The Perils of Costly C-sections

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Statistics are boring to the extent that we have made a cliché on it- “don’t be SIMPLY a statistic.” But what happens when statistics start to stand out?

  • In the year 2000, the percentage of cesarean deliveries, as opposed to normal deliveries, was about 3%.
  • Over 11 years, the percentage of c-section deliveries has jumped to 24%.
  • Fast forward to the last two years- between 2016 and 2018, the number of c-section births has risen by an unbelievable 51%.
  • Almost 80% of all births in this country are c-section.

Research has shown multiple reasons for this alarming rate of increase in a seemingly dangerous procedure. But before we go into the whys and wherefores, let us first understand the process of surgically delivering babies and their pros and cons.

Normal delivery is a natural process where a woman experiences painful contractions to push her baby through the birthing tract. While labour pains are known to be at a higher extreme of the pain spectrum, there are merits to opting for normal birth. As the baby travels through the birthing track, it is exposed to certain bacteria only found in that chute which help to increase the infant’s immunity levels and makes it resistant to diseases later in life. Babies born normally are also at a much lower risk of diabetes and obesity than others. For mothers, the recovery time after giving birth is lesser than if they go through surgery. This helps a mother start the breastfeeding process for her baby sooner and makes sitting positions easier for them as they don’t have to go through post-operative pain.

However, despite the merits of normal deliveries, doctors may prescribe c-section deliveries for several reasons. If the pregnancy is a risky one, or if the baby’s position is not as it should be, or even if the mother loses strength somewhere through the process, doctors may help the process along by cutting open the abdomen and taking the baby out. However, this is a secondary option, meant to be used only if the natural process somehow failed. Until planned c-section.

Planned c-sections are painless, making then the most popular reason among mothers. Another advantage of a c-section is that women don’t lose too much of their sex drive and can fall back into coital bliss soon after delivery. What needs to be understood, however, is that although surgical procedures are common these days, they are also riskier than the natural process. A c-section is a major surgery and may include risks such as blood loss, organ damage, intolerance to anaesthesia, higher recovery time, lifelong pain in the spine or abdomen, complications in subsequent pregnancies, etc. In fact, the Canadian Medical Association Journal has even mentioned that chances of maternal deaths rise by almost 5 times after a c-section than after a vaginal delivery.

Causes of Concern:
The purpose of this article is not to proclaim a winner. Nor is it to demean anyone who chooses comfort over pain- after all, labour is not an easy job by any means. No one, except a mother and/or a doctor can decide which process would be better for them, is it due to medical expertise or mere maternal instinct. This article simply explores the risks associated with a surgical procedure that may or may not be highlighted by doctors due to questionable reasons and whether the procedure would be chosen as casually by mothers had they been warned of the demerits.

There is much reason to believe that doctors not only skip warning mothers of the dangers of this procedure but are also known to scare mothers who are perfectly capable to go for normal births into going for the more complicated and expensive option of cesarean delivery in their greed to soak in more money.

Two mothers, Shity and Heema (names changed to protect their privacy) went through some issues with their doctors that require some pondering. Shity claims that her doctor was silent on many issues that needed clarification. She was not checked for thalassemia and was later found to be thalassemic when her pregnancy was very advanced. She was kept in darkness about her baby’s overly small size as well as about her lack of amniotic fluids. All of this made the final few months of her pregnancy very traumatic and painful for both mother and child. While Shity is immensely grateful for a healthy baby at the end of it all, she still feels that maybe if the doctor had been more open with her, she might have been able to have a much easier pregnancy.

Heema had an easy pregnancy all through the nine months. She was not told what kind of birth to expect but looking at the ease with which her pregnancy was coming along, she had no reason to believe she would need anything but a vaginal birth. At the last minute, she was told that she had a small complication and that she would have to go for a surgical delivery. “For pregnant women, the safety of their child is paramount. At a sensitive time like that, even the smallest issue can trigger a lot of anxiety. It’s like placing your life in your doctor’s hands. If they speak of potential risks, we mothers will go through anything to protect our babies. We have no way of knowing the truth from a lie. This is why, even when it instinctively felt unnecessary, I went through with a c-section”, said a thoughtful Heema.

Not all is lost, though. There are still, many practising OBs who encourage healthy, first-time mothers to go for natural births. Sharna Jahan, a working mother who recently delivered a healthy baby has only good things to say about her doctor. “Not once was I pressured into going for a surgery. My husband and I were fully prepared to go through with normal delivery and our doctor supported our choice. I could not stay firm on my decision because labour was proving to be more difficult than I had imagined, so I gave in and went for a surgery halfway through the pains. However, there was nothing from the doctor that suggested that I could not have gone through with natural birth if I had persevered.” There are many such beacons of hope as Dr Shaila Parvin, practising at Marie Stopes who choose to put professional ethics above personal gain and new parents have a lot to thank such doctors for.

Water births, midwifery, partner coached birth and epidurals to regulate painful labour, there have never been as many birthing options as there are now. Expecting parents have the right to make informed decisions based on correct diagnosis and honest and experienced expert opinion. The idea is to give parents all the means to choose well, not to scare them into only seeing one myopic option which may well be serving a completely different purpose altogether.

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