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Ganesh Talkies
Ganesh Talkies
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Welcome to the blog page of Dr. Megha Khanna, one of the best lady gynaecologist in Kolkata.
When it comes to modern obstetrics, few topics generate as much discussion as the rising rates of caesarean section deliveries. While this surgical procedure can be life-saving in certain circumstances, exploring the factors that influence its increasing prevalence is essential. One of the key areas of focus is antenatal care—the regular medical and psychological support a woman receives during pregnancy.
As the best lady gynaecologist in Kolkata, I, Dr. Megha Khanna, believe that while antenatal care is designed to monitor the health of the mother and baby, in some scenarios, it may also inadvertently contribute to the likelihood of a caesarean section. Let’s explore how.
Antenatal care refers to the routine health check-ups, screenings, nutritional guidance, and education that pregnant women receive from healthcare professionals. The objective of antenatal visits is to ensure the optimal health of both the mother and the fetus, detect complications early, and prepare the mother for delivery.
Regular antenatal care helps identify high-risk pregnancies, manage existing medical conditions, and reduce maternal and neonatal morbidity and mortality. However, in recent years, the role of antenatal care in influencing delivery methods has come under scrutiny.
Though antenatal care is crucial for positive pregnancy outcomes, it can sometimes lead to an increased rate of caesarean section for the following reasons:
With advanced technologies and screening methods, even borderline findings can be perceived as potential threats. Conditions like mild gestational hypertension or slightly lower amniotic fluid levels often prompt obstetricians to opt for caesarean section as a precautionary measure.
In-depth antenatal counselling may make mothers overly anxious about the pain of labor or the safety of vaginal delivery. Some women, especially first-time mothers, request caesarean section to avoid complications discussed during antenatal care sessions.
In today’s healthcare environment, where legal accountability is high, doctors may choose a caesarean section to avoid any potential risks that could arise from vaginal delivery—even if the chances are minimal.
Some hospitals have protocols or pressures—subtle or overt—that promote caesarean sections for convenience or financial reasons. In these cases, antenatal care becomes a funnel guiding patients toward surgical delivery, rather than allowing natural labor to proceed.
Improving antenatal care to reduce the need for caesarean sections involves a multifaceted approach that combines clinical best practices, patient education, supportive care models, and system-level changes. Drawing on recent evidence and expert recommendations, here are the key strategies:
As the best lady gynaecologist in Kolkata, I emphasize that antenatal care should empower women—not alarm them. A well-balanced approach that includes:
can significantly reduce the chances of an unnecessary caesarean section.
The quality of antenatal care significantly impacts the likelihood of a caesarean section, with several key factors influencing this relationship:
Studies show that a higher number of antenatal care visits, particularly more than six, is associated with an increased probability of caesarean section by about 47%. This may seem counterintuitive, as antenatal care aims to reduce complications, but frequent visits often lead to closer monitoring and detection of potential risks that prompt medical interventions, including caesarean delivery.
The quality of antenatal care, not just the quantity, plays a crucial role. Poor quality care characterised by brief, protocol-driven appointments with limited dialogue and insufficient participation from nurses or midwives can lead to fragmented care and dissatisfaction among pregnant women. Such care tends to emphasise procedures and risk management, which may increase the likelihood of opting for caesarean section rather than supporting natural birth processes.
Early initiation of antenatal care (within the first trimester) and receiving comprehensive care contents are linked to a higher likelihood of caesarean section, as early and thorough assessments detect obstetric, medical, or surgical complications that may necessitate surgical delivery. This suggests that quality antenatal care enables timely identification and management of risks, which can increase caesarean rates but potentially improve safety.
The World Health Organisation emphasises that quality antenatal care should be women-centred, involving emotional support and shared decision-making. When women are adequately informed and actively participate in birth planning, unnecessary caesarean sections may be avoided. Conversely, poor communication and a lack of shared decision-making can lead to higher caesarean rates.
Lack of antenatal care or poor-quality care is associated with increased maternal complications in caesarean deliveries, including infections and haemorrhage. Thus, good-quality antenatal care can reduce emergency caesarean sections and related complications by early risk identification and planned interventions.
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| Aspect of Antenatal Care | Impact on Caesarean Section Likelihood |
| More than six visits | Increases caesarean likelihood by ~47% |
| Poor quality, fragmented care | Leads to higher caesarean rates due to protocol-driven approach |
| Early initiation (1st trimester) | Associated with higher detection of complications, increasing caesarean rates |
| Lack of shared decision-making | Increases unnecessary caesarean sections |
| High-quality, women-centered care | Supports informed choices, potentially reducing unnecessary caesareans |
The current antenatal care system faces multiple significant challenges that affect the quality, accessibility, and effectiveness of care for pregnant women. These challenges are experienced by both healthcare providers and pregnant women, impacting the overall outcomes of antenatal services.
