Many of us who frequently travel and often have to eat in strange restaurants and places often pick up stomach infections which result in dysentery and diarrhoea

Caesarian Sections and Episiotomies

-by Sheela Rani Chunkath

The number of Caesarian sections being performed on mothers to be alarms me. Today having a normal delivery has become a luxury in many urban areas of India and even in many rural areas of the more developed states, such as Tamil Nadu and Kerala. Only 10% of all deliveries should normally be Caesarian, but in urban areas such as Chennai, the percentage is very high and if we take elite private hospitals the percentage is even higher. Similarly, episiotomy the surgical incision made below the vagina is very routinely performed leading to much pain and trauma for the mother. In a study undertaken when I was Secretary, Health Department, Government of Tamil Nadu, we found that in teaching hospitals where obstetrics and gynaecology was offered as a postgraduate course, almost 100% of the primigravidae had had an episiotomy whereas in another teaching hospital where obstetrics and gynaecology was not offered as a postgraduate course, the number of episiotomies performed was only about 50%. The desire to have hands-on experience, the reluctance to wait, the fear of unregulated tears all lead to such unnecessary episiotomies being performed.

Today everybody is in a rush and so too with the doctors. Nobody wants to wait and give the baby a chance of being delivered naturally. And of course babies are no respecters of time or day. Friday evening 8 pm, early Sunday morning 3 am are all fine by them to make an appearance. Many doctors would rather not have their schedule and life upset so repeatedly. Fix a time for Caesarian section when it is convenient for you and the mother, scare up the family a bit, saying this is a precious baby, do you really want to chance it, go for a Caesarian section, all will be well. Mother’s bodies are being unnecessarily traumatised and their natural concerns for their baby exploited to perform unnecessary Caesarian sections and episiotomies. I think we need a movement of doctors, midwives and women to check this growing trend.

Ayurveda has a wonderful regimen for pregnant women on what to do and what diet to follow for each month of the pregnancy. In the meantime select an obstetrician/vaidyar who has the time and patience to let you have a natural delivery and to resort to a Caesarian section only when signs of foetal distrress develops or there is danger to the mother’s life.

I think we have now come a full circle; many who thought it modern and prudent to have an institutional delivery would now prefer to deliver at home with a competent midwife with emergency provisioning close at hand. Chances of avoiding unnecessary surgeries are also ensured.

The antenatal and postnatal care in Western medicine is very minimal whereas ayurvedic texts contain elaborate rituals to take care of the mother and the newborn baby. For example after the placenta comes out of the vagina, the entire body is anointed with oil and massaged. Meat is to be avoided for twelve days. Medicated ghees and thin gruels are prescribed depending on the health of the mother. For at least one and a half months, the mothers diet is to be carefully monitored. Sarirasthana chapter in Ashtanga Hridaya deals with this at length. The modern practice of women rushing back to work and eating so-called normal food should be avoided. The mother needs gentle and loving care following the birth of a child.

--- The writer was earlier Health Secretary, Govt. of Tamil Nadu and is currently CMD, TN Industrial Investment Corporation; Sheelarani.arogyamantra@gmail.com