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Dr. Copsidas news

21 April 2011
With great pleasure, I would like to announce the publication of my new book on applied operative...
25 January 2010
With pleasure we announce the organization of the 1st Training Seminar in Operative Obstetrics, i...

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Natural labor and caesarian surgery

HISTORY

Labor is the complete expression of the female existence. In most cases, the woman can give birth naturally on her own, or as it used to happen in the early days, with the help of a “wise” woman, as they used to call the obstetricians back then.

From early years till the first half of the 20th century, labor had complications that many times led to the death of the infant and the mother, no matter its natural status. The huge developments in midwifery began after 1950 resulting in a dramatic drop in maternal and infant mortality rates.

The improvement in mortality was due to new methods, as well as the developments of older methods of intervention in complicated deliveries by obstetricians, always assisted by skilled midwives.

THE TWO TYPES OF LABOR

Labor is divided into two types: vaginal childbirth and caesarian surgery.

A)THE VAGINAL CHILDBIRTH

The vaginal childbirth is divided into the absolutely natural birth, which means without any help of the doctor and to the invasive delivery, where the doctor helps the birth of the infant with forceps or suction fig. Trusting an experienced and well-trained obstetrician, can have fabulous results!

B)BIRTH WITH CAESARIAN SURGERY

Unfortunately today, caesarian has a very important role in labor, taking part in most of the births, without taking into consideration the real reasons that would need such a surgery.

The caesarians take place without any serious reason and this is one of the most important issues that should be faced in the specialty of the obstetrician-gynecologists.

The reasons why today caesarian is carried out:

  • Wrong information given to the women concerning the safety of the infant and the mother.
  • Faulty training of the doctors in interventional gynecology.
  • Less time of occupation for the doctor.
  • Bigger economic gain for the doctor.

In Greece, the percentage of caesarian surgery is about 75% out of all labors, while internationally it is more than 25%. There are multiple reasons that are stated above. Frequently, the mother relates to the fear of the doctor, who, for many reasons does not want to face the more conservative methods of a natural birth. A well trained doctor can use many different tools that can make a natural labor easier, as to avoid caesarian surgery, which can lead to problems and complications, no matter how much it is advertised for its safety for both the mother and the infant.

Moreover, it is claimed that if there has been a caesarian once, the rest of the labors should be in caesarian too. This is a myth and the woman can give birth naturally most of the time even after caesarian surgery. For sure, there are always exceptions and a good doctor has to explain clearly the reasons and the strategies that he/she is going to follow during the labor.

The mother has to take into consideration the choice of the doctor, so as to avoid unpleasant surprises and the need of a caesarian for no apparent reason.

In order for a caesarian surgery to be carried out, the following should be taken into consideration:

  1. Risk to the survival of the fetus before the great expansion of the vagina.
  2. Disproportion between the fetus and the pelvis of the woman.
  3. Bleeding complications not manageable by other means.
  4. Complicated fetal position, not manageable.
  5. Heavy pathological situations of the mother or the fetus.

The big myth, that has been spread out is that the caesarian surgery is totally safe for the mother and the fetus and that it is more preferable than natural birth. This is a big lie! The fetus is at risk from both operations and the non-enzymatic activation mechanisms that nature has provided to be activated through normal delivery.

For those reasons, a big percentage ends up in incubators and requires special care.

As for the mother, there can be dangers due to extensive injury to adjacent organs and infections. Also, there can be problems by using antibiotics and other drugs, which could have been avoided.

A very serious risk is bleeding, that if it cannot be stopped, can even lead to death.

There are always more rare complications, which do not need to be analyzed more.

For those reasons, caesarian should be the solution in very needy situations, when there is no other way and not the “easy solution” for the doctor.

Additionally, we have to take into consideration the high cost, the disruptive to the immediate rehabilitation of the woman and all the social problems created in a home from a person that has been into surgery.

DANGERS AND CONSEQUENCES OF THE CAESARIAN SURGERY:

For the mother:

  • dangers due to extensive injury to adjacent organs
  • dangers from infections
  • health dangers from antibiotics and other drugs
  • bleeding danger, that when cannot be stopped can lead to death
  • disruptive to the immediate rehabilitation of the woman
  • more rare complications for the infant: dangers from the doctor’s treatment
  • dangers from the non-activation of enzyme mechanism of the organism of the mother

LABOR TODAY

Labor with anesthesia

Labor today can be easier due to anesthetics. The anesthetic is done in the lower part of the spinal cord, when the woman starts feeling the contractions or from the beginning of the labor if it is essential.

The anesthetic is totally safe, and it facilitates the oxygenation of the fetus and the descent to a normal birth. If invasive methods are needed, this makes it easier as the woman does not hurt and can cooperate with the doctor.

In the case of caesarian, the woman does not need to have a complete anesthetic and the surgery can be done only with partial anesthesia.

In conclusion, the lesson is: “We have to be careful in the selection of our doctor and we shall not believe everything he says”!

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