C-Section Births on Rise in India. Deliberate or Unavoidable?

Discussion in 'Politics & Society' started by Daredevil, Nov 17, 2012.

  1. Daredevil

    Daredevil On Vacation! Administrator

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    I have seen an increase in C-Section (Caesarean Section) births in India. I have been looking at many births that happened in my near and immediate families and invariably everyone has undergone C-Section operation to give birth to the baby. I see that this is a deliberate plan on the hospital authorities and doctors to get more fee in the name of c-section operations even when it was unnecessary. This has implications to the women's health and very dangerous to them in the long term.

    For example, if a women undergoes unnecessary C-section during first birth, more often than not she has to undergo C-section for second birth as well.

    In the past 4 decades, it seems, the C-sections have jumped from 1 in 20 births (4%) to 1 in 4 births (25%) world wide. According to a ToI article, the C-sections have arisen from 5% to 65% in private hospitals.

    What should be done to stop this unnecessary evil?. Should there be punishment to the doctors or authorities who indulge in this malpractice of unnecessary C-sections? How does one identify when does one need a C-section or not?. What can women do to avoid this unnecessary C-section and have a natural birth?.

    I'm attaching these two articles for the perusal of this discussion. Please chip in with your views.

     
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  3. The Messiah

    The Messiah Bow Before Me! Elite Member

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    Deliveries through Caesarean section double in five years in Chennai

    CHENNAI: The percentage of deliveries through Caesarean section has more than doubled in Chennai over the past five years. At least one in every three women in the city now opts for a C-section instead of normal childbirth.

    Doctors quote a variety of reasons including lifestyle-related diseases, late deliveries, an increase in the number of women opting for artificial insemination and a desire to deliver at the most auspicious moment. One of the most common reasons, however, is that women do not want to go through labour and the pain of childbirth.

    According to a private hospital in the city, the number of C-sections has increased by 25% in the past two years. Government and corporation hospitals recorded an increase, with 16.10% choosing the procedure in 2007-2008 and 37.45% in 2011-2012, according to records with the Chennai Corporation.

    However, there has not been a corresponding decline in the infant mortality rate. Between 2007 and 2012, the infant mortality rate actually increased from 8.1% to 8.2%.

    Obsterician-gynecologist Dr Jayashree Gajaraj says a health complication during pregnancy — such as high blood pressure and diabetes — is the primary reason for pregnant women choosing to undergo a C-section or being advised to opt for the procedure by their doctors.

    Women today lead a sedentary lifestyle and usually have unhealthy diets, she says. "They postpone pregnancy for the sake of career and work often causes stress and high blood pressure," Dr Gajaraj says. "Many women have diabetes at a young age or during pregnancy. In such cases, a C-section is inevitable."

    Doctors report that women often request for a C-section because they don't want to suffer labour pain. "We tell them about options like epidurals, which relieve pain during labour," Dr Wahida Suresh of Apollo Hospitals, where nearly 40% of deliveries are C-section. "But many women insist on C-sections."

    Doctors advise pregnant women to have normal deliveries because of the health benefits, including faster recovery time and the likelihood of a normal second delivery.

    But C-section fertility experts like Dr Priya Selvaraj say C-section is a safe option. "Earlier a woman with complications was advised not to have children. Now we say have children, we can help," says obstetrician-gyneacologist Dr Geetha Haripriya of Prashanth Fertility Clinic.

    At times a C-section is done when the baby's heart beat fluctuates and the delivery is prolonged. "A baby's brain cells could get affected permanently if it suffers a shortage of oxygen during labour," Dr Haripriya she said.

    Deliveries through Caesarean section double in five years in Chennai - Times Of India
     
  4. The Messiah

    The Messiah Bow Before Me! Elite Member

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    WHO: most C-section births in India 'unnecessary'

    New Delhi, January 20 -- According to a recent survey on maternal and perinatal health by the World Health Organisation (WHO), nearly one in five women in India are going under knives or giving birth by Cesarean section, or C-section, as compared to vaginal births.

