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What Can We Do To Increase Chances Of Normal Delivery?

By Dr. Manju Khemani in Obstetrics And Gynaecology

Nov 13 , 2020 | 3 min read

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Recent data from the National Family Health Survey 2014-15 (NFHS-4) reveals that at the all India level the rate of C-sections has doubled over the last decade, while in last 20 years, it has risen six times. Rates of cesarean section are much higher in private hospitals than in public hospital.

Until 2010, cesarean—or C-sections—were limited to 8.5% of all deliveries in the country, But in the last decade or so, the numbers have escalated in many parts of the country. It’s not only in India but all over world caesarean rates have increased. Turkey is at the opposite end of the scale with just over half of all babies delivered via c-section. The United States and Australia also have higher cesarean rates than average, 32.5 and 32.1 per 100 live births respectively.

The question that arises here is whether caesarean section delivery is free of all complications and if no, then what can a woman  do to reduce possibility of ending up in caesarean section .


What Are The Complications Of A Caesarean Delivery?

Let's see what are the complications of caesarean section vis a vis normal delivery-

  1. More woman die during caesarean section then in normal delivery.
  2. Woman is also exposing herself to complications of anaesthesia.
  3. She is more likely to have fever, wound infection.
  4. Blood loss is more than double as compared to normal delivery and hence woman feels weak for a long time after caesarean section.
  5. She is also more prone to have clots in veins.
  6. In next pregnancy she may have ectopic pregnancy or caesarean scar pregnancy. Rarely she may end up in getting her uterus removed because of rupture uterus in next pregnancy or placenta accreta.

All this information is important for patients who request caesarean section on demand.


Is Caesarean Section A Result Of Lifestyle Diseases?

Answer is yes. All over the world, because of economic growth food is abundant Average weight gain during pregnancy  in affluent society is 14 -20 kgs  as compared to recommended 9-11 kgs. Exercise in day to day life is almost nil. Because of hired help for household work manual work is  extinct. All these life style changes have made labour much longer as compared to 50 years back. Lastly majority of educated working woman are not ready to bear pains.


Tips For Pregnant Women to Avoid Ending Up In Caesarean Section

We do not know what brings labor pains? In France it was seen that washer woman who was doing lot of manual work were usually delivering very prematurely and once government intervened and they were made to stop work in 7th month these women could carry pregnancies till term. So we can extrapolate that if pregnant woman will do some exercise it may push her towards normal delivery. In one population based study from Denmark it was seen that those women who were doing some leisure time activity were less likely to have emergency caesarean section. This study also proved that increasing leisure time physical activity before and during pregnancy was associated with a less complicated delivery.

It’s a myth that doing exercise can lead to preterm birth. Scientific studies have proven that Aerobic exercise for 35-90 minutes 3-4 times per week during pregnancy can be safely performed by normal-weight women with singleton, uncomplicated pregnancy because this is not associated with an increased risk of preterm birth or with a reduction in mean gestational age at delivery. Studies have also shown that exercise during pregnancy is associated with a significantly higher incidence of vaginal delivery and a significantly lower incidence of caesarean delivery. It also helps with weight management, reduces the risk of gestational diabetes in obese women, and enhances psychologic well-being. Before starting any regular exercise routine it’s essential to take permission from your obstetrician.


How Much Exercise A Woman Should Do During Pregnancy?

For healthy pregnant and postpartum women, the guidelines recommend at least 150 minutes per week of moderate-intensity aerobic activity (ie, equivalent to brisk walking). This activity should be spread throughout the week. Serena Williams continued to play tennis during her pregnancy. If you are not accustomed to doing exercise then start slowly and gradually increase over a week. May be one can start 5 minutes of walking per day and gradually increase to reach 30 minutes per day. Remember that during pregnancy, joints are relaxed because of pregnancy hormones so avoid doing sudden and jerky movements. Avoid doing anything which is making you breathless.

One should drink plenty of water before and after exercise to avoid dehydration.

Examples of safe exercise during pregnancy are brisk walking, swimming, cycling on static bicycle or modified yoga. When a person is doing exercise a feel good hormone endorphin is released from brain which makes a person happy. If a pregnant woman is happy she will have a happy baby.