an examination of the role of antenatal care attendance in ...

Literature shows that high rates of caesarean delivery do not necessarily indicate better delivery and
post natal care and is likely to be associated with high risks of adverse birth outcomes. A study
conducted in Latin America on caesarean delivery rates and pregnancy outcomes found while there
might have been a need for caesarean surgery to take place due to primiparity previous caesarean
deliveries, etc; the chances of adverse outcomes were vast. The results of the Latin American study
showed that an increase in the rates of caesarean delivery was associated with an increase in fetal
deaths and morbidity, resulting in babies being admitted to intensive care for seven days or more. In
addition, rates of preterm delivery rose at 10 to 20 percents rates of caesarean section deliveries
between (Villar et al. 2006).
Other studies have found similar results on the adverse effects of caesarean deliveries throughout the
world. According to the Coalition for Improving Maternity Services fact sheet (2004), babies born
through caesarean section are 50 percent more likely to have low Apgar scores, five times more likely
to have required assistance with breathing and to be admitted to intermediate or intensive care. Some
babies will inadvertently be delivered prematurely due to the fact that they might not be naturally ready
for delivery. In addition, babies delivered through caesarean section are more than four times as likely
to develop persistent pulmonary hypertension compared to naturally born babies. Also, they may find it
difficult to form an attachment with their mothers, and might be likely to have difficulties
breastfeeding.
According to a study conducted in Canada, women who have planned caesareans had an overall rate of
severe morbidity of 27.3 per 1000 deliveries compared to an overall rate of severe morbidity of 9.0 per
1000 planned vaginal deliveries. The planned caesarean group had increased risks of cardiac arrest,
wound haematoma, hysterectomy, major puerperal infection, anaesthetic complications, and
haemorrhage requiring hysterectomy over those suffered by the planned vaginal delivery group
(Shiliange 2007).
Another study found that women who had just one previous ceasarian section were more likely to have
problems with their second birth. Women who delivered their first child by cesarean delivery had
increased risks for malpresentation, placenta previa, antepartum hemorrhage, prolonged labor,
emergency cesarean, uterine rupture, preterm birth, low birth weight, small for gestational age and
stillbirth in their second delivery (Robyn 2007).
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