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Could a Caesarean kill you?

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baby birth lib

AP

Experts want midwives and doctors to ensure new mothers get the maximum opportunity to have skin-to-skin contact right from the start.

London - They should have been the happiest days of her life. Joanne Johnson and her partner David had long dreamed of the day they would bring their baby home and make him the centre of their loving little family.

Instead, Joanne, 27, spent the first days after the birth of her son in such crippling pain she was barely able to care for her baby, let alone experience the overwhelming joy she had always imagined would envelop her after giving birth.

Within a week she was in such agony that she couldn’t walk and had to be taken into casualty in a wheelchair.

Joanne, a nurse, gave birth by Caesarean at Rotherham District General Hospital almost six years ago, after doctors noticed her baby’s heartbeat was slowing and feared the umbilical cord might be wrapped around his neck.

To Joanne and David’s relief, he was born perfectly healthy on November 27, 2006, and they named him Harrison. Yet, on December 2, Joanne developed stomach pains and her family took her to the hospital’s walk-in centre, where a doctor diagnosed constipation.

Joanne’s mother, Barbara, an experienced nurse, told the doctor the symptoms were too serious for that, but Joanne was still sent home.

Two days later, she was so ill she had to be re-admitted to hospital, where doctors realised that she was suffering from a serious infection.

‘They put her into the intensive care unit for emergency antibiotic treatment,’ says her father, Glenn, a technology teacher in Rotherham, South Yorkshire. ‘The ICU staff said she’d be back with us the next day.’

But Joanne never recovered. She died six weeks later, on January 14, after toxins from the infection destroyed her lungs.

Like so many of us, Joanne and her family thought of a Caesearean as a routine operation - and even an easier option than a natural delivery. The NHS even relaxed its guidelines last year, making it easier for mothers to have Caesareans, a move driven by demand.

Indeed, the number of C-sections has doubled in Britain since 1990, and they now account for almost a quarter of all births.

Many celebrities plump for the op, scheduling their babies’ deliveries between concert tours, acting jobs and TV appearances, which has given rise to the phrase ‘too posh to push’.

The operation is now far more common than in the Fifties, when only around 3 percent of babies were delivered by Caesarean.

But growing research now suggests that this ‘easier’ option could be putting mothers and babies at greater risk. Troubling new statistics show that one in ten women develop an infection after a Caesarean.

This comes on top of a raft of other recently discovered dangers including infertility and child-bonding difficulties for mothers and for babies a significantly raised risk of obesity and allergies such as asthma. The stark reality is that C-sections involve serious surgery - with serious risks.

Shortly after Joanne’s death, her mother was diagnosed with lung cancer. ‘Barbara died only 18 months after we lost Joanne,’ says Glenn.

‘I am certain my wife could have beaten the cancer, but she’d lost Joanne, then she lost the will to live.’

Harrison is now five and ‘a fabulous boy,’ says Glenn. ‘Harry lives with his father, who has left work to care for him. I have him twice a week and every other weekend. Harry knows his mom is dead - we’ve told him she’s a star in the sky.’

In March 2010, a coroner’s inquiry criticised the hospital’s actions. Nicole Mundy, the Rotherham coroner, told an inquest that Dr Ben Gatenby, the doctor who had seen Joanne at the hospital, had given ‘insufficient regard’ to Joanne’s complaints and notes from her GP.

Rotherham NHS Foundation Trust was ‘unable to comment’ due to legal proceedings but offered condolence and support to Joanne’s family and were ‘committed to learning from any situation where changes can be made to improve what we do’.

Her father is not satisfied. ‘To say it was constipation was ridiculous,’ says Glenn. ‘We are still fighting a lawsuit against the hospital. We are fighting for damages for Harry, but we are also trying to help ensure this never happens again.’

Yet, with soaring numbers choosing the operations - NHS figures show that the percentage of babies delivered via C-section is up from 12 percent in 1990 to almost 25 percent today - it is almost inevitable that more women will suffer dangerous complications.

Research undertaken in London in 2009 found almost 10 percent of mothers who had C-sections suffered post-surgical infections.

Last September, Carly Holmes, 24, a childcare worker from Enfield, North London, went into Homerton Hospital, East London, expecting to give birth naturally to her first child.

‘I went into normal labour, but the doctors realised my baby’s heart rate was dropping,’ says Carly, who lives with her partner Richard, 25, a barman. ‘They said his head wasn’t low enough in the birth canal for me to have a safe normal delivery.

‘I wasn’t aware how serious it was. But my mom and partner were with me, and I could tell they were upset. I was given a general anaesthetic and taken into the operating theatre.’

Carly came round three hours later to be presented with her healthy baby boy, Thierry. She was told everything had gone well and was discharged two days later on a Saturday.

The following Wednesday, however, she began to feel ill. ‘By Saturday, I was in crippling pain.’ Carly could see fluid seeping from her Caesarean scar and called NHS Direct, which sent a doctor to see her that evening.

‘The area from my navel down to my scar was red and inflamed,’ says Carly. The doctor said the wound was infected and that I should seek further help the next day.

‘My partner was working nights, so I was alone. I couldn’t move because of the pain - I couldn’t even hold my son, I hurt so much.’

A midwife saw Carly the next morning, by which time the redness had spread - a possible symptom of blood poisoning. She was sent back into hospital and drip-fed antibiotics for a week.

