Too many women risk having a baby cut out – doctors

THE rate of caesarean sections has doubled over the past 10 years, with one in every four women now having the procedure in South Africa.

Despite the risks attached to anaesthetics, there has still been a 23.9 percent increase in the public sector and a 73.9 percent increase in the private sector, according to the latest District Health Barometer report.

Last year the Council for Medical Schemes revealed that nearly 70 percent of births by women covered by a medical aid scheme were by C-section, which raised concerns among health professionals regarding the safety of the procedure.

Dr Siva Moodley, chairman of the Durban Obstetricians and Gynaecologists society, said the main reason for increasing incidence of C-sections in private practices was due to increasing medical litigation by patients. Many have been suing hospitals for issues such as missed abnormalities on ultrasound, cerebral palsy and birth trauma.

He said doctors were wary of lawsuits, resulting in more of them having a lower threshold in order to avoid complications.

In the public sector, he argued that the reason for an increase in C-sections was the high rate of teen pregnancies. As teenage patients’ pelvic bones are not fully developed, a caesarean section is common.

Many women also opt for C-sections rather than natural births because of the fear of urinary stress incontinence, poor sexual function later and trauma caused to the vagina.

However, Patti Good, a UKbased maternal specialist who conducted research in Durban, said this was not the case.

Good, who also started the My Birth, My Choice campaign, which aims to lower the C-section rate in South Africa’s private sector, has surveyed thousands of South African woman who did not want to have C-sections, but were pushed to do so by their doctors.

“Doctors in the private sector get paid the same amount for C-sections as normal births on medical aid. (But) these doctors can perform more C-sections in a day than natural births, which eventually means more money for them,” she said.

Foetal and maternal specialist, Dr Ismail Bhorat, says there are several risks attached to C-sections. These include:

Risks to the mother: anaesthetic risks; risk of infection and bleeding; implications for future pregnancies.

Risk to the foetus: risks of prematurity; respiratory depression if a general anaesthetic is used.

Both Moodley and Bhorat said that natural deliveries are “best” mainly because it is what nature intended.

Patients who deliver naturally have decreased incidence of complications. A shorter hospital stay. Bonding and feeding takes place immediately.

Admission to neonatal ICU is less likely.

Labour may be shorter and quicker in the future.

The recovery period after giving birth is quicker.