Everyone involved in childbirth care should know a lot about caesarean section because it has become a very important method to deliver pregnant women safely.
Women delivered by caesarean section account for about 50% or more of all women delivered in most hospital settings across the world.
In settings where the ‘midwives’ did not receive any formal training to take deliveries, an increasing number of women who patronize them are being whisked off to hospitals to have a caesarean birth when they fail to deliver vaginally.
There is a need for these ‘midwives’ to know the role they can play to make caesarean birth safe for those women who need it. This work is intended to make them avoid delaying the women in labour that need caesarean birth in their centres. This is because such delay can produce death or morbidity (severe illness) of both a woman or her baby or both of them.
The book is also aimed at helping them avoid complicating the challenges some pregnant women that need a caesarean section may have.
For example, it will make ‘midwives’ avoid turning a baby lying transversely or that is bottom – down in a woman who had a previous caesarean section. This helps to avoid rupture of the uterus and its terrible consequences. Going through this book will help any ‘midwife’ know how to use aseptic techniques or infection protective devices to prevent infecting women and their babies and to protect herself from dangerous germs.
The following are personal infection protective devices
- Hand and elbow-length gloves
When women that must have a caesarean section to be safe come to the hospital from places where they have been infected with dangerous germs, those germs make caesarean section extremely dangerous to saving these women and/or their babies. When these women arrive at the skilled childbirth centre already infected and dehydrated, the cost of restoring them to a condition that can be said to be safe for caesarean section is increased. Some unschooled baby surgeons can operate such dehydrated and/or infected women without resuscitation and infection treatment and kill them
Therefore, birth attendants have a role to play in presenting pregnant women or those in labour in a condition in which surgery can be safely done on those who need it. They are not to delay them in their centres. They are not to complicate their problems and they are not to cause problems for them.
They need an understanding of what caesarean birth is all about and how it can be made safe for women and their babies.
Hence their need for this book. This work will help all ‘midwives’ have an open mind about all methods of childbirth including caesarean section and avoid a vaginal-delivery-only mindset which is responsible to some extent for delaying women that need a caesarean section.
They are also to know what will make a birth attendant to be known as unskilled and/or greedy and avoid such things. The book aims to give some skills to all childbirth attendants that will make them safe for our pregnant ones.
They will be able to know high-risk pregnant women that will need caesarean section and send them to obstetricians instead of delaying them or fiddling with them and provoking complications or worsening the challenges these women already have. They will know the need for haemoglobin estimation for all pregnant women and how to treat those who are anaemic to avoid presenting anaemic women to surgeons to operate for those that will need it.
Infection screening and treatment will also be necessary to minimize the risk of chorioamnionitis (infection of the amniotic fluid and membranes) which can lead to challenges during caesarean section and possible death of a mother or baby. Childbirth attendants have a role to play to make caesarean section safe.
One role every childbirth attendant should play to make caesarean section safe for women that need to is to ensure such women have normal blood pressure. They should check their blood pressures during every visit to the clinic during labour and even during caesarean section. Efforts should be made to keep the blood pressure of pregnant and labouring women normal through the use of antihypertensive drugs, anxiolytics (anxiety-reducing drugs) counselling.
Counselling sessions are meant to reduce the fear of the unknown and instil confidence in all the process of safe delivery including caesarean section. The issues around the woman and/or her baby are weighted against all options for safety and the best approach communicated to the woman and her spouse. All that is done to make caesarean section safe are told her, her spouse and her mentors to make them accept a needed caesarean section without fear.
People easily oppose or reject what they don’t understand or know. Opening up the caesarean section to childbirth attendants will help reduce opposition to it and encourage it. They need to know their roles in making it safe for women and/or their babies by helping to normalize blood pressure of pregnant or labouring women who need a caesarean section, the birth attendants make the job of surgeons easier. Instead of grappling with obstructed labour and severe high blood pressure at the same time, they can just face only obstructed labour. Instead of grappling with eclampsia and thinking of caesarean section later they can just face carrying out a caesarean section on a woman who is hypertensive and eclampsia have been prevented by a compassionate birth attendant who used antihypertensive to treat the high blood pressure earlier on.
Doctors who are not specialists in obstetrics but who take deliveries need this book. Nurses and midwives, traditional birth attendants, auxiliary midwives and all the people that take deliveries need this book. It will help them make caesarean sections safe for their clients who need the operation. The work is to make the work of surgeon easy as they prepare their patients that need caesarean sections adequately to ensure the safety of the procedure.