    The trend for C-section is on the rise in the hospitals throughout the world; many of the operations are “unnecessary” and are merely for financial gains.

    In China, nearly one in every two births are delivered by C-section, and the rate is around two in five in Thailand and Vietnam.

    Review of births in nine countries

    WHO reviewed 107,950 births from nine countries in Asia, including India, China, Japan, Nepal and Sri Lanka, during 2007-2008, and found that 27 percent births were delivered by C-section.

    Another similar survey which was conducted in Latin America found that 35 percent of pregnant women gave birth by C-section.

    Out of 107,950 births, 24,000 were from Indian states of Madhya Pradesh, New Delhi and Gujarat.

    Findings of the survey

    According to WHO survey, C-section births have gone up beyond the recommended level of 15 percent in these countries not "because of an immediate medical need for it but due to financial gains".

    The WHO health experts feel that such boom is unnecessary and C-section deliveries can harm mothers’ health.

    The study result found that women who undergo C-sections that are not medically necessary are more likely to die as compared to women who give birth naturally.

    Various American studies show that babies born by C-section are more susceptible to respiratory problems. The Asia survey found the procedure helps newborns during breech births.

    WHO advises against unnecessary operations

    They warn that "mothers should only get a C-section when there is a need for it as it increases risk of maternal death, infant death, admission into an intensive care unit, blood transfusion and hysterectomy as compared to spontaneous vaginal delivery.”

    Adding further, they said, "But these risks have not necessarily been absorbed into medical culture because in two thirds of the hospitals which took part in the survey, the institution had carried out Caesarean to earn more money as it costs more that the normal delivery, for example in India it is nearly Rs 20,000 costlier."

    On Wednesday, another study which appeared on online edition of the ‘Lancet’, found that females who underwent C-section without requiring it were 10 times more likely to be admitted to ICU than those with vaginal birth.

    WHO: most C-section births in India 'unnecessary' | TheMedGuru
     
  5. The Messiah

    The Messiah Bow Before Me! Elite Member

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    Turkey Adopts Law Restricting Cesarean Births

    The Turkish Parliament has passed a new law restricting Cesarean births, which can now only be carried out in cases of utmost medical necessity.

    Wednesday's enactment comes in the wake of statistics on C-section births released by the Health Ministry which had sparked debate on the topic. In May, Prime Minister Recep Tayyip Erdogan had voiced his opposition to C-section births, and described abortion as a crime, following which the new law was passed in order to reduce the number of births by Cesarean operation. His remarks had drawn fire from women activists who staged protest rallies in several Turkish cities.

    C-section births in Turkey in 2009 was 39.3 percent of all births in public hospitals, 61.8 percent in private hospitals and 63.2 percent in university hospitals. In 2010 the rates increased to 40.2 percent, 63.7 percent and 65.2 percent respectively. By 2011 it stood at 36.8 percent of all deliveries in public hospitals, 66.6 percent in private hospitals and 65.9 percent in university hospitals, indicating an increase in C-sections, Turkish media reported.

    The acceptable percentage of C-section births according to the World Health Organization (WHO) is between 15 and 18 percent. The Health Ministry launched a media campaign earlier this year to help curb increasing rates of births by C-section, and set a target to reduce the rate to 35 percent by 2013.

    Even before the Ministry's campaign began, Health Minister Recep Akdag urged women to exercise due caution with C-sections. The Ministry conducted several studies to determine how best to reduce the rate, and worked with hospitals to devise feasible solutions, such as enhancing the training of doctors, and better informing the public about birth options and the potential risks of C-sections.

    In addition, the Social Security Institution (SGK) reduced state financial support for C-sections from TL 675 ($374) to TL 475 ($263) and increased support for natural births from TL 250 ($138) to TL 400 ($221), the report said.

    Turkey Adopts Law Restricting Cesarean Births

    We should adopt this law also.
     
