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What are vaccines?

Vaccines are essentially the agents that activate the immune system without causing the disease. They can be manufactured from weakened or inactivated viruses, viral proteins, genetic material (mRNA) that encodes a viral protein. Taking a vaccine resembles getting survived from the disease, minus the drawbacks.

What are the concerns with the current vaccines for COVID-19?

  • There is very little knowledge regarding the long-term immune response to COVID-19.
  • A vaccine, when available, will only initiate the beginning of a prolonged and sluggish ramp down and the duration of this ramp down will rest on the vaccine’s efficacy.
  • Vaccines are always tested on healthy individuals. Their effectiveness in the real-world scenario is still unknown and vaccines may provide hope, but just relying on the vaccine is not advisable, as per the expert opinion.
  • Vaccine-induced immunity, though, tends to be weaker than immunity that arises after an infection. Vaccines are typically given as a shot straight into a muscle. Once your body recognizes the outside invader, it mounts an immune response by producing long-lasting antibodies that circulate in the blood.
  • However, respiratory viruses don’t usually attack the muscles. Instead, they invade respiratory cells and usually enter through the smooth linings of the nose and throat. Vaccinations do not encourage ample antibody production in these linings despite induction of antibodies in the blood, implicating that they are not completely reliable in preventing the virus from entering the body. However, they can indeed protect deeper tissues in the body from viral invasion. This trait of the vaccine agent prevents the worsening of the infection. Experts believe that a COVID-19 vaccine is not likely to attain “sterilizing immunity,” which, in simpler terms, means complete disease protection.
  • Hence, currently, it is perceived that the first vaccine might just restrict COVID-19’s infection severity, minus a total viral spread.
  • Also, contemporary regulatory guidelines have identified that the initial COVID-19 vaccine may be far from a 100 percent effectiveness mark; as the regulatory benchmark for a vaccine is that it should prevent or reduce severe disease in at least 50 percent of people who receive the vaccine, which is not ideal.
  • Several vaccines from different corporations have shown favorable data that their investigative vaccine products can induce antibodies that kill the coronavirus in lab tests as well as in clinical trials, but their real-world scenario is unknown, as of now.

Challenges in Vaccination

  • The success in delivering hundreds of millions of doses, and the willingness of people to get it at all. It is awful to contemplate the suffering still ahead. It is easier to think about the promise of a vaccine.
  • Biologically, a vaccine against the COVID-19 virus is unlikely to offer complete protection.
  • Logistically, manufacturers will have to make hundreds of millions of doses while relying, perhaps, on technology never before used in vaccines and competing for basic supplies such as glass vials. Then the federal government will have to allocate doses, perhaps through a patchwork of state and local health departments with no existing infrastructure for vaccinating adults at scale.
  • All of this means that we may have to endure more months under the threat of the coronavirus than we have already survived. Without the measures that have beat back.

What is the best way to prevent COVID-19 infection, even after vaccines are available?

  • Experts state that the outcome of COVID-19 is not going to change overnight, and the continuation of COVID-19 pandemic behavior remains important. Perceiving the vaccine as a magic bullet is troubled by danger. Social distancing accompanied by biological vaccination will have to continue in this long fight against this viral pandemic.
  • When vaccines are approved, ample doses that can fulfill the needs of the entire population will not be available, and an effective system will be required to store and distribute these vaccines.
  • Some of the foremost COVID-19 vaccines could also pose new transportation challenges, as they require storage at temperatures lower than –80°C.
  • Again, it is quite probable that a COVID-19 vaccine will require two doses; the first dose to activate the immune system, while the second dose to induce a stronger immune response. Administrators would have to balance supplying two doses to the entire population, ensuring each individual receives both the doses.
  • It seems it will create a situation where some individuals will be eager to get the vaccine, while some will be scared to get the vaccine.
  • Currently, there is no evidence of any major virus mutation. But sadly, in addition to reports of a mutated strain of COVID-19 virus from Britain entering India, our COVID-19 preventive behavior has also fatigued and people have become careless and are not following social barriers, as religiously as they need to do. Everyone has to pitch in and become a COVID-19 warrior once again, as they did during the early days of the pandemic.

Overview

We have all heard about a loved one or a friend suffering from a sudden cardiac arrest, commonly known as a heart attack. But what exactly is a heart attack and how does it affect people? The answers to the questions are things that everyone needs to know about.

What is a heart attack?

