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Revised guidelines will ‘cut down’ on unwanted C-sections
Union Minister Maneka Gandhi’s suggestion to name and shame doctors, who carry out unwanted caesarean sections, have been met with mixed response from the medical fraternity. Most doctors are of the opinion that the government should first give a set of guidelines under what circumstances should doctors opt for C-section.
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Chennai
The World Health Organisation says that the rate of C-section would be around 10 to 15 per cent of the total number of deliveries in India. However, the recent National Health Family Survey (2015-2016) noted that in just over 10 years there has been a spike in the C-section procedure by 18 per cent and 12 per cent at private and public health facilities respectively in the state.
Districts like Kanniyakumari, Perambalur and Virudhunagar top the list with 51 per cent, 44.3 per cent and 43.9 per cent respectively and Chennai comes way below with 28 per cent. However, in all the districts, private facilities take a huge share of the percentage.
Doctors say that late pregnancies and the subsequent complications have made C-sections a norm, though they maintain that it was only advisable in the most difficult cases. “Earlier, in the joint family system, women endured long hours of labour with help from family. Today, they have one or two children and they don’t want to leave any chance for risks,” says Dr Gowri Meena, consultant obstetrician and gynaecologist, Apollo Speciality Hospitals, Vanagaram.
Dr K Kalaivani, superintendent, Government RSRM Lying-in Hospital, says that advancements have made spotting complications early, giving ample space for controlling it, preventing the need for C-sections. “However, people with breach presentations turn up late for diagnosis in the 38th week; at that stage, it is difficult to reverse or control it. So, we are left with no other option but a C-section,” she says.
Dr Gowri points out the need for a new list of indications for the procedure. “Earlier, doctors used to go for this procedure only if the patients are affected by polio patients or suffer from acute vitamin deficiency. However, we don’t see such cases any more. On the other hand, there are newer trends like increased IVF pregnancies and a spike in gestational diabetes that range from 15- 20 per cent,” she adds.
Rapid choice
- The WHO prescribed rate for C-sections is 10-15 per cent of total deliveries.
- Tamil Nadu has seen a spike in the C-section by 18 per cent and 12 per cent at private and public health facilities in the state, respectively, compared to the rate 10 years ago.
- The total rate of C-sections is 36.1 per cent for TN, while some districts have a rate as high as 51 per cent.
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