“I thought C-section was very easy. I thought it was a few days. But after the C-section, when I got into a regular bed and the nurse came in and moved my bed up and down for me, until I couldn’t move, I thought my life was over.’
Habiba Khan is a squash player from Karachi. She is one of the women who gave birth to a child in Pakistan through an operation called C-section in common medical parlance.
The biggest challenge for Habiba was when she had to rest for six months after the birth of her son, whereas after a C-section, doctors say a maximum of one month rest, but this also varies from case to case.
What is a C-section?
C-section is a surgical procedure for giving birth. According to the doctors, the aftercare should be the same as after a normal surgery.
A C-section usually requires a 10 cm long cut, but the length and depth of the cut depends on the size and need.
Year-round C-section data in Pakistan is not available. Explaining the reason, Gynecologist Dr. Samreena Hashmi said, “Each hospital has different data, which has not been collected in one place through a survey.”
Is c-section an option or a necessity?
There are two different opinions on this question, but in the opinion and experience of most doctors, C-section is nothing more than an option and C-section is done only under extreme necessity.
This is necessary in cases where the uterine passage is small and the baby is large, the baby does not come out for four hours, the amniotic sac (the bag-like skin around the baby) becomes green or the mother has a high fever during delivery. . A C-section is also performed if the mother has gestational or pre-diabetes.
Apart from these reasons, Dr. Samreena Hashmi said that a woman’s body is perfect for normal delivery. During labor, the uterus contracts and straightens with each contraction. The uterus dilates one centimeter in one hour. In this, after a forty-second interval, the child gets pushed forward. But if the path for the child is not being made, then a C-section has to be done.
Women who have had two previous operations, instead of having a third C-section, are given a delivery date and are operated before the onset of pain.
Dr. Samreena said that the second delivery can be normal even if it is a C-section for the first time.
But it has to be seen that the C-section wound does not burst first. Therefore, along with taking care of the wound and stitches, the doctor also examines the wound before the second delivery.
In the UK, women are given the option by the government to freely decide whether or not to have a C-section.
According to government guidelines, women who are willing to undergo a C-section without any medical grounds should be informed about the surgery and its complications, which is the responsibility of the doctor.
In this regard, Dr. Samreena said that whether a woman should undergo a C-section in Pakistan or not, this right rests with the doctor or the girl’s in-laws.
“We are trying to train midwives to give them the right to help women make these decisions so that girls can make these decisions before they come to the hospital.”
C-section as a source of income, what is the status of C-section in Pakistan?
According to a study by the British scientific journal Lancet in March last year, about three hundred thousand women in the developing countries of the world lose their lives as a result of C-section every year.
Data from 1.2 million pregnant women from 67 low- and middle-income countries were examined for the study, published in the Lancet, which found that for every 1,000 C-sections, about eight women die.
C-section is becoming a source of income in Pakistan.
In the period from 2009 to 2013, doctors in Karachi have asked to avoid considering C-section as a method of childbirth because according to them it is not needed in every case.
About this, Dr. Samreena Hashmi said, “At present, most of the doctors in Pakistan are seen running from one hospital to another.” In this race, a C-section is recommended in the cycle of telling the patient an ‘easy process’. Those who sacrifice their lives for the sake of convenience but later regret it.
Currently, the cost of normal delivery and C-section is different in each hospital in Pakistan. While patients who go to private hospitals pay from 50 thousand to 1.5 lakh rupees, normal delivery in government hospitals is done for a few thousand.
Habiba had a miscarriage during her first child, after which she took great care during her second pregnancy.
“Keeping this precaution in mind, my husband and I decided to have a C-section as there was no other solution.”
However, Dr. Samreena said, “Government hospitals are notorious for this, but people go there only when their case worsens elsewhere.”
Hospitals now also distribute pamphlets as a guide so that people think before taking any advice.
Dr. Samreena has kept the charges for normal deliveries low at her hospital to ‘encourage women to have a normal delivery’.
Surgery and tips?
Doctors complain that usually people around women mislead them in the name of tried and tested things and due to lack of awareness they follow them.
Dr. Nighat Shah, associated with the Gynecology department in Karachi, said that two types of patients come to him. One who starts work immediately after the operation, they have to be told to rest and the other who are threatened not to get out of bed.
“Don’t drink cold water”
He said that after the operation, the cleaning process interferes more than the drugs. “As it used to be, don’t go in the water, don’t drink the water, it will make your stomach come out, it’s cold, it’s hot, it’s cold, it’s hot, the evidence is not found in the research.”
Before the birth of Habiba’s son, her blood pressure increased, she was diagnosed with hepatitis and her diabetes also shot.
But after the operation, everything stopped. I used to ask people around me what I should do and what not. I had a diet plan, but the elders told me that apart from eating Panjiri and Pakhi, I was forbidden to go up and down the stairs.
About this, Habiba said, “I did not hold my son for a month after the C-section because I was forbidden to lift weights.”
But later when he told another doctor about it, he said that there is no such prohibition.
I was so afraid not to do this, not to do that, that instead of three months of rest, I did six months of caution. Because of this, I used to play squash for hours, I used to sit down only after playing two or three shots. I stopped stretching before playing because I was afraid the stitches would come undone.
Imrana Waseem, a resident of Karachi, said that she started working immediately after the operation. Imrana lives in a joint family where at least 15 people live according to her.
Their daily work includes washing dishes after breakfast and lunch, standing for hours to make bread and making tea after dinner.
She says that before the surgery, I took my mother-in-law to the doctor and asked the doctor not to do the operation on me.
My surgery was done in emergency. When I went for a check-up a month after my daughter was born, my stitches were full. As a result of the filling, another minor surgery was performed and the stitches had to be redone.
About this, Dr. Nighat said that after the operation, the abdominal and internal stitches need time to heal. Because of which walking is appreciated.
In the same way, care must be taken to clean these stitches, if not done, there is a risk of the stitches falling out and opening.
About food and drink, Dr. Nighat said that either people around the patient say, “Don’t eat or drink anything” or they will say to eat panjeeri, halwa, ghee, and butter.
“If you have lost a lot of weight after the birth of the child, then you can eat a little more. But this is also a certain amount of food.”
He said that there is a debate going on in Pakistan whether C-section should be done or not, but most women are not allowed to rest after C-section. Therefore, most of them try to go to their mother’s house after the birth of the child where they can be taken care of more.