Cardiovascular diseases (CVDs) also called Heart diseases are a group of disorders of the heart and blood vessels. The root causes of cardiovascular diseases is atherosclerosis (blockages in coronary arteries), a process mainly governed by lifestyle factors.

A heart attack also called a myocardial infarction occurs when the flow of the blood towards the heart is blocked, mostly due to the accumulation of fat, cholesterol, or other substances. This build-up results in the formation of plaque in the coronary arteries, ones that feed the heart. The plaque can form a blood clot which leads to interrupted blood flow thus damaging the heart muscles. This eventually leads to a heart attack.

How do you spot an oncoming heart attack?

A heart attack can be fatal depending on the severity of the attack. Heart attack symptoms can vary from person to person ranging from mild to severe. Some people may get a sudden heart attack whereas some may experience symptoms a few days or months in advance. Continuous and recurring chest-pain is the most recognizable symptom, and it is advised to seek medical assistance if the pain persists over a long duration. But there are a few symptoms that are easy to spot. These include:

  • Feeling of tightening, pressure, and pain in the chest
  • Difficulty in breathing
  • Fatigue
  • Cold Sweat
  • Abdominal problems- indigestion, heartburn or stomach pain
  • Nausea
  • Dizziness

Other than this, the heart attack symptoms in men specifically include chest pain, chest discomfort or pressure, or shortness of breath. The heart attack symptoms in women include pressure or squeezing in the center of the chest, shortness of breath, and nausea.

What are the factors that cause a heart attack?

So far, we have learned how to spot a heart attack. But, it is essential to know the factors that lead up to it.

The main heart attack cause is the blockage of coronary arteries that result in a build-up of fatty substances. This forms plaque that may rupture and spills substances like cholesterol in the bloodstream, hampering the flow of the blood. A clot forms at the place of the rupture that blocks the blood flow in the coronary arteries making it impossible for the oxygen and nutrients to reach the heart. This condition is also called Ischemia. Such coronary artery disease causes heart failures.

There are two types of blockage/heart attacks you must know:

  • Partial Blockage- NSTEMI (non-ST elevation myocardial infarction): A less serious form of heart attack, the coronary arteries are partially or temporarily blocked. Proper medication and evaluation are required to diagnose this condition.
  • Complete blockage- STEMI (ST-elevation myocardial infarction): This is a form of heart attack that completely blocks the coronary artery resulting in a large part of heart muscle deprived of blood flow.

Am I at risk of getting a heart attack?

People of a certain age group and pre-existing conditions are at a higher risk of falling prey to a heart attack. These include:

  • Age: Women above the age of 55 and men above the age of 45 are more prone to a heart attack as compared to younger people.
  • Blood Pressure: High blood pressure damage your arteries increasing the change of blood pressure. Pre-existing conditions like obesity, diabetes, or cholesterol can worsen the situation and make you more likely to have a heart attack.
  • High Cholesterol levels or Triglyceride levels: There is an increased risk of heart attack if your body has high levels of low-density lipoprotein (LDL) cholesterol or high levels of triglycerides (a type of blood fat).
  • Diabetes: If your body is unable to produce insulin- the hormone secreted by the pancreas results in increased blood sugar levels in the body which in turn causes the risk of a heart attack.
  • Family history: If you have a family history of heart attacks, it increases the risk of heart disease.
  • Preeclampsia: A heart attack symptom in women is preeclampsia- a risk condition that causes high blood pressure in women during pregnancy. If any woman has a history of this condition, she is prone to heart attacks for a lifetime.
  • Other risk factors to consider: decreased physical activity, obesity, tobacco consumption, drugs, stress.

How do the doctors diagnose a heart attack?

If you are showing any heart attack symptoms you should be immediately admitted to a hospital. Firstly, your blood pressure, temperature, and pulse will be checked followed by you getting admitted to a heart-care unit. You will be connected to a heart monitor to diagnose your condition. There are varied tests done for diagnosis:

  • ECG (Electrocardiogram): A process done within the initial minutes of admitting the patient, an ECG test measures the electrical activity of your heart. It is a painless test that involves flat metal discs also called electrodes attached to your chest, arms, and legs. These electrodes have wires that are connected to the ECG machine that display the electrical impulses on the monitor or gets printed on the paper. This helps the doctor to know whether you are going through a heart attack.
  • Other tests are done for the diagnosis of a Heart attack: Blood tests to check leakage of proteins in your blood, chest x-ray, Echocardiogram (graphic outline of heart’s movement), Coronary angiography (detection of blockages in the coronary arteries), MRI (Magnetic Resonance Imaging), etc.

