justified, and should be implemented by all hospitals. In fact a doctor has to spend a tremendous amount of time and effort during a normal delivery. Even though you may be signing a form that states you will not hold the doctor responsible for any mishap during surgery, no doctor takes the surgery casually. You must remember that we are dealing with human lives - not objects. If some case does develop complications, despite best efforts and judgment, the doctor feels extremely bad about it, and is equally pained as the patient and her relatives. We are also human, and we do have a conscience. Also, remember that doctors in India and in any other country are same - equally good (or equally bad). Coming to the indications for CS, they are briefly classified as: A. For fetal (baby) reasons - common indications are: fetal distress (numerous ways of identifying a fetus in distress), transverse lie and breech presentation (baby presents as feet first). B. For maternal (mother) reasons - one common indication is contracted pelvis (passage small for baby). Others are non- progress of labour, failure of induction, bleeding in pregnancy (APH) etc. It is impossible for me to comment on your sister's case. We need to examine the case and go through entire records to do so. A patient must have trust and faith in her doctor - that is one of the important ingredients for a successful outcome.

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