EDITORIAL: Find out cause of sudden rise in Caesarian births

A nurse attends to a baby at the Kenyatta National Hospital. FILE PHOTO | NMG

The question as to whether a mother should have normal or assisted delivery through surgical operation should ordinarily be a matter of personal choice.

However, when that choice comes with enormous financial and health implications, those in the position to intervene cannot afford to remain indifferent.

That’s why the concerns raised by the National Hospital Insurance Fund (NHIF) over a sudden rise in births through Caesarian section (CS) cannot be taken for granted. 

What used to be rare has all of a sudden become the method of choice as one in every three women opt for CS. The national health insurer particularly raised its concern after it found that 58.2 per cent of its maternity costs or Sh1.2 billion funded the CS births.

The NHIF pays Sh30,000 for CS births and only Sh10,000 for normal delivery. Top private hospitals charge more than Sh200,000 for CS compared to between Sh100,000 and Sh120,000 for normal delivery.

The price differentials could be an important factor in the sudden shift to CS births, perhaps from hospitals seeking to profit from the NHIF cash.
Insurers do not ordinarily pay for elective CS operations.

That means a doctor – the specialist who has the authority to call out emergency situations- features somewhere in the choice that women make.

And because a doctor – and the health facility - earns more from a CS than a normal deliver patient, there is already a perfect motive to skew the medical opinion.

The NHIF should not just stop at raising the alarm. It must go ahead and investigate to find if the inflated figures have anything to do with unethical practices.

Lest we forget, the CS, just like any other surgical operation, comes with health risks on the part of the mother. It is important that the women only opt for it in cases of emergency or where they have full information as to the choice they are making.

The World Health Organisation has itself warned that CS is increasingly being misused globally, putting women and their babies at risk of short and long-term health problems.

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