Cesarean section is not a form of delivery, but a mandatory surgical intervention!

Stating that the rate of cesarean section surgery in Türkiye is well above the reasonable limit of 15 percent, experts say that almost one out of every two children is born by cesarean section.

Stating that cesarean section is a method that should not be preferred unless there is a medical necessity, Faculty of Health Sciences Midwifery Department Asst. Prof. Tuğba Yılmaz Esencan expressed that "When complications develop that may endanger the health of the mother and baby, cesarean delivery may become necessary as a vital intervention. Moreover, it should not be forgotten that cesarean section is not a mode of delivery, but a mandatory surgical intervention, and the widespread use of cesarean section may have negative effects on public health."

Üsküdar University Faculty of Health Sciences Vice Dean, Midwifery Department Asst. Prof. Tuğba Yılmaz Esencan touched upon the birth process and delivery methods and informed about the effects of cesarean section and normal birth.

The birth process is extremely important for the health of the mother and baby

Stating that the birth process is an extremely important period for the health of the mother and baby, Asst. Prof. Tuğba Yılmaz Esencan expressed that "In this process, it is essential for a positive and safe birth environment for the expectant mother to feel safe, respected, protect her privacy, provide freedom of movement and receive continuous physical and emotional support in order for the birth to proceed in its natural flow. The expectant mother is more comfortable and peaceful when giving birth in an environment where these needs are met. This contributes to the healthy progress of the birth process."

Is cesarean delivery a necessity or a choice?

Asst. Prof. Tuğba Yılmaz Esencan stated that "Cesarean delivery can have negative effects on the health of the mother and baby when preferred outside of medical necessity. Scientific studies show that asthma, respiratory tract infections and allergic diseases are more common in babies born by cesarean section, breastfeeding problems are experienced, and mother-infant interaction is impaired. Moreover, cesarean section prolongs the recovery process of the mother after childbirth and makes physical and mental recovery difficult. However, cesarean section can be a mandatory intervention for mother and baby in some cases. In risky pregnancies or complications during childbirth, cesarean section can save the lives of both mother and baby. At this point, it is important to distinguish between situations where cesarean section is necessary and unnecessary interventions. Cesarean delivery can be considered a healthy option, especially when it becomes necessary due to the risks faced by the mother or baby during childbirth."

Almost one out of every two children is born by cesarean section

Stating that the high cesarean section rates are an important health problem in our country, Asst. Prof. Tuğba Yılmaz Esencan continued her remarks as follows: "In our country, this rate is well above the 10-15 percent level recommended by the World Health Organization (WHO). According to the 2022 Health Statistics Yearbook data, the rate of cesarean section in Türkiye is well above the reasonable limit of 15 percent, almost one out of every two children is born by cesarean section. While the ratio of total cesarean section surgeries in hospital births in all state, university and private hospitals was determined as 62.8 percent in 2022, this rate was recorded as 60.9 percent in 2021 and 59.6 percent in 2020. The cesarean section rate in university hospitals has reached 75 percent. While the ratio of cesarean section surgeries in hospital births in public hospitals was 42.8 percent in 2020 and 44.6 percent in 2021, this rate increased to 46.4 in 2022. Therefore, we must act and take precautions."

What is behind the increase in cesarean section rates?

Noting that there are factors such as "fear of childbirth, pregnancy at an advanced age and the perception of cesarean section as an easier option" behind the increase in cesarean section rates, Asst. Prof. Tuğba Yılmaz Esencan stated that "However, if there is no medical necessity, it is recommended to prefer normal birth. Cesarean section is a method that should not be preferred unless there is a medical necessity. When complications develop that can endanger the health of the mother and baby, cesarean delivery may become necessary as a vital intervention. This decision ensures that the healthiest delivery method for mother and baby is chosen. Moreover, it should not be forgotten that cesarean section is not a form of delivery, but a mandatory surgical intervention, and the widespread use of cesarean section may have negative effects on public health."

Normal birth also reduces the risk of postpartum depression

Expressing that that cesarean delivery negatively affects the postpartum bonding process between mother and baby, and that early contact and delays in the breastfeeding process can lead to health problems in the future lives of babies. Asst. Prof. Tuğba Yılmaz Esencan stated that "We should also consider that the hormone oxytocin, which is secreted during normal birth, strengthens the bond between mother and baby by ensuring the natural progression of birth and reduces the mother's risk of postpartum depression."

There are misconceptions that babies born by cesarean section are more intelligent

Emphasizing that normal birth offers many health advantages for both mother and baby, Asst. Prof. Tuğba Yılmaz Esencan stated that "In the normal birth process, the baby is exposed to bacteria important in terms of intestinal microbiota as it passes through the birth canal, and this contributes to the development of the immune system. It is stated that babies born with normal birth can receive more breast milk and are more resistant, and these advantages may decrease in mothers who give birth by cesarean section. Cesarean delivery, on the other hand, stands out as a life-saving surgery in emergency medical situations. Cesarean section can be preferred when the baby is in an inverted position, if the structure of the mother's hip bone is not suitable, or when there are complications of childbirth. However, the perception of cesarean delivery as an indicator of wealth for a period of time and the false beliefs that babies born by cesarean section are more intelligent have been effective in increasing cesarean section rates."

What are the possible risks that mother and baby may face during the normal birth process?

Stating that despite the naturalness of normal birth, there are some risks, Asst. Prof. Tuğba Yılmaz Esencan continued her remarks as follows: "The normal birth process is a journey of surrender in which the end cannot be clearly predicted. Unexpected situations may occur. What is really important here is how we can deal with these situations and the presence of a midwife who accompanies us on this journey. Prolonged births can cause physical exhaustion and birth trauma for the mother. Moreover, prolonging the duration of labor for the baby can lead to a decrease in oxygen levels. However, most of these risks can be minimized with medical interventions. This is where the importance of the union of pregnant and midwife in birth emerges. The presence of a midwife at birth will help a woman to experience an unforgettable birth journey. This situation should also be considered independently of the type of birth. For every woman, the journey of childbirth is unique. Whether it is a cesarean section or a normal birth, if the woman has been able to write her own story in the birth journey, if the mother and baby are healthy, the main goal has been achieved. However, it should not be forgotten that by encouraging normal birth, the health of both mother and baby can be protected in the long term."

Benefits of normal birth on mother and baby

Noting that normal birth, as a non-invasive process, will enable the mother and baby to experience positive physiological, psychological and emotional effects, Asst. Prof. Tuğba Yılmaz Esencan said that "The hormones secreted during birth facilitate the bonding of the mother and the baby, contribute to the faster arrival of breast milk and more successful breastfeeding. Moreover, when the baby passes through the birth canal, the intestinal flora develops, which strengthens the baby's immune system. Another important advantage of normal birth is that the mother recovers physically and mentally faster after birth. In the absence of a traumatic birth experience, the mother can more easily adapt to her new roles and baby care after birth. Although pregnancy and childbirth are defined as a developmental crisis in a woman's life, every birth is actually a process in which a woman is born to her own motherhood and becomes stronger."

What are the potential risks of a cesarean delivery?

Stating that cesarean delivery can prolong the recovery time of the mother in the short term and cause more pain, Asst. Prof. Tuğba Yılmaz Esencan said that "It can also adversely affect the mother-baby bonding process after birth. Another risk dimension is that mothers after cesarean section may face the risk of postpartum depression, which may weaken the bonding between mother and baby. In the long term, health problems such as asthma, allergies and obesity can be encountered more frequently in cesarean babies."

Üsküdar News Agency (ÜNA)