‘The doctors reopened the stitches and removed the infected tissue. The pain was incredible,’ says Carly. ‘I was never told the cause of the infection.’

After a week, she was sent home with antibiotics, and had to visit her GP every day to have her dressing changed. The wound improved over the next week, but then Carly noticed her stomach becoming red again.

‘I saw the GP, who put me on stronger antibiotics,’ she says.

Carly has now recovered, but is angry about what she went through. ‘The infection ruined my first two weeks of bonding with my baby,’ she says. ‘Now I worry about having another baby, and whether something similar might happen again.’

Some women’s experiences have been so traumatic that they have decided never to have another baby.

Emma Iannarilli, a 38-year-old from Wolverhampton, was the acting headteacher of a primary school when - seven-and-a-half months pregnant with her first child - she had an emergency Caesarean in December 2008. The repeated and uncontrolled haemorrhaging that followed was so bad doctors feared they would have to perform a hysterectomy.

Emma suffered such severe trauma that she had to give up teaching. And she has now vowed never to have another chld.

‘I was really happy to be pregnant. I was 34 and it was my first child, so I was over the moon,’ says Emma, who lives with her husband Peter, 39, a carpenter.

On December 16, she went to the The Manor Hospital in Walsall for routine checks and the doctors said they had found abnormally high levels of protein in her urine. This is a warning sign of pre-eclampsia - a dangerous pregnancy complication linked to high blood pressure.

‘Doctors told me they would deliver my baby the next day,’ she remembers. ‘I was worried - it felt like too early in the pregnancy. But their scans showed he was a healthy size.’

After Joe was born, Emma initially felt fine. At about 1.30am, four hours after the delivery, her sister came to visit and sat on the end of the bed.

‘I had a urine catheter in, which is normal after a Caesarean, and suddenly felt the bed become warm and wet,’ says Emma.

‘I told my sister I thought she’d sat on the catheter line, but she had a look and ran off to get a nurse.

‘The staff nurse came and told me I’d had a haemorrhage, which can happen with Caesareans. But within ten minutes, I’d started to have another one. The nurses didn’t seem too panicked, and said again that this can happen. Within the next 20 minutes it happened twice more. The fourth time it happened, I thought I was dying.

‘On that occasion, my husband said he could see blood pouring out of the side of the bed.

‘All the staff started running around, my bed was surrounded by screens and I was rushed to intensive care, where I stayed for 27 hours. I was so sedated that all I remember is hearing my mom crying.’

Doctors said that if the bleeding persisted, they would have to perform a hysterectomy. ‘I was horrified,’ adds Emma.

Fortunately, the problem began to abate, though only after days of further bleeds. But the traumatic Caesarean had a lasting legacy, sparking post-natal depression and preventing Emma from bonding with her new baby.

‘I only saw him very briefly after the birth, and then I was drugged up for so long I was beyond caring,’ says Emma. ‘The drugs in my bloodstream meant I couldn’t breastfeed. I had to bottle-feed him and I was not confident with that.’

Emma spiralled into ever-deepening anxiety, misery and panic. Seven months later, she was diagnosed with acute postnatal depression.

‘I couldn’t stop crying at everything, good or bad,’ she recalls. ‘I couldn’t do anything around the house. I was convinced I was a bad mom. I also had physical symptoms such as diarrhoea and migraines.’

Emma tried to go back to work, but couldn’t cope. Within a month, she was signed off for stress. She never returned to teaching. Six months of counselling helped her to recover.

‘It all comes from that horrific birthing experience,’ she says. ‘If I could have had a normal delivery, I would certainly have gone for that. I could never agree with having a Caesarean for lifestyle reasons.’

Emma adds: ‘It has never been explained to me what happened with the haemorrhaging, or why it was so hard to stop. I directly attribute all my problems to the Caesarean.

‘Will I try for further children? No. I think that all the same problems could very well occur again.’

Emma’s fears about Caesareans are well-founded. Evidence shows that the operation may significantly raise a woman’s risk of having to undergo a hysterectomy - and the risk increases further after two births.

Studies show that problems may be caused by the accumulation of scar tissue in the womb. Caesareans have also been proven to cause difficulties with mother-baby bonding.

In 2008, American researchers compared brain scans of six healthy mothers with those who had undergone Caesareans to those of six mothers who delivered naturally. They found key areas of the brain regulating feelings such as empathy and motivation on the sound of their baby crying were more active in women who hadn’t undergone C-sections.

The process of normal birthing prompts massive spikes of different hormones in the mother, including oxytocin, the ‘cuddle’ hormone linked to feelings of love and trust.

Research also highlights problems affecting some babies born by C-section. These include immune-system troubles, obesity and asthma.

Now, experts speculate that these may be caused by the baby failing to absorb vital bacteria to which they would normally be exposed in the birth canal.

And research published by Harvard University in June found that babies delivered by Caesarean section are twice as likely to be obese by the age of three as those born naturally.

The study said babies born by Caesarean develop different intestinal bacteria from those born vaginally. Similar bacterial problems may explain why Caesarean babies are nearly 80 percent more likely to develop asthma compared with those born vaginally, according to Swiss researchers.

But information about all these potential perils is often kept from mothers who are considering a Caesarean delivery.

That is a serious problem, because research has revealed that informing women fully about the implications of Caesareans could prevent tens of thousands of unnecessary operations every year in Britain - and a lot of unnecessary misery. - Daily Mail


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