History and safety of caesarean sections
What is the history of caesarean section?
Nobody knows for sure. It is certainly known that caesarean delivery (which means abdominal delivery) has been practised in various civilizations for over 2500 years. History shows a specific law in the Roman empire in the year 715 BC known as "Lex caesarea", which demanded the abdominal delivery of a baby if the mother died during pregnancy or labour. The term caedere means "to cut" in Latin.
How safe is caesarean section?
It is very safe. When compared to a century ago, the safety of caesarean section has improved light-years. It has improved enormously, even when compared to the mid-1930s.
Compared to vaginal delivery, caesarean section - even in developed countries - has significantly higher complication rates. For this reason alone, caesarean section is and should be resorted to only when necessary. At least, this is the argument still holding sway as the 21st century gets underway.
Why is caesarean section safer today, compared to the past?
There are several reasons why there has been tremendous progress in this area.
Operation techniques have evolved over time to reach a stage where optimal approaches have been adopted.
The safety of anaesthesia has improved quite dramatically in the last few decades. Both regional (spinal or epidural) and general anaesthesia are now much safer compared to only fifteen or twenty years ago.
The control of infection, another major scourge of surgical procedures, is much better now. This is a result of an effective creation of a sterile environment necessary for operations as well as the development of antibiotics. Many people forget that antibiotics have only been around since the late 1920s.
Blood services are much more reliable now. Since excessive blood loss is one of the more serious potential complications of this operation, reliable blood replacement is an important facet. Nowadays, blood and blood products are readily available and safe.
The Caesarean Operation
How is a caesarean section done?
It is easy for doctors and midwives, who live with this common operation in their daily working lives, to assume that everybody knows what happens. In fact, many woman confront it with no idea as to what it involves. Basically, a caesarean delivery will involve cutting open the abdomen and then the uterus to deliver the baby. It is therefore an abdominal delivery as opposed to the usual vaginal delivery.
How is the abdomen opened in a caesarean section?
By far the most common incision is the "transverse" one, made just above the bikini line. It is also known by various other names, but the wound and ultimately the scar will look the same, more or less.
Less commonly used is the "midline vertical" (up and down) incision. This extends from just below the navel to just above the pubis. It accounts for probably less than 5 per cent of all caesarean skin incisions. Needless to say, the more common transverse incision gives significantly better cosmetic results.