Biz rules as AP tops in C-section deliveries

Hyderabad: Medical ethics are ignored as business rules in Andhra Pradesh hospitals. A massive 45 per cent of the deliveries in the Twin Cities are performed through the caesarean procedure and the story in other urban areas is not different.
In fact, AP has the dubious distinction of being top among the southern states in the number of C-section deliveries. Predictably, fuelling the figures is private hospitals where the lions share of caesareans are performed.
Alarmingly, city gynaecologists themselves point out that there are not many normal deliveries in the state, more so in urban areas. The percentage of caesarean deliveries at private hospitals stands at 70 per cent while the figure at government hospitals hovers between 17-18 per cent, a trend healthcare experts attribute to economics (see box).
In fact, a recent WHO survey published in the medical journal Lancet found that one in five childbirths in India are through caesareans. The incidence of such births has increased from 5 per cent to 65 per cent in private hospitals. This rise in C-section numbers is not due to medical necessity but motivated by the fact that the surgical removal of the baby is more profitable for doctors and hospitals. C S Rangarajan, medical ethics activist, says that C-section, which was earlier an emergency procedure has now been reduced to an elective procedure. Even when the patients are inclined for a normal delivery, they give various reasons starting from high blood pressure to the baby not being in an appropriate position to placental problems, says Rangarajan.
Gynaecologists from the city admit that in bigger hospitals, the caesarean deliveries are much higher than those in government facilities. However, they attribute the rise to a variety of reasons ranging from availability of better technology to more late pregnancies among urban women. The cost of the procedure,they maintain,is not the key factor. Dr G Shailaja,member,Federation of Obstetrics and Gynaecological Societies of India (FOGSI),says,We detect problems much earlier these days. With sophisticated technology,the unborn child can be monitored closely.Decreased blood supply to the brain or an odd position can be detected easily.Besides,patients as well as doctors want to be on the safer side.
Dr Manjula Anagani of Care Hospital attributes this growing trend to the dip in number of births per person and complications arising due to late pregnancies and higher incidents of diabetes and hypertension. Parents want doctors to do their best. They want them to make sure everything goes right and many parents are more comfortable if it is all preplanned and after 37 weeks are over, nobody wants to take a risk, says Dr Manjula.
Gynaecologists also say that astrological superstitions are making parents to go for caesarean deliveries for the right time and appropriate day.Doctors further note that more women are preferring to go under the knife in their first pregnancy and are keen on a normal delivery in the second.However,90 per cent of women with previous C-section deliveries are often advised to opt for the procedure for subsequent deliveries as the risk of complications is high. While doctors are often guilty of recommending C-sections when there is no need,a fraction of expectant mothers also regard a caesarean delivery as a painless way of having a baby. But,the Lancet report indicates that women who undergo caesarean without requiring it are more likely to develop complications compared to others.

Leave a Reply

Your email address will not be published. Required fields are marked *