End unnecessary C-sections

Minister for Women and Child Development Maneka Gandhi has rightly called for strict regulation of caesarean deliveries in the country. Responding to a Change.org petition drawing attention to women being forced by unscrupulous doctors towards surgical deliveries or Caesarean sections (C-sections) when these are not needed, she has suggested that it should be made mandatory for the hospitals and doctors to make public the number of C-sections and normal deliveries they perform each month. Doctors who recommend caesareans when these are not medically necessary should be named and shamed, she says, stressing that the problem requires a multi-pronged approach. The C-section deliveries are far more expensive than normal ones. They are a huge financial burden on the parents of the new-born. But for hospitals, gynaecologists, anaesthetists etc, they are a money-spinner. Greed, lack of medical ethics and pressure from hospitals to meet targets for C-sections prompt doctors to force pregnant women to undergo caesarean deliveries. There are situations when a caesarean delivery is necessary such as when the mother or baby is in distress or other factors make a vaginal delivery dangerous. In such situations, a C-section is a lifesaver. The decision whether to go in for a caesarean delivery is a medical one, which is made after considering the health and well-being of the mother and the baby. But with profit considerations fuelling the decision, C-sections have become the first choice of the doctors. They have become routine procedures, rather than life-saving ones.

According to the World Health Organisation, the “ideal rate” for C-sections is 10-15% of all deliveries in a country. However, the National Family Health Survey 2015-16 reveals that the rate of C-sections in India far exceeds this norm. In Telangana, for instance, the C-section rate is 58%, the highest in the country. Worryingly, the percentage of caesarean births has registered a sharp increase over the past decade. In Tamil Nadu, C-section deliveries rose from 20.3% in 2005-06 to 34.1% in 2015-16. While private hospitals are driving the high rate of caesarean deliveries in the country, government hospitals too opt for unnecessary caesarean deliveries. In Telangana, for instance, caesarean deliveries accounted for 75% and 41% of all deliveries in private and government hospitals, respectively.

Like all surgeries, C-sections carry the risk of excessive blood loss, blood clots and infections. Complications could even result in the death of the mother and/or the infant. Robust measures are needed to halt the excessive resort to caesarean deliveries. In addition to punishing errant doctors and hospitals, there is a need for creating public awareness. That would not only reduce exploitation by doctors but also compel pregnant women who ask for C-section deliveries to reconsider their ill-informed choices.

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