Demand for Caesarean section births rises

Doctors and midwives should also work together to encourage expectant mothers to opt for normal delivery and help reduce the fear of pain. PHOTO | FILE | NATION MEDIA GROUP

Pregnancy and childbirth are normal processes and health workers should only intervene if they can do better than nature. However, while a natural birth is best, access to emergency obstetric care must be available for all to deal with any complications.

For this reason, Caesarian section, which is a lifesaving procedure for both the mother and her baby, should be universally accessible. But it is not. In a recent report published in The Lancet, we highlighted the considerable variation in C-section rates between and within countries.

Richer countries tend to have more C-sections, while less-developed countries (especially those with higher fertility, lower levels of educated women and fewer physicians) have lower C-section use. Within countries, women in rural areas and those from low socio-economic backgrounds have much lower use of C-sections than urban and better-off women.

In 2015, 29.7 million children (21 per cent of all births in the world), were born via C-section. This was nearly double the number of C-section births in 2000, indicating that many C-sections are unnecessary. In Kenya, the national C-section rate is around nine per cent, with huge variations in counties.

Some counties have a C-section rate of less than five per cent, which indicates that women and/or newborns are dying because they lack access to health facilities that can perform C-sections if needed. On the other hand, many private facilities providing care to wealthier women have more than 50 per cent of the babies born via C-section, often without medical reason.

Given the growing use of C-section, a better understanding of the health implications for women and children has become a priority. C-section remains a surgical procedure with potential complications for the mother and the baby.

To avoid misconception and fear of childbirth, midwives, nurses and doctors should provide adequate information to support and prepare women for childbirth. C-section should be a last resort by both medical practitioners and expectant mothers. Doctors should let midwives handle normal deliveries but be on standby to handle any emergency.

Doctors and midwives should also work together to encourage expectant mothers to opt for normal delivery and help reduce the fear of pain associated with normal delivery which in turn will ultimately reduce C-sections to recommended levels.