Safe delivery

While public hospitals prefer vaginal delivery unless specific medical conditions necessitate a C-section , couples in private hospitals can choose either approach depending on various factors .

Increasing prevalence of C-sections According to Dr Vigneswaran Ramakrishnan , an Obstetrician and Gynaecologist at Prince Court Medical Centre in Kuala Lumpur , there are two types of delivery options generally practised at hospitals : vaginal delivery and delivery via caesarean section ( C-section ). “ Generally , we encourage mothers to choose vaginal delivery unless clinical factors or personal preference led them to consider a C-section ,” he told ��o�a� �ea�th �sia��aci�c�

While public hospitals prefer vaginal delivery unless specific medical conditions necessitate a C-section , couples in private hospitals can choose either approach depending on various factors . “ Expecting mothers , specifically those who conceive in their later years , choose C-section for various reasons , mainly for protecting their perineal area which consists of the urethra ( where you pass urine ), vagina and rectum and also because they want to deliver their baby at a certain time ,” Dr Vigneswaran added .

This trend correlates with reports from the Organisation for Economic Cooperation and Development ( OECD ) and the National Obstetrics Registry indicating the increasing practice of C-sections at healthcare facilities at local and international levels in the past decade . In Malaysia , this may be attributed to the rising maternal age among women , where the average childbearing age increased from 26.6 years in 2001 to 27.9 years in 2019 , according to the Department of Statistics .

Dr Vigneswaran explained that the C-section delivery rate in Malaysia has steadily increased and now accounts for up to 30 percent of hospital deliveries . “ These statistics are likely due to the experience of attending doctors and maternal preference which opted for C-sections ,” he said . The choice of C-section is also influenced by maternal indications , such as active genital infection and cardiac disease , as well as foetal conditions like multiple pregnancies , placenta covering the uterus , which can obstruct the baby ’ s delivery , and foetal distress where the baby is not receiving adequate oxygen from the placenta .

C-sections also offer pregnant women advantages in terms of speed and convenience , allowing them to deliver the baby at any time , which does not apply to vaginal delivery . “ Some mothers want to deliver the baby at a preferred time specifically based on horoscope . In addition , the mother experiences minimal anxiety due to the planning of delivery time , reducing the risk of injury to the perineal area , rectum , bladder , and anus , and maintaining vagina integrity ,” Dr Vigneswaran elaborated . But expectant mothers delivering their first child via C-section should be aware that it can alter subsequent birthing procedures . “ Once you ’ ve delivered via C-section , you are 30-40 percent more likely to deliver in the same manner for future pregnancies ,” he said .

Moreover , a C-section increases the risk of uterine rupture during labour which can endanger the mother and child . And because continuous C-section deliveries can increase this risk , Dr Vigneswaran suggests that mothers who have undergone three consecutive C-sections consider a tubal ligation , a birth control procedure that involves cutting or obstructing the fallopian tubes to prevent future pregnancies . While surgical incision during C-section is generally painless due to the mother being administered with an epidural , the recuperation period post-delivery can take up to one month compared to vaginal delivery , which can take just days or weeks .

Home birth : A risky tradition In Malaysia , births occur not only in hospitals but also in homes , following a practice known as home birth . This option is normally preferred by pregnant women who want to deliver at a comfortable and familiar environment with minimal medical interventions as well as for cultural or religious purposes . But Dr Vigneswaran cautions that , while home births are deeply rooted in pre-hospital times , they still pose several complications . “ In every ten pregnancies , nine produce no difficulties . Our concern is the one pregnancy with high mortality risk that requires medical intervention in a hospital setting ,” he said .

He explained that the health complications that can occur in a home birthing setting include extensive injury , lacerations to the vagina extending to the rectum , excessive bleeding , and a large size baby that can have trouble passing through the vagina . “ I have seen couples who attempted home birth and presented conditions such as umbilical cord prolapse , a condition where the cord comes out of the uterus before the baby , prompting us to conduct an

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