  6. Singh

    Singh Phat Cat Administrator

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    Reminds of the Sach Ka Samna series on medical malpractices in India.
     
  7. blank_quest

    blank_quest Senior Member Senior Member

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    ----Self delete----------
     
    Last edited: Nov 17, 2012
  8. blank_quest

    blank_quest Senior Member Senior Member

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    Over one million prematurely born babies die each year
    Premature baby
    Fifteen million babies globally are born prematurely each year and one million of them die, according to the World Health Organization (WHO).

    Yet, the agency adds, 75 per cent of these children could be saved without expensive, high technology care.

    WHO says that more than half of the world's pre-term babies are born in Southern Africa or Asia.

    Dr. Elizabeth Mason is the Director of the WHO's Department of Maternal, Newborn, Child and Adolescent Health.

    "Pre-term baby means that they are born alive before 37 weeks of completed pregnancy and with pre-term babies they are more vulnerable to infection. They have more problems with breathing. They can also suffer other complications particularly they are more prone to have, if they survive, developmental problems as a child. Of these 15 million, one million babies die every year."

    Dr. Mason says there are many simple measures that can save the babies' lives, including giving a steroid that costs less than a dollar to the mother who has gone into pre-term labour before the baby is born.

    The other example is what is called Kangaroo Mother Care, which is putting the baby skin to skin on the chest of the mother to keep the baby warm and allow access to breast-feeding.

    World Prematurity Day, observed on 17 November this year, is highlighting these effective low-cost measures to save babies' lives.
     
  9. Yusuf

    Yusuf GUARDIAN Administrator

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    Very few genuine doctors remain.

    I may be wrong but if your gynac is someone in a big hospital then chances are you will have a C section.

    Smaller nursing homes seem to have some humanity left it seems. I may be wrong but I tell this from my own experience and from my near and dear ones.
     
  10. Singh

    Singh Phat Cat Administrator

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    Smaller nursing homes are worse in this regard.
     
  11. Yusuf

    Yusuf GUARDIAN Administrator

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    That's why I said I may be wrong and posted about personal experience.
     
  12. hit&run

    hit&run Elite Member Elite Member

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    I can tell, most of them are deliberate.
     
  13. LETHALFORCE

    LETHALFORCE Moderator Moderator

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    There is no reason for any nation to have over a 15% C-section rate, at one time the C-section
    rate in human history was 0% and women still gave birth to healthy babies and survived to have
    more kids with mostly mid-wives doing the deliveries.
     
    Last edited: Nov 17, 2012
  14. LETHALFORCE

    LETHALFORCE Moderator Moderator

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  15. LETHALFORCE

    LETHALFORCE Moderator Moderator

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  16. Yusuf

    Yusuf GUARDIAN Administrator

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    There are two things here.
    1) many "modern" women don't want to go through any pain. They tell upfront to their gynac try want a C section and plan months in advance including book a bed in the hospital.
    2) Gynacs scare the parents with all kinds of scenarios and the hapless couple will let the doctor do a C section.
     
  17. hit&run

    hit&run Elite Member Elite Member

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    To avoid deliberate C-section a determined/willing pregnant women must ask doctor to give written reason/indication of why He/She wants to go ahead with C-section.

    Since most of the decisions are deliberately made on the hoof after initiating artificial contractions on EDOD or past EDOD a little patience by part of family members and pregnant women undergoing titration of hormones therapy for contractions can discourage doctor not to benefit from the panic they create.

    When you clearly tell your doctor to that you have considered options to see another doctor or nursing home for the delivery and medical advise, it deters doctor to manipulate you.

    To have awareness about your medical condition/well being is important, reading some good books and Google can help.

    Doing some good appropriate physical exercises, yoga, pilates throughout 2nd and third trimester, understanding the terms like, crowning, descending of baby downwards, knowing good optimum positions (changing within hours or days) of baby and placenta in the womb for normal or difficult delivery (breach), indication of C-Section; can help a lot while discussing things with doctor.

