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Nation Posted On Sunday, November 08, 2009 | Agencies
Mumbai, Nov 8
One in four children born in Mumbai is delivered by caesarean section. But this is not the only worrying aspect highlighted in the latest The reasons that the report attributes to the trend are equally eye-opening: unscrupulous doctors who want to save time even while multiplying their fees as well as pregnant women who "fear that their husbands might lose interest in them following vaginal expansion" that could follow a natural birth.
Dr Smita Allahabadia, a city-based gynaecologist who practises in central Mumbai, backs the UNDP observation. "Women are worried about taking pain and feel it will affect their sexual life. They insist on C-section and are aware of a study which suggests there is no way to repair and restore vaginal muscles."
Dr Rekha Daver, the head of the gynaecology department of JJ Hospital, the city's premier teaching hospital that also is the refferral centre for some of the most complicated pregnancy cases, concedes that cases of C-section are as high as 50% among women hailing from the middle- and upper-middle-class families.
Dr Duru Shah, former president of the Federation of Obstetrics & Gynaecological Societies of India, too, concedes that cases of caesarean deliveries were up to 50% among the upper classes while among the rest it stood at 20%. According to the UNDP report, "Of the total hospital-based live births in Mumbai, 40,382 (which amount to around 23-25% of total births) are by caesarean procedures." This is alarming, given the fact the the World Health Organisation, the umbrella organisation that decides public health policies for its various member countries, insists that only 10-15% of the births would require surgical delivery. The UNDP report also revealed another worrying aspect of Mumbai maternal and infant health: around 0.7% (1,310) of the total 1,79,861 deliveries in the city were still conducted at home by relatives and neighbours. This could result in higher rate of infection and ill-health. Overall, Mumbai recorded 77,731 (43.3%) births in government and civic hospitals in the year 2007. Around 1,00,820 (56%) deliveries were conducted at private hospitals and nursing homes.
Off the record, many doctors state that the percentage of C-section deliveries in private hospitals is too high for comfort. Consider the allegations levelled by an NGO, Birth India, which promotes natural delivery, on its website: "The caesarean surgery rate in India's urban areas is approximately 50% and is estimated to be as high as 80% or more in some private hospitals."
But newer studies state there could be a biological reason for this high caesarean section rate. According to a study published in the open-access medical journal, Public Library Of Science, in July 2008, this could be the result of delayed childbirth among women. The researchers suggested that this could be because advancing age is associated with "impaired uterine function, resulting in a reduced degree of spontaneous contraction" needed for a natural birth. Dr Allahabadia says that the profile of her patients has been changing visibly in the last decade. "Patients are educated, career-oriented who delay marriage and pregnancy. Moreover, they are aware of the consequences of every treatment and complication. They participate in their own treatment," she says.
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Monday, February 08, 2010