Another concern for the expectant mother and other relatives is, is it normal or Caesarian section? Many couples today tend to say that a caesarean section will work, even if the older ones at home insist that the delivery be normal.
Let's take a look at some of the misconceptions about childbirth from one of my experiences and incidents in today's blog.
Exhausted from the day's work, Corona fell asleep in the DMO duty room at night. At around 2 am, the hospital staff informed me through call on my mobile that ANC came in labor room and she had a headache. So I attended patient immediately as it could be sign of impending eclampsia for those who knows better.
That pregnant lady came , did not have any sonography or report with her, all the ANC files were forgotten at home in the village. This is the usual experience while working in the public health department, but this tai has educated and is ignorant despite being pregnant for the second time. When I examined the pregnant Tai, her baby's heartbeat was very fast and her blood pressure was high. The baby's head was very high as the place of delivery was small as compared to baby's head. There is no cervical dilatation so informed in lucid language to understand her that ur cervix was not opened such that to deliver baby. But the water around the baby means the amniotic fluid was all depleted because the amniotic membranes were ruptured and the special thing was that on examining that the patient was operated previously for caesarean delivery when you know what you can do as a gynecologist in a situation like a first cesarean.
As the baby was not coming out, some 'remedies' were taken at home without taking the patient to the primary health center as the people of maternal side wanted to give her birth normally.
If the patient is experiencing any of these such as headache, dizziness, vomiting, nausea and the patient's BP is elevated, we immediately inject Magnesium Sulphate as the case of impending eclampsia (before the convulsions) as per protocol and give Anti HTN Labetalol to the patient.We refer to Tertiary Care Center Medical College immediately. Similarly, we started preparing to forward this patient. Already this patient has spent a lot of time at home.
In fact, with the first caesarean section, no one immediately thinks of normal delivery. Doctors do the elective lscs of such patients
same for us without waiting for the full months .But normal delivery can be done with few exceptions or in exceptional circumstances.
above picture of same patient who delivered at higher centre by caesarean section. There is a ruture of scar through scar membranes seen bulging.
It was also very risky to prepare her at night and perform surgery on her because she did not have any report and USG. In fact, she kept her at home on purpose. She was well thought out and had a previous pregnancy. Doctors told her on discharge that she had LSCS for eclampsia, placenta previa and CPD. There is a mentality in the villages or in some cities that doctors do lscs for no reason at all, so there is nothing that doctors can do when they spend some time in the life threatening industry. Occasions like these happen in the life of every obstetrician. This is not new, especially to doctors who have a business in small towns, as well as doctors in government hospitals. This is due to the fear of a cesarean and the urge to have a natural delivery. Many come to the hospital too late when nothing to be done . They think that if they go early, they will perform the operation. Of course, the lack of facilities and ignorance in the villages in our country is also the reason for this.
The second case is a doctor's clinic in a wealthy neighborhood in the city. An educated, self-employed woman pleads with her partner to be a doctor - ‘Doctor, we only want one child. The boy / girl will do anything; But the condition is the same if there is any danger to me or my baby, it is not acceptable to me at all. I don't want the possibility of obstructions in natural childbirth. I want 100% assurance from you that everything will be fine. Besides, I will not be able to bear the hardships and physical hardships of natural childbirth. We’ve got all the information from the internet and from different books and you will have a caesarean section at the time I tell you (looking at the moment). ’Given the nature of her and the baby, she was more likely to have a natural delivery. However, there are some people who say that her insistence on cesarean section persisted even after all was explained. This incident which happens in many countries around the world is currently happening in many big cities of our country. The doctor at the primary health center and also like me know very well what it feels like when there is no anesthesiologist at night when there is a delivery with complications, when there is a high risk delivery,and when no patient comes with a report.
Even when you are an obstetrician yourself, you can only think of a caesarean section and in such a situation you can't do anything, so you start to feel like an ignorant uneducated person and nothing else. But in this case, there is no other option but to send the patient to a higher center for cesarean and sonography. MEDICAL OFFICERS working in the public health department come across situation like this but occasionally to a rural hospital or subdistrict hospital. Of course, it seems that we are uneducated doctor.
@ crazycervix
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