What happens to a person during a heart attack?

Various complications can occur from a heart attack. Some people may experience a mild heart attack with no serious complications. Some may experience a major heart attack with varied grave complications. Following are some of the other complications that are commonly faced by people:

  • Arrhythmia: This includes irregular or abnormal heartbeats- beating too quickly, beating too slowly, or beating irregularly. A heart attack damages the heart muscles disrupting the electrical circuits that control the heart leading to Arrhythmia. Some arrhythmia causes mild symptoms such as dizziness, palpitations, or chest pain. However, some arrhythmia can be life-threatening and can result in death.
  • Heart Failure: When your heart is not able to pump blood to your body effectively, it results in heart failure. There are times when a heart attack damages heart tissues extensively leading to the inefficient working of muscles. The intensity of the condition depends on the situation and can be treated with proper medications or surgery.
  • Cardiac Shock: A cardiogenic shock leads to a sudden stopping of the heart without any warning. If the heart attack causes extreme damage to the heart muscles, your heart can no longer pump enough blood required for the functioning of the body, as a result causing this complication.
  • Heart Rupture: A serious complication – heart rupture refers to the splitting or rupturing of the heart’s muscles or walls. Usually, open-heart surgery is recommended.

What are the treatments involved?

The heart attack pain can become worse sometimes. Depending upon the situation, medical or surgical treatment is suggested by the doctor. A few treatments are as follows:

  • Oxygen Therapy: Oxygen therapy is kind of a treatment where extra oxygen is supplied to the body via nasal cannula, face mask, or a small tube inserted into your windpipe. This helps the body to work well.
  • Medicines such as Beta-blockers, ACE inhibitors, Anticlotting medicines, Aspirin, etc. are given to maintain heart health or to reduce the risk of another heart attack.  They are often prescribed to prevent first or recurrent stroke.
  • Thrombolytics: These drugs, also called clot busters, help dissolve a blood clot that’s blocking blood flow to your heart. The earlier you receive a thrombolytic drug after a heart attack, the greater the chance you’ll survive and have less heart damage.
  • PCI – Primary Percutaneous Coronary Intervention: Also known as coronary angioplasty and stenting, in this treatment, the doctors insert a long, thin tube or catheter via an artery in your groin or wrist to widen the blocked coronary artery.
  • Coronary Artery Bypass Surgery: This surgery is mostly done in emergencies, at the time of heart attack. The bypass surgery involves taking a blood vessel from another part of the body and attaching it to a place beyond a blocked coronary artery to improve the blood flow.

How do I stay clear of a heart attack?

Prevention is always better than cure. Take preventive steps to avoid having a heart attack or even another heart attack. Resorting to a healthy lifestyle is a paramount heart attack prevention measure to avoid heart attack as well as its complications.

  • A healthy, balanced diet and lifestyle: Improve the health of your heart by maintaining a healthy weight, avoid smoking and drinking, exercise regularly. Managing stress by indulging in yoga and focusing on yourself helps in heart attack prevention. Control conditions like high blood pressure, diabetes, and cholesterol by consulting a doctor.
  • Medical Monitoring: Consult a doctor and monitor your heart condition regularly especially if you have pre-existing conditions like high blood pressure or high levels of cholesterol. Take medications that can reduce the risk of heart attack and help your heart to work efficiently.

Post-Surgery care

After a heart attack, the condition of the heart tissues and muscles continuously deteriorate. Hence, it is very important to undergo immediate heart attack treatment.

The doctor will assess your situation and recommend the medications. You must stick to the routine set by your doctor so that you can steer clear of relapse or any additional complications.

To conclude, a heart attack can be a traumatic experience, but if you maintain a balanced lifestyle and keep an eye out for symptoms, you can stay clear of it. If a person does show the signs that they are getting a heart attack, it is important to immediately reach out to a doctor and seek medical assistance. Even if it isn’t a heart attack, it is always best to be completely sure and safe!

As we enter 2021, experts all around the world are bending their backs to find a way to control COVID-19 and take humans away from year-long health hazards. Let’s talk about what is Herd Immunity and why is it important?

What is Herd Immunity?

