About the book
Forty years ago CS was not a common Obstetric surgery with a frequency of just over or less than 10%. In the following decades, there was a dramatic increase in the frequency of the order> 1% / year.
The tendency to have a smaller number of children led to a higher percentage of primigravidas who are at increased risk for caesarean section. The widespread application of assisted reproduction methods has led to increased rates of twin (35%) and multiple (77%) pregnancies and consequently a rise in the percentage of CS's.
There is a trend that supports the view that the induction of childbirth between 39-40 weeks of pregnancy will help to reduce the incidence of stillbirths.
Active birth control is mainly used to reduce cesarean sections. However, epidural analgesia may increase the frequency (13% vs. 8% in the US).
The passage of the newborn through the mother's vagina, the skin contact after childbirth as well as breastfeeding give the newborn the advantage to colonize with the beneficial germs of his mother, for which has already have antibodies from the fetal life. Their penetration into the digestive system of the newborn contributes to the creation of the normal intestinal flora, along with the activation of its defense system with the possibility of maximum development.
Microbes that their mother does not have are dangerous to them. When a field of labor is sterile, such as a caesarean section, the newborn will be colonized by the first germs it comes in contact with, which are other than those of its mother. From a microbiological point of view, the newborn needs to be in contact with a single person, his mother.
CS is a surgical procedure that should be done only on real medical indications, as it can lead to potential consequences such as infection, thrombosis, bleeding, emergency hysterectomy, persistent pelvic pain, infertility, even death.
The final decision on how to terminate the pregnancy is individualized for each woman individually, based on the particular medical - obstetric indications of the pregnant woman, her personal medical and surgical souvenir but also her needs and preferences that must always be taken seriously by the responsible Obstetrician-Gynecologist.
Extremely important is the role of thorough information, based on documented knowledge, that every pregnant woman should take from health professionals before making any decision.
The consulting role of the Obstetrician-Gynecologist is catalytic, in order to responsibly and objectively inform the pregnant woman both about the special, possibly, conditions of the specific pregnancy, and about the general documented scientific guidelines on the choice of the way of termination of the pregnancy.
It is important that the recording of the provided information, the special indications (with the identification of the prominent one), and the signed consent of the pregnant woman for a caesarean section after her thorough information are included in a special form of her medical file.
Equally important is the provision of informed information to the pregnant woman during pregnancy and not only at the end of it or during the delivery process, regarding the possibility of cesarean section and the accompanying parameters: indications (such as fetal distress, or failure to progress during childbirth, breech presentation, etc.), methods, relative risks and benefits, potential effects on future pregnancies and deliveries.
The common consent and the choice of the woman for the way of the outcome of her childbirth are the main reasons for the change of the obstetric practice.
The use of documented guidelines is one of the appropriate ways and their implementation will mean the reduction of CS percentages.
