Having A Baby The ‘Normal’ Way In Urban India – A Thing Of The Past?

Posted: June 8, 2013

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Natural ChildbirthEverywhere I look around today, I see babies – In real life, friends / family are on their way to have babies, On Facebook, I see photos of smiling babies, happy families all smiles

Having a baby is one of these unexplainable moment in your life – Let me just say it is an “Aha” moment; just that the tone and reasons of the “Aha” can vary between “Aaaaaaaaaaaaha” to “Aaaaaaha” to “Aha” to “Ahaaaaa” to “Ahaaaaaaaaaaaa” – You see the range and variation can take you physically / mentally / emotionally/ financially / socially from this end to that 🙂

But that’s not what this blog is about.

It is about how Indian women of today are having babies. I personally don’t know of too many women who’ve had normal deliveries in India (Of course! There’s Aishwarya Rai Bachchan who was in the news when she had a baby, and everyone I know gives that as a classic example of the modern Indian women having a normal delivery). But the people I know who had normal deliveries DID NOT have their delivery in any of the new large fancy Air-Conditioned branded hospitals. It was in a normal small clinic which has been around for decades, and predominantly staffed by old experienced doctors and old motherly medical support staff (They do make a difference in the overall approach in dealing with pregnant women).

For majority of the women who underwent surgery (C-section) the reasons for the surgery don’t seem to be very convincing to the logical and curious mind – At least when you do a post-facto analysis! Almost in all cases, there appeared to be a situation in which treating doctors / medical staff highlighted with a serious somber expression and an urgent tone “A significant risk to the baby and that it’s not worth taking a chance”; “What exact risk?”,”What exact chance..?”.. remain as unanswered questions

I can’t help but wonder what’s the cause of this trend?

Agreed that women are having babies later than they did a few decades ago. Most of the women I’m talking about are between 27 to 35 years old (as opposed to the earlier generation who had babies between 22 to 25 years of age), but does that reduce your chance of a normal labor and delivery? I don’t think so. Even today, I personally know of women between 30 to 40 years of age (Indians / Other nationalities) in other parts of the world (US, UK, etc.) who’ve had perfectly normal deliveries.

Agreed that there are some women who personally decide that they don’t want to go through the pain and effort of a normal delivery, and opt-in for a surgery. Well! It’s a personal choice. To each women, her own.

Agreed that in some conditions the medical situation demands that you go in for a surgery – because of the risk factors involved to the life of the mother or the baby. In such cases, it is for lack of an option.

But surely, the above cannot add up to majority of the overall population of expectant mothers having to undergo a surgical procedure to deliver their babies!

Then the BIG WHY remains? Why are so few women not having babies the normal way? Is it a thing of the past?

Quiz your mother or grandmother, and they’ll say that majority of the women in their times had a normal delivery. Surgery was really an exception, almost unheard of in many places. And 30+ years later, a normal delivery happens as an exception.

At this point, let me narrate a personal story. My maternal aunt who is now well in her 50’s and is also a renowned gynecologist told me that when she was going through her labor (About 25+ years back), the pain was unbearable. Even though she was a practicing doctor by then and had seen so many women deliver the normal way, when it came to her own delivery the experience was something else. At that one moment of excruciating pain, she wanted to opt for the easy route of surgery. And when she suggested it to her treating doctor (who incidentally was also her family friend and teacher at medical school), she was rewarded with one pat on the back and a firm response that surgery was simply not an option & that she had to try harder. Consequently, she had to endure the process of natural child birth. And she did!

Looking back at her own personal experience, here’s what she said “I hated my doctor for what she told me then. But today when I look back at my life and think about it rationally, I am grateful that she insisted I go through a normal delivery. The point I am making is that child-birth can be a difficult and painful experience for most women. The mother is in physical pain and it is visible. The husband and family feel miserable to see the pain and agony of the expectant mother & want to do what it takes to alleviate the pain by opting for surgery. At such instances, the role of the treating doctor and medical staff is of paramount importance. They should be patient and motivate, support and encourage the expectant mother to deliver the normal way. They also play a very important role in re-assuring and listening to the questions and anxieties of the expectant father and family. It is in that ONE VULNERABLE MOMENT that the decision to go for surgery or not is usually made. And the doctor’s words makes all the difference here!”

I can’t help but wonder:

– Has something changed in the anatomy or physiology of women in the past few decades that has brought such a turn of numbers?

Is it purely commercial interests that drive medical institutes to convince women and their families to go in for a surgical procedure?

– Is it personal convenience which drives medical staff to recommend a surgical procedure ; since you can control the time of the delivery (and plan for it during business hours, as opposed to odd-working hours), and the duration in a surgical procedure (a normal delivery typically lasts longer for the doctor, than a surgical procedure)

– Is it purely achieving professional targets (in terms of the surgery costs / number of deliveries done / number of hospitalization days) which drive doctors to achieve their goals?