Herd Immunity is nothing but ‘Herd Protection’ or ‘Population Immunity’. To protect the growing cases of Coronavirus, scientists and medical experts all around the world are trying to attain ‘Herd Immunity’- a concept that is used for vaccination.

Herd immunity occurs when most of the population becomes immune to a disease, making the spread of disease from person to person unlikely. As a result, the whole community becomes protected — not just those who are immune. Here, a population can be protected from a certain virus if the vaccination has reached a certain threshold. In the past Herd Immunity has been attained for many such diseases. Similarly, a Herd Immunity for COVID-19 is also in the phase of being developed. The percentage of people who need to have antibodies to achieve herd immunity against a particular disease varies.

How does Herd Immunity work?

To fight the disease, vaccines train our body to create proteins known as ‘antibodies’. These antibodies build our immune systems to protect us from the diseases and prevents them from passing on. Thus, breaking a chain of transmission of the disease. Individuals can become immune by recovering from an earlier infection or through vaccination. When we talk about Herd Immunity, it acts as indirect protection against the diseases that reduce the likelihood of infection for individuals who lack immunity.

Why is Herd Immunity important?

Once this threshold of herd immunity has been reached, the disease gradually disappears from the population – which is called eradication. Attaining Herd Immunity for COVID-19 is important to control and minimize the spread of diseases. It can be attained naturally or through inducting vaccines among people. Herd Immunity only applies to contagious diseases i. e. a disease that is passed on from one person to another. Herd Immunity has helped to eradicate many epidemics or pandemics in the past like Smallpox, measles, polio, etc. Each of these diseases has a Herd Immunity of 95% (for Measles), 80% (for Smallpox and Polio) respectively. 

Is Herd Immunity a way to fight COVID-19?

The scientists are still learning about Herd Immunity for COVID-19. Most of the people who have been infected with COVID-19 develop immunity in the initial weeks. But it is yet to be studied how long or strong the immune response is. As per WHO, it is also scientifically problematic and dangerous to reach Herd Immunity by exposing people to viruses. Because letting COVID-19 spread through any age or population will lead to serious infections or death.

There are also exceptions to Herd Immunity like infants who are too young to receive any vaccines or people who are immunodeficient due to HIV/AIDS, Lymphoma, Leukaemia, Bone Marrow Cancer, etc. Vaccines on these people will be ineffective. In addition to not being immune, they may also be at risk of developing complications and other infections due to their immunodeficiency.

Herd Immunity is just one of the ways to fight COVID-19. It is thought that 60-70% of the global population must be immune to achieve Herd Immunity and stop the coronavirus from spreading. Till then, the world continues to take other precautions to combat the battle of COVID-19 – right from lockdowns, social distancing, sanitization.

How far are we from achieving Herd Immunity?

A community is said to have reached Herd Immunity when a large percentage of its population gains antibodies or natural immunity for the said infection. It is yet to determine the threshold of Herd Immunity for COVID-19 given the trajectory of the pandemic and we are still far from reaching the same. However, European Union has launched a mass vaccination campaign after giving a go-ahead to Pfizer vaccine and India is gearing up for the dry runs to inoculate 30 crore ‘priority population’ which includes the frontline and healthcare experts. Vaccines such as Pfizer/BioNtech, AstraZeneca, Moderna, Sputnik, etc. are being introduced and are being approved by countries to induce Herd Immunity Vaccines. Although vaccination is in process, researchers still need to work on how long will the protection last. Thus, when it comes to Herd Immunity, we are in the process of identifying its full potential and effectiveness.

Herd Immunity in India

When it comes to Herd Immunity in India, given its vast population, we have a long way to go. Precautions are being taken to test the vaccines and attain an assured result of India can bank on for COVID-19 vaccines. As per India today’s latest article from 90k cases per day to 45k cases per day, the experts say that COVID-19 is done affecting the metropolitan cities and would be engulfing the rural areas in the coming months. Although people in slum areas have shown a higher prevalence of antibodies, the process of vaccination is being sped up tenfold to control the spread of the disease in all parts of India.

According to the reports, the majority of cases are still concentrated in less than 50 percent of India’s 28 states. Amongst these top 50% states, most cases are concentrated in and around large metros like Mumbai, New Delhi, Chennai, Bengaluru, Lucknow, Ernakulam, Hyderabad, etc.