    Ultrasound examination done near date from a different centre and second opinion on report from a good radiologist and gynaecologist can give you clear picture about your pregnancy.

    Ooooffffffffff ! dishonesty can make things complicated but hey ! world is hard place to live, to be little clever, little mean, little aware but intelligent doesn't hurt.

    If you are an educated person instead searching on Google one can read any Textbook on Gynaecology, the book medical students read, its not a rocket science to learn. We study in hospitals by one method ''Book to Patient- Patient to Book''. Have good ears when your doctor tells you about your condition, write it down and then go back to book if confused, not satisfied or feel being unnecessarily scared.
     
    Last edited: Nov 17, 2012
    Daredevil likes this.
  18. hit&run

    hit&run Elite Member Elite Member

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    Elective C-Section is common in women who live luxurious,comfy life (I would say lazy women) and doesn't want to suffer pains of delivery. Modern Science has made things easier for all of us, but at the end of the day its individual decision whether to go with natural delivery or having a permanent scare on your belly. Once C-section done means 99.9% indication of C-section for the next baby.
     
  19. VIP

    VIP Ultra Nationalist Senior Member

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You're completely(not partially) wrong when you say this, do you know that ??
     
  20. VIP

    VIP Ultra Nationalist Senior Member

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    Well, Ob&G is one hell of profession in India which never sees decline.Always incline. I don't believe in such kind of studies which has very low sample size and selection bias but yes, in private hospitals, it's true. Hospitals like Apollo are just printing press of green paper. The authorities force docs to do wrong and that's why you won't see same doc in those hospital after 2-3 years.They do private practice to avoid the situation but system changes everybody as govt can't pay you as you can earn by private practice. These hospitals are the worst to get treatment but unfortunately, only they can afford hi-fi machines which are essential for critical life support.
     
  21. Tolaha

    Tolaha Senior Member Senior Member

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    Long before we had even decided to have a baby, my wife would keep telling me that she wanted to have a normal delivery. We tried to read up materials on the net and then discuss with folks regarding healthy lifestyle for would-be mothers. After she was pregnant, wifey attended those yoga sessions specific to expecting mothers.

    After discussing with cousins, aunts and all, we decided to approach a particular doctor in her hometown for the delivery. After the initial discussions, we got a feeling that he was inclined towards C-section. As my wife just didn't want to get one, she took a decision to change her gyno and then approached another gyno who is quite well-known over there. She checked all the health parameters and unlike the previous gyno, declared that all was well and there shouldn't be a problem for a normal delivery!

    When my wife started getting those signs(bleeding), we rushed to the pre-decided hospital around 8 PM. My wife again reminded us that she wanted a normal delivery. Then began the ordeal. She initially got those pains around 2 AM. The doctors told her to try to sleep rather than put any effort! Around 5 PM, they said the opening is happening but still some left. Made me come inside and talk to her. The nurse enquired and told us that things were going fine and there should be a normal delivery. Around 6 PM, they asked her if she wanted a C-section. My wife was very weak at that time with all the pain but she feebly told that she still wanted a normal delivery. It was 15 hours since she got the pains. At 7 PM I was told that the baby had passed stools and that this had increased the risks. No other choice after that obviously and I agreed. At 8 PM, wife delivered my sweet little angel. Both baby and mom were fine!

    Ofcourse my wife was upset about the mode of delivery. Especially after all the research and the precautions. One visiting relative couple days later even commented in front of my wife that "38 year old Aishwarya Rai just had a normal delivery... too bad you couldn't!!" :tsk: But the thing that I hate the most to remember is my wife asking me right after the delivery, in barely audible little gasps (after 18 hours since pain and 24 hours since bleeding), if the baby was fine and then if she had a normal delivery. Was c-section really required? I have no idea. All that counted for me was that both were healthy. I am grateful to the doctor to have performed this operation safely. The monies were paid by the Insurance company and I'm thankful to them too! :)
     

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