Caesarean section — boon or bane?

June 24, 2012 01:36 am | Updated 01:36 am IST

The Caesarean section is a unique procedure performed the world over. It has contributed more to the welfare of mankind and saved more lives than most, nay any other surgical intervention designed or devised till date. It is a procedure of choice to retrieve a mature, viable baby from the womb through wounds inflicted on the abdomen in order to bypass the vaginal route.

The etymology of the expression ‘Caesarean section’ is uncertain. ‘Caedere’ in Latin means ‘to cut’ and the origin of the expression seems to be from this word. More popularly, it is attributed to the birth of Julius Caesar.

The operation was designed originally to retrieve a live foetus, only from a dead or dying mother. Times have changed; the accepted indications and performance of the procedure have also undergone a sea change.

Jacob Nafer performed the first ever Caesarean section, in 1500 A.D. in Switzerland, that too on his wife. She was in labour for several days and, in spite of the help of several midwifes, could not give birth to the baby. Finally, Jacob took courage and with permission from the authorities did the first Caesarean section. The story goes on. She gave birth to five children, including twins subsequently.

The architecture of the pelvic cage which lodges the brood chamber, the flexibility of the bony arch overhanging the royal outlet for the safe passage of the foetus, the design of the musculature that is in a great measure responsible for the expulsion of the foetus, and its resilient restoration and return to the status absolutely as it were are miracles which we humble humankind could only marvel and admire.

The dominant role played by the foetus, the self-driver in the game of delivery, far surpasses what is exhibited by some oviparous creatures. Some of us might have seen the fowl chick in the hatchery, peck and knock down the eggshell barrier between it and the universe and come out alive and agile. The foetus plans, initiates and monitors the muscular forces of the womb and opens up the royal gateway to this world all by means of secretion of certain hormones. These secretions have been detected and precisely identified in the amniotic fluid. In addition, the foetus itself moulds, turns and twists and squeezes itself out of the mother’s womb. Have you come across or can you even remotely imagine a better example of symbiosis among the live and would-be live?

Nature has made elaborate arrangements for childbirth. Then why should we resort to artificial methods? Scientifically speaking, there are only two groups of indications for resorting to alternatives.

Mechanical abnormalities or functional disorders of the genital organs or the passage; and an imminent danger to the foetus — when its stay any longer in the womb would be disastrous to itself, technically called foetal distress.

A pertinent question is, “Is there any handicap to the Caesarean baby?” Probably “Yes.” It has been pointed out that the foetus is not just a passive cargo that is bailed out at its destination. The foetus, in fact, is driving its own body down the lane. This activity of the foetus, its propulsion to the vast expanse of the universe by moulding, turning and twisting give the infant its first and only training in coordinated muscular-skeletal activity at a most opportune time that will keep it in good stead throughout its life. The Caesarean section deprives the foetus of this unique experience.

The message is loud and clear. If feasible and possible, allow the foetus to “Follow the royal road.” The Germans say: Folgen Sie die Koengliche strasse

(The writer’s email is kuruvilla_mj@bsnl.in)

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