Since people are looking up on Herd Immunity as a hope to end COVID-19, the journey is still far-fetched. From past experiences, experts have seen that Herd Immunity has its pros and cons. However, with the advancement in medical technology in the coming year, it can be overcome and zero spread of infections can be seen among people.

Till then, let’s not forget to keep a safe distance and sanitize!

Introduction: COVID Vaccine in India  

There are several institutions including academic/research and vaccine manufacturing companies in India that are in the process of developing of Covid-19 vaccine. There are four companies listed on the WHO website that are in the process of various stages of development. Serum Institute of India, in collaboration with Oxford University and Astra Zeneca, is undertaking a Phase 3 trial of the ChAdOx1 nCoV-19 vaccine in approximately 1600 healthy subjects 18–55 y of age. On successful completion of the Phase 3 trial with one dose of vaccine, the company shall start mass production.

Current Major Players in India for COVID-19 Vaccine

1) COVAXIN™

COVAXIN™ is India’s original COVID-19 vaccine developed by Bharat Biotech in cooperation with the Indian Council of Medical Research (ICMR) and National Institute of Virology (NIV) – Government of India. This native form of the vaccine is developed and manufactured at Bharat Biotech’s high containment facility having the maximum bio-safety level (BSL-3).

The vaccine received approval from the concerned regulatory authorities for conducting human clinical trials to check its safety and effectiveness in healthy subjects. After successful completion of the interim analysis from the Phase 1 & 2 clinical trials of COVAXIN™, Bharat Biotech also received approval for Phase 3 clinical trials in 26,000 participants in over 25 centers across India.

Present Status of COVAXIN™ Vaccine Trial in India

  • Pre-clinical studies with small and large animals: COMPLETED.
  • DCGI approval for Phase I & Phase II Human Clinical Trials: RECEIVED.
  • Phase I Human Clinical Trial: COMPLETED.
  • Phase II Human Clinical Trial: COMPLETED.
  • DCGI approval for Phase III Human Clinical Trials: RECEIVED.
  • Phase III Human Clinical Trial: ONGOING.

2) Covishield

The Serum Institute of India (SII) and Indian Council of Medical Research are jointly conducting advanced phases of clinical trials to determine the safety and the ability of Covishield (COVID-19 Vaccine) to induce an immune response.

ICMR has funded the clinical trial site fees while SII has funded other expenses for COVISHIELD. At present, SII and ICMR are conducting Phase 2/3 clinical trial of the vaccine at 15 different centers, across the country. It has completed the enrolment of all 1600 participants, as of 31 Oct 2020. The vaccine is being developed at the SII Pune laboratory with a master seed obtained from Oxford University/Astra Zeneca. The original vaccine prepared in the UK is currently being tested in large effectiveness trials involving participants from the UK, Brazil, South Africa and the USA. The encouraging outcomes from these trials so far have boosted assurance that COVISHIELD could be a genuine way out from this fatal pandemic. COVISHIELD is by far, in the most advanced phase of vaccine testing in Indians. SII along with ICMR will track the first disposal of this vaccine for the Indian population based on the Phase 2/3 trial results. SII has already mass-produced > 40 million doses of the vaccine, under a license from DCGI.

3) ZyCoV-D

Indian pharmaceutical giant, Zydus Cadila, involved in manufacturing innovative medicinal products, has declared its vaccine, ZyCoV-D for prevention of COVID-19 infection. The safety of this vaccine in healthy individuals is established in its Phase I clinical trial and has been recognized by an Independent Data Safety Monitoring Board (DSMB). On this basis, Zydus commenced the Phase II trial of its vaccine.

Present Status of ZyCoV-D Vaccine Trial in India

  • DCGI approval for Human Clinical Trials: RECEIVED
  • Phase I Human Clinical Trial: COMPLETED
  • Phase II Human Clinical Trial: ONGOING

4) Sputnik

Dr. Reddy’s Laboratories Limited and Sputnik LLC are together carrying out a multicentre, phase II/III adaptive clinical trial to evaluate the safety and ability of its vaccine to invoke an immune response.

Present Status of Sputnik Vaccine Trial in India

  • DCGI approval for conducting Human Clinical Trials: RECEIVED
  • Phase II Human Clinical Trial: ONGOING.

