MUST READ: CEASERIAN SECTION, GOOD OR BAD?

CONSIDER THIS STORY: She is a booked 33 year old primigravid hospital staff who presented at a GA of 39w+2d on account of drainage of liquor 5 hours prior to presentation. Had augmentation of labour. However following an assessment of prolonged second stage labour secondary to cephalopelvic disproportion, she was counseled on the need for an emergency caesarian section, but she declined. At the 8th and 16th hour review, with obvious fetal distress, she was again offered a C/S but bluntly turned it down. 18 hours after presentation, she had assisted vacuum delivery of a male neonate that weighed 3.97Kg with an apgar score of 2 in 1 and 3 in 5. Attempts at further resuscitation failed. She had postpartum hemorrhage with 3rd degree laceration that was repaired under anesthesia in the theatre.

HERE IS A SECOND STORY: She is a booked 31 year old G2P1+0A1 Nurse who presented in active phase of labour at 40w+1. She had augmentation of labour. An assessment of prolonged second stage of labour secondary to persistent Occipitoposterior Position was made and was counseled on the need for an emergency C/S. One would have expected that being a nurse, she would have appreciated the untoward consequences of the assessment made and wouldn’t hesitate to give informed consent.

Alas, this nurse declined C/S. Later her husband came around and muttered something about Hebrew women delivery to her. At the 12th hour review, with obvious fetal distress and chorioamnionitis, she again declined a C/S. Eventually with much scolding and admonition from her fellow nurses, she reluctantly agreed to the operation and signed the informed consent form.  She was lucky, as she was delivered of a life female neonate that weighed 3.15Kg with an Apgar score of 7 in 1 and10 in 5. Funny enough, the husband came back (the consent form was signed in his absence) rather than being appreciative of the effort of the doctors, he kept threatening the doctors for taking his wife to the theatre. Anyways, I wouldn’t blame him that much, I would rather blame the nurse who placed such decision bothering on her reproductive right and life in the hands of a lay and misinformed husband of a man.

The above real life instances highlight the widely held misconception about C/S amongst women in general and women of southeastern extraction in particular who view anything short of a vaginal delivery as failure of maternal achievement.

This misconception is further compounded by the widely held and taught, but misinformed and misunderstood concept of ‘Hebrew Women Delivery’ amongst Christian faithfuls. Whereas the traditional Igbo woman who goes under the knife to have her baby is dismissed by her family(particularly her mother inlaw) and scorned at by the Umuadas as been weak and unworthy of womanhood, the Christian woman’s case is further compounded by her brethren and Pastors who thought her deficient in her faith as to have failed to ‘claim’ the promise of the ‘Hebrew women Delivery protocol’.

Suffice it to state that in the western world, 37.9% of women willingly book for elective caesarian section as their preferred mode of delivery. Therefore, that a woman undergoes a C/S to have her baby does not make her any less a woman, it equally does not make her any less a believer of God’s promise of a safe delivery for His daughters. For indeed an uneventful Caesarian Section with good fetomaternal outcome is equally synonymous to a ‘Hebrew women delivery’.

With respect to Caesarian section, the depth of ignorance is so deep and it’s grip so firm that even health workers are not spared its siege and spell.

For if the average 21st century registered practising healthworker in a Federal Teaching Hospital has such a skewed perception to Caesarian Section, one can only but wonder at the burden of ignorance on the street.

Ignorance can be bliss, but certainly not in matters of health.

REFERENCE : Dr. Ogbu Nathaniel 07039040488, Enugu, Nigeria

 

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Cynthia Isuekebhor