Pregnant women demand for C-section, say doctors

CHENNAI: While many women blame doctors at private hospitals for preferring Caesarean or C-section deliveries to vaginal births, doctors in the city say that the reasons for these range from health issues, social factors and also C-section on demand by pregnant women. Recently, Subarna Ghosh from Mumbai started an online petition campaign seeking a regulation on C-section deliveries as these are expensive, take longer for the mother to recover and can cause post-partum depression. Her petition earned over 95,000 signatures in two weeks. She mentioned that though she did not have serious complications she had to undergo a C-section, as it was said to be ‘scientific, modern and risk-free.’

In 2015, the World Health Organization (WHO) announced that caesarean section rates higher than 10 per cent are not associated with reduction in maternal and newborn mortality rates. According to WHO, an ideal rate of C-section is 10-15 per cent. “A C-section depends largely on the condition of the mother and the baby, how the pregnant woman goes into labour, the availability of facilities at hospitals, operative details and most of all, what the mindset of the family or their choice is,” said Dr Gowri Meena, consultant obstetrician and gynaecologist, Apollo Speciality Hospitals. She added that doctors suggest vaginal births even after a C-section has been done earlier.

According to the National Family Health Survey-4 (NFHS4), the total percent of births by C-section in Tamil Nadu in 2015-2016 was 34.1 per cent, of which 36.1%   were in urban and 32.3 per cent in rural areas. Dr Gowri added that the percentage of C-sections by private hospitals in rural areas (55.2 per cent) as against in urban areas (48.6 per cent) might be due to the lack of infrastructure and transport facilities. C-section is also becoming common as women and their families demand it because of the risk factor. “Over the years, fetal indications are widening. Also, if it is possible to save a baby by C-section, we will do so,” said Dr ShanthiGuna Singh of Kilpauk Medical College.

Caesarean may take toll on mom’s health, caution experts:

Research did over the years has shown despite being considered safe, C-sections take a toll on the mother’s health, like any other surgery. One of the reasons, C-sections have become commonplace is that it is easier, and a safer way to combat risks to the mother and the child. But Subarna Ghosh, says it is not so. “It is a surgery. A woman’s abdomen is cut open in the guise of it being risky for the baby. Delivery – irrespective of the method – is a painful process, and most of the C-sections done have become a means to earn more money – something that makes the profession unethical,” she said.

“A baby’s life is very important, but the mother’s life is as much important. By convincing a mother for C-section, a fear is instilled in her mind – that she won’t be a good enough mother is she doesn’t go for C-section,” she added. According to her, C-section pregnancies are not regulated at present, and the aim of her petition is to bring in some regulation so that malpractices in the healthcare sectors come down in number. “I took a much longer time to recover. It is not just pregnancy, but the period after it – more time is taken for the life of a woman to come back to normal is much higher than that taken in deliveries. Also, the blues that follow childbirth,” she continued.

Psychologists feel that irrespective of the method of delivery, some women face post-partum depression, and some take longer to cope with it. “Main reasons are the disturbed sleep patterns and the anxiety. Having her family around, and members to support her through the initial days of childcare helps women cope faster and they don’t fall victims to post-partum depression,” said B Elayaraja, a psychological counsellor with the 104 helpline. Relaxation, therapies, and managing sleep with the help of family members helps women to a large extent, he added.