5) Biological E’s novel Covid-19 vaccine

Biological E Limited is piloting an initial phase of a clinical trial to assess the safety and capacity of its novel Covid-19 vaccine to induce an immune reaction against SARS-CoV-2 for preventing Covid-19 disease, upon intramuscular administration in two doses (0, 28D) to healthy volunteers. (Information based on ICMR website)

Present Status of Biological E Vaccine Trial in India

  • DCGI approval for Phase I & Phase II Human Clinical Trials: RECEIVED
  • Phase I/II Human Clinical Trial: ONGOING

Government Plan to roll out COVID-19 vaccine in India

The Indian government is getting prepared to roll out its Covid-19 vaccination drive through state-of-the-art technologies and alphanumeric trackers while depending on the established methods of distribution of vaccines. The strategic planning of vaccine roll out and its distribution throughout the country is being done by the National Expert Group on Vaccine Administration, a member at the NITI Aayog.

1) Criteria For Identifying Who Gets Vaccinated First:

As per government authorities, a full study on the urgency segments of the population that would have the first right of entry to the vaccination has been prepared based on recommendations of CDC (USA) and the WHO. Regardless of their financial background, the vaccine will be initially offered to individuals who are in urgent need.

2) Priority Groups Identified For The First Phase Of Covid-19 Vaccination:

The first allotment of 3 crore people to be vaccinated has been recognized. These include approximately 1 crore doctors and 2 crore health care personnel, including policemen, home guards, defense officers, civic workers including Asha workers and community workers.

People aged > 50 years and those aged < 50 years but having co-morbidities will be vaccinated in the second round.

The government strategizes to use the novel eVIN (Electronic Vaccine Intelligence Network) platform for storage and tracking of the vaccine and the citizen digital health ID to guarantee immunization while counting on the identical route of the Universal Immunisation Program (UIP).

3) Vaccine Stocking:

The authorities have confirmed that the eVIN network, is being re-equipped for delivering the COVID vaccine. The eVIN platform is currently functional across twelve states in India. It aims to help the Indian Government’s Universal Immunization Programme by providing actual information on available vaccine stocks and their transportation, as well as storage temperatures across all cold chain logistical hubs in these locations.

Approximately, 17,000 government officials have been skilled on the eVIN application while more than 6,700 temperature loggers have been functionalized. The program is to be ascended to cover the entire nook and corner of the country.

4) Vaccine Distribution:

The vaccine distribution will be as per the voter registration application to ensure each citizen is covered.

5) Role of State Governments

The Central government has notified the State governments to form committees for the Covid-19 vaccine roll-out. The state’s role will be to vaccinator identification through government and private sectors to restrict disturbances in repetitive immunization services at the time of Covid-19 vaccine introduction, and planning and charting sessions of vaccination for health care personnel. Mostly, the Covid-19 vaccination drive will last over a year with many groups being vaccinated serially beginning from health care workers. Hence, a strong guidance and coordination mechanism is vital to be created at the state and district level to monitor the process of Covid-19 vaccination with the assurance of minimum disturbance to other regular healthcare services.

As of today, the vaccine will take some time for the actual rollout but transport provisions will have to be kept ready well in advance to prevent any last-minute problems.

Childbirth is a miracle that everyone looks forward to. But sometimes, complications may arise and in place of normal delivery, a woman may need to opt for a Caesarean delivery.  Caesarean delivery or C-Section is a delivery operation where a surgical cut is made in the mother’s abdomen and uterus.

The decision to undertake a C-Section delivery depends on the doctor. If a medical professional feels it’s safer for the mother to undergo a caesarean surgery over normal vaginal delivery. Caesarean delivery is avoided before 39 weeks of pregnancy for the child to have proper time to develop in the womb. But, in some acute cases, complications may arise and caesarean delivery will need to be performed before the 39 weeks. This is why pregnant women must undergo prenatal care when they’re pregnant so that the doctors can spot any complications beforehand.

In this surgical delivery, a cut is made in the skin and into the uterus at the lower portion of the abdomen of the mother. However, the cut in the skin and mostly, a transverse uterine cut is preferred in the majority of cases, due to good healing outcomes and also less bleeding. Also, it raises future chances for a vaginal birth. However, the type of cuts depends on the mother’s and the fetus’s conditions.

C-section delivery depends on case to case. As such, the doctor will decide whether to go for a horizontal cut, known as a transverse cut or opt for a vertical cut. In a transverse uterine cut, the surgeon makes an incision across the lower part of the uterus. Since these muscles do not contract during labor it is unlikely to tear. In a vertical cut, the doctor will make the incision that extends from the belly button to the pubic hairline.

