Worldwide the accepted rate of vaginal delivery for a standard safe fetal and maternal outcome should be 70- 75 %. Which means only 25- 30 % women (higher in institutions which tackle high risk deliveries) should ideally require a caesarean section. But today because of various reasons, the rates of planned and emergency caesarean section arerising. The reasons could be large for size babies, sedentary lifestyles, medical complicationsin pregnancy like hypertension and diabetes, late age pregnancies, pregnancies conceivedafter ART, pregnancies with previous caesarean section, low threshold for pain, social
reasons, medico-legal implications etc.
Planned elective caesarean section is generally performed at 39 weeks of pregnancy or earlier based on various maternal and fetal parameters. On the other hand, the decision for an emergency caesarean section is taken during labor, in case of conditions like inability of the fetal head to descend despite good contractions ( cepahlo-pelvic disproportion ) , non
progress of labor, fetal distress, passage of meconium, maternal bleeding etc.The decision for a caesarean section , whether planned or emergency is taken after detailed discussion with the patient and the family explaining the risks and benefits of the procedure.
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