Increasing number of C-sections crosses all danger thresholds

Crossing the 15 percent ratio set by the World Health Organisation by a humongous margin, the ratio of Caesarean Section (C-Section) in public hospitals of the metropolis has alarmingly swelled to around 40 to 50 percent, causing a serious threat to the lives of would-be mothers and their babies.
The limited machinery at the under-equipped government hospitals is usually over burdened, while the junior doctors working in Gynaecology wards are usually looking forward to enhancing their experience at surgery and encourage patients to undergo c-section, even when a baby could be delivered normally, Pakistan Today has learnt.
Another reason is that according to recommended practice, an expectant mother should be kept under observation for at least three days but in public hospitals, this is intentionally avoided. Another factor which is also important is the callous and negligent attitude of most of the doctors, who do not give attention to patients and recommend surgery even in the face of a little, curable complexity. Apart from that, there is no arrangement to monitor expectant mothers on a one-to-one basis.
Beyond danger threshold: According to WHO, no region in the world can justify having a Caesarean ratio greater than to 15 percent following documented medical risks on the health of the mother including infections, haemorrhaging, transfusion, injury to other organs, anaesthesia complications, psychological complications and a maternal mortality rate two to four times greater than of a vaginal birth.
It was observed that the medical staff including doctors, nurses and paramedical staff could not manage multitude of patients properly.
Nasreen Hayat, a patient in Lady Willingdon Hospital, said she was not educated enough to understand the medical complexities and she was relying totally on the diagnosis of the doctors regardless of either this diagnosis was accurate or wrong.
Dr Saqib Sadiqque, ex-head department of Gynaecology of Services Hospital said the expectant mothers were usually referred to public hospitals owing to complexities and in such condition, C-section was inevitable, however, if all the data is collected from the entire population, the ratio of LSCS is not more than 20 percent. He said the C-section ratio in England was about 30 to 35 percent and if in Pakistan it was about 20 percent, it did not mean that the situation was better in Pakistan in this regard. He said the safety of foetus is more important than C-section and low ratio of C-section in Pakistan was also a cause of increasing causalities of the newly-born babies in the country.
More common in private hospitals?: Renowned Gynaecologist Prof Dr Yasmeen Rashid refuted the claim of ‘needless surgeries in public hospitals’ and said the trend is only rampant in private hospitals as an easy way of earning more. “A Caesarean operation is a major surgery and should be done only when the health of the mother or the baby is at risk,” she added.
Or in public?: Senior registrar at Sir Gaga Ram Hospital Dr Asma Yaseen said the main reason behind the increase is lack of staff and facilities in public hospitals. “Most of the cases received by the public health facilities have complications and are often cases of other small clinics,” she said.
Bad eating habits and lifestyles: Dr Rubina said eating habits and lifestyles also contribute in the increase of caesareans in Pakistan. “Women belonging to the middle class are prone to deliver naturally, as compared to those belonging to the upper-middle and richer classes. This is because the latter section usually witness high blood pressure and diabetes, reducing chances of a natural birth,” she said, adding that the growing cases of infertility caused by late marriages, stress and lifestyles further add to the rising rate of caesareans.
On the other hand, some senior doctors said the standard rate of caesareans in hospitals, which take up all types of cases, should not be more than 10 percent while in referred cases the percentage can go up to 30 percent only.