Healthcare providers often lack a dedicated, private consultation room or designated space for antenatal education. This results in overcrowded clinics where multiple patients are seen in the same room, compromising privacy and the quality of education and counselling provided. Providers report disturbances and interruptions during consultations, which hinder effective communication and patient engagement.
High patient volumes and multiple responsibilities for healthcare workers lead to work overload. Providers frequently do not have sufficient time to spend with each pregnant woman, limiting opportunities for thorough examination, counselling, and education. Time constraints mean antenatal education is often superficial or omitted altogether.
Many antenatal clinics suffer from understaffing, with insufficient numbers of doctors, nurses, and especially midwives. The absence of midwives, who play a critical role in providing comprehensive antenatal education and support, is a notable gap. Staff shortages exacerbate workload issues and reduce the quality of care.
Appropriate educational tools are scarce, such as leaflets, videos, and other teaching aids. Healthcare providers rely heavily on limited materials or verbal instructions, which may not effectively meet the diverse educational needs of pregnant women. This shortage limits the ability to deliver comprehensive, understandable antenatal education.
Pregnant women often face difficulties understanding the medical terminology used by healthcare providers. The use of unfamiliar language and medical jargon without adequate explanation creates confusion and anxiety, reducing the effectiveness of antenatal counseling.
Antenatal care frequently lacks personalization. Women report that care providers do not adequately address their specific concerns or provide detailed information about childbirth, postpartum care, and newborn care. This superficial approach leaves women with unanswered questions and fear, especially for first-time mothers.
Overcrowded clinics with large numbers of pregnant women waiting for care reduce the quality of the antenatal experience. Long queues and insufficient seating or amenities such as clean toilets and drinking water discourage women from attending regular check-ups.
Factors such as poverty, seasonal migration, cultural norms (e.g., women moving to their mother’s home during pregnancy), and generational beliefs about when to start antenatal care disrupt continuity of care and reduce utilization. These social determinants often limit access to timely and adequate antenatal services.
Fragmented maternity systems, underfunding, and inadequate health infrastructure contribute to inconsistent quality of care. Administrative delays, inflexible scheduling, and lack of continuity in caregivers further complicate access and engagement with antenatal care.
| Challenge | Description |
| Infrastructure & Privacy | Lack of private consultation rooms and designated education spaces |
| Work Overload & Time Constraints | High patient load limits time for counseling and education |
| Staffing Shortages | Insufficient doctors, nurses, and midwives |
| Educational Resources | Scarcity of teaching materials like leaflets and videos |
| Communication Barriers | Use of medical jargon and language barriers |
| Lack of Personalised Care | Antenatal education not tailored to individual needs |
| Overcrowding & Waiting Times | Long queues and overcrowded clinics reduce care quality |
| Sociocultural & Economic Factors | Poverty, migration, cultural norms disrupt care continuity |
| Health System Limitations | Fragmented services, underfunding, and administrative inefficiencies |
It’s important to recognise that caesarean section is not inherently negative. It can be life-saving in situations such as:
In these cases, antenatal care plays a crucial role in identifying the need for surgical intervention early and preparing the mother physically and emotionally.
Yes, in some cases, detailed antenatal monitoring may lead to overdiagnosis of risks, which can influence the decision to opt for a caesarean section even when not necessary.
Doctors may recommend a caesarean section if antenatal tests show potential complications or to avoid legal risks, even if a normal delivery might still be possible.
Balanced antenatal care focuses on accurate diagnosis, patient education, and supporting natural birth when safe, helping reduce unnecessary surgical interventions.
Yes, fear or anxiety about labor pain or complications, often heightened during antenatal visits, can lead some women to request a planned caesarean section.
Consult an experienced obstetrician like the best lady gynaecologist in Kolkata, discuss your birth plan openly, and focus on evidence-based care to support a safe vaginal birth whenever possible.
While antenatal care is essential for ensuring the well-being of the mother and the baby, it’s also important to avoid over-medicalisation of pregnancy. The key lies in individualised care, informed decision-making, and the guidance of an experienced professional.
If you’re expecting and want to ensure the safest and most suitable delivery path for you, consulting the best lady gynaecologist in Kolkata can make all the difference. I, Dr. Megha Khanna, am committed to providing personalised and evidence-based antenatal care that respects your choices and supports a healthy birth experience.
Book your antenatal consultation today and take the first step toward a healthy, informed, and confident pregnancy journey.