In most cases, a transverse uterine cut is preferred because it leads to good healing outcomes and also lesser bleeding. It also raises the chances of normal vaginal birth in the future. But, the decision to do so will be in the hands of your doctor, as they know what is the safest option to undertake.

Now that we have a bit of a background on C-Section delivery, let’s see it’s different types.

Types of C-section

1)Planned C-section

As the name implies, a planned C-Section is one where the mother knows well in advance that her baby will be delivered via cesarean delivery on a particular date and likely won’t even go into labor. During a planned c-section, the doctor will take 10 to 15 minutes for making the incision and delivering the baby. Throughout the pregnancy, the mother can be better prepared for what is to come.

2) Emergency C-section

Unlike a planned delivery surgery, an emergency C-section will be a decision that is made by the doctor on the spot. If complications occur during the delivery, the doctor will opt for this surgical procedure. During an emergency C-Section, the baby will be delivered in about 2 minutes from the time the doctor makes an incision in the mother’s uterus.

This brings us to the most important question – Why does a woman need to undergo caesarean surgery?

Typically, a caesarean delivery is performed when complications from pregnancy make natural vaginal birth difficult or put the child or mother at risk. Sometimes caesarean delivery is planned or scheduled early in the pregnancy, but they are most often performed because of problems during labor.

Several conditions make a caesarean delivery a safer choice to deliver a healthy baby. These include:

  • A tangled umbilical cord: The umbilical cord, which connects the fetus to the uterus, may get pinched, or the fetus may have an abnormal heart rate.
  • Size of the head: A baby’s head can sometimes be too big for the birth canal or the baby may too large to travel through the cervix. At such times, a C-Section is needed.
  • Lack of contractions: At times, contractions may not open the cervix enough for the baby to move into the vagina for delivery. When this happens, the doctor may choose to make a surgical incision.
  • Multiple gestations:  When a woman is pregnant with twins or triplets, she may need to deliver via a C-section delivery
  • Previous caesarean delivery: In this case, the doctor may recommend a repeat caesarean delivery to avoid further complications.
  • Position of Foetus: The fetus is in the breech or transverse position. During these conditions, C-section might be the safest way to deliver a baby
  • Pre-existing conditions: If the mother has active genital herpes that could be transmitted to the baby, then the doctor may choose to go for a C-Section.
  • Early pregnancy complications

However, a cesarean delivery is an intensive procedure that requires a longer healing process than a vaginal delivery. Only opt for a CDMR (Cesarean Delivery on Maternal Request) once a doctor provides a clear picture of the risks and side effects associated with the procedure.

What are the risks and side effects of caesarean delivery?

Caesarean deliveries are becoming a more common delivery type worldwide, but it’s still a major surgery that carries risks for both mother and child. Vaginal birth remains the preferred method for the lowest risk of complications. The risks of caesarean delivery include:

  • Bleeding: It can lead to a blood transfusion or having the womb removed.
  • Abnormal placental separation: Especially if a prior caesarean delivery has taken place.
  • Bladder or bowel injury can occur during caesarean delivery.
  • Uterine infection:  You might be at risk of developing an infection of the lining of the uterus because of a C-Section.
  • Surgical wound infection: The mother might be at an increased risk of an incision infection post a caesarean delivery.
  • Problems in passing urine after having a cesarean delivery.
  • Delayed resumption of regular bowel function.
  • Blood clot formation: Having a c-section might increase the risk of developing a blood clot inside a deep vein.

Not just the mother, even the infant can have complications. These include:

  • Surgical injury: A cut to the baby’s skin, caused during surgery. Most often, this is minor and heals quickly.
  • A higher risk of admission to the neonatal unit(an intensive care unit (ICU) specializing in the care of ill or premature new-born infants)
  • Breathing problems – This is more common if the C-section is performed before 39 weeks of pregnancy. Most breathing problems get better after a few days but some babies need to go into the neonatal unit.

So, should you be worried if you have undergone a C-Section?

Pregnancy in itself is a beautiful and memorable process. But for many women, especially those who are delivering for the first time, it may be a bit intimidating. So, if you have to undergo a C-Section, there isn’t much to be scared of. Both planned and emergency caesarean surgeries carry a certain amount of risk, but if you follow the advice of your doctor, many of these risks can be controlled and you will be able to enjoy the miracle of childbirth once the said risk passes.