A C-section is a life-saving procedure to both the mother and infant, and should be universally accessible but they are not! A recent Lancet report, co-ordinated by Prof Marleen Temmerman, highlights that there is a considerable variation between and within countries in C-section rates.
Richer countries tend to have more C-sections. Less-developed countries, especially those with higher fertility, lower levels of female education and fewer physicians, have lower C-section use.
Rural women as well as the poorest have much lower use of C-sections than urban and better-off women.
The Lancet Series also reports that the number of children born by C-section worldwide was 29.7 million (21.1 percent of all births) in 2015 – nearly double the number in 2000 and shows that many C-Sections are unnecessary.
In Kenya, the national C-section rate is around nine percent, with huge variations between counties, some at less than five percent, which indicates that women and/or newborns are dying because of lack of access to health facilities that can do the C-sections if needed, and on the other hand facilities-many private that are providing care to wealthy women, with over 50 percent of the babies borns via C-section, often without any medical reason.
Given the growing use of C-section, a better understanding of the health implications for women and children has become a priority. Pregnancy and childbirth are normal processes whereby the health fraternity should only intervene if they can do better than nature.
A natural birth is best, but access to emergency obstetrical care has to be available for all in case of complications.
On the other hand, a C-section remains a surgical procedure with potential complications for the mother and the baby.
To avoid misconceptions, and fear of childbirth, adequate information provided by midwives, nurses and doctors is key to support and prepare women for childbirth.
MARLEEN TEMMERMAN, Chair, Department of Obstetics and Gynaecology, Aga Khan Hospital.