– Is the Hippocratic Oath / the Modern Medical Oath (refer below) meant only for theory, and really for practice? Is it just a piece of paper to be signed as a part of standard procedure?

The reality is this – there’s a natural way babies are meant to be born. And when you try to bend the way things are meant to be done – for convenience, comforts or commercials, there are bound to be consequences – for individuals, for families, for communities and for the world at large!

That’s my view. What’s yours? Leave a comment to let me know


Modern Medical Oath

At the time of registration to be a doctor, each applicant shall be given a copy of the following declaration by the Registrar concerned and the applicant shall read and agree to abide by the same:

  • I solemnly pledge myself to consecrate my life to service of humanity.
  • Even under threat, I will not use my medical knowledge contrary to the laws of Humanity.
  • I will maintain the utmost respect for human life from the time of conception.
  • I will not permit considerations of religion, nationality, race, party politics or social standing to intervene between my duty and my patient.
  • I will practice my profession with conscience and dignity.
  • The health of my patient will be my first consideration.
  • I will respect the secrets which are confined in me.
  • I will give to my teachers the respect and gratitude which is their due.
  • I will maintain by all means in my power, the honour and noble traditions of medical profession.
  • I will treat my colleagues with all respect and dignity.
  • I shall abide by the code of medical ethics as enunciated in the Indian Medical Council (Professional Conduct, Etiquette and Ethics) Regulations 2002.
  • I make these promises solemnly, freely and upon my honor.

[Src: http://www.ima-india.org/IMA_medical_oath.html ]

*Photo credit: Michael Rhode (Used under the Creative Commons Attribution License.)

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  1. Interesting post!!

    I had my daughter at the age of 25 and i had a C-Section because of low amniotic fluid level..

    Even i am hearing more and more cases of women having only C-Section even where it seems like there are no medical complications and when full-term is completed..i know so many cases even in suburban areas, mostly C-Section deliveries are happening..

    I feel Doctors today prescribe C-Section due to all the reasons you mentioned..there are very few Doctors who actually encourage Normal deliveries..

    • Sri – thanks for stopping by. In many cases, a C-section is essential for medical reasons. But in many instances that I have heard or personally seen, there are many open questions!

  2. A minor detail, but it bugged me to no end…both vaginal and c-sec are “normal” deliveries. It is more appropriate to differentiate using the words “natural” and “c-sec”. 🙂

    • Manasee – Thanks for stopping by. I checked with a couple of doctor friends – and they say that “normal” and “natural” are both commonly used.

  3. Sarbani Mandal -

    I personally feel that a woman should be the ultimate decision-maker in matters like this. When I opted for a C-section 11 years ago, many said that I would be incapable of doing a number of activities, such as lifting a bucket full of water, etc. I have a perfectly normal life and feel that women should be given a right to choose the method of delivering her babies. I am all for painless births. I mean, why should a woman unnecessarily bear with this pain when alternatives are available? And it’s not as if her life will be any less happy/successful if she had C-sections.

    • Sarbina – Agreed it should be the women’s choice. but after you are equipped with all the information to make an educated choice. Every woman’s body is different, and hence recovery time varies. And there are options to have less pains even for natural birth. Nischala

  4. Arunima Shekhar -

    “But the people I know who had normal deliveries DID NOT have their delivery in any of the new large fancy Air-Conditioned branded hospitals.” – beg to differ. I delivered the baby in one of the new, swanky AC hospitals in Bangalore, in Jayanagar 3rd Block. But in spite of having a very long and difficult labor, in spite of my family pleading with the doc, he refused to do a C-sec. His only argument was “she’s totally fine”. I hated my doc at that time, but today I’m grateful to him. And I know at least 4 other women who delivered at the same place with the same doc. Point here: A generalization in this case is not possible. A lot depends on the doctor, and where his/her priorities lie.
    As for the change in physiology of women in the past few decades, I would say yes. Today we have a more sedentary lifestyle than our mothers or grandmothers. Also eating habits are very different. These do make a lot of difference on whether you deliver naturally or not.

    • Arunima – I was happy to read your response and that you had a normal delivery. I am not generalizing that its the case everywhere and with every doctor, but it appears to be an increasingly predominant trend across India. There are ample reports and statistics to indicate this. Nischala

  5. I believe it mainly depends on the doctor/gynaec whom you are going… I delivered my 1st at the age of 31 with cord around her neck (discovered at the last) but had a normal delivery and my second one was 3.64 and I was scared if I can push him out..But my doc (she is gem) said anything is possible.. you just don’t worry… Also there are some hospitals like cloud nine where they go for normal delivery rather than c-sec. Reason is they charge you rather than killing the patient with wrong reasons..

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