The rising case of Caesarian-sectioning

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It was a typical working day in the life of a Lagosian - left home as early as 6:00 am and came back around 11:00 pm. Tired, by all means, I slept off almost immediately only to be woken by a knock on my door. I jumped up from the bed, looked at the time on my phone, and was about to curse the alarm for not going off as programmed when I noticed that the time was 2:00 am. Could it be that the time on my phone is out of sync or why is my uncle's wife waking me up at this time?

The knock became louder. I answered to notify her that I am already awake and will attend to her shortly.

I just gave birth.

I was still trying to process what she said when she repeated the statement.

I just gave birth to a bouncy baby boy

What! How possible could that be? I put on a light cloth and quickly dashed for the door. The scene that greeted me looked like a part of a horror movie. She was holding the neonate in her hand with the umbilical cord still connecting the placenta. I was totally at a loss as to what to do. She told me where the cord clamp is and some other birth paraphernalia. Within a few minutes of passing instructions, the baby was ready and both mother and child are ready to be taken to the hospital. I put a call through to one of our neighbours and within a few minutes, we landed at the hospital. The rest is now history as the boy is about 10 years old now.

The experience always makes me wonder how the entire process from labour to giving birth can be a piece of cake to some women and a life-threatening process to others. I was the only one at home with my uncle's wife and she gave birth without making any form of noise (I am not a deep sleeper). Apart from her own case, I have heard stories about pregnant women gisting with their neighbours outdoor one minute, only to step inside their cribs, self-administered the delivery process, and then come out to announce a newborn the next minute.

Meanwhile, I have seen pregnant women going through the labour process for days, often ending up with assisted births such as Caesarean sectioning. In the olden days when conventional medical services were unavailable, women give birth on the farm in the middle of work and in places that would be considered weird by modern-day standards. Although not in all cases that the process goes smoothly, it is scientifically unimaginable that a huge success could be recorded in giving birth without conventional medical attention.

Nowadays, the percentage of women that give birth without being assisted keeps shrinking with Caesarian sectioning now accounting for more than 21% of annual births. All other things being equal, in Nigeria, a pregnant woman would normally be advised to register for antenatal latest by the end of the first trimester. Thereafter, a series of tests, scans, and drugs follow until the due date. There was nothing like antenatal care back then and vaginal birth was the only option available. Despite that and going by the available anecdotes, complications were very few and far in between.

Apart from those that willingly opt for Caesarian sectioning without any medical reason, a couple of reasons exist medically why women might require assistance in giving birth.

  • when the positive feedback loop for the Labour process does not progress naturally as it should.
  • When the fetus is in distress
  • when the birth canal is too small for the baby size, also known as Cephalopelvic disproportion
  • when the baby refuses to descend headfirst - abnormal positioning.
  • When the umbilical cord slips into the cervix
  • Underlining health condition
  • Abnormal placental positioning
  • Multiple fetuses at a go.

By David Thompson - sherrys camera 172.jpg, CC BY 3.0, https://commons.wikimedia.org/w/index.php?curid=17255859

Why the surge in the number of Caesarian sectioning?

There is no doubt that surgical procedures for removing a fetus from the womb have been fine-tuned to a very large extent. Nevertheless, this should not be the reason for a surge in the number of Caesarian sectioning.

The second baby we had could have been by Caesarian sectioning going by the prognosis of the doctor we met on duty when I and my wife visited the hospital on an emergency after observing some unusual symptoms in the middle of the night. In actual fact, we have been booked for Caesarian sectioning and are in the process of getting all the necessary drugs and materials when the consultant that has been on our case from inception came in, apologized to us, and told us to go home that nothing warrants a CS. My wife delivered safely about 30 hours after.

What I am trying to say in the essence is that wrong prognosis could be a major factor in the surge in the number of Caesarian sectioning, especially in the developing parts of the world where the technical know-how remains inadequate.

Another factor to consider is that Caesarian sectioning comes at a cost that is significantly higher than vaginal birth. Many pregnant have complained about not being given an adequate chance to prove that they can deliver their babies vaginally. In fact, many have complained of being coerced into opting for Caesarian sectioning. If these claims were to be true, the only logical deduction would be that Caesarian sectioning is being promoted for economic gains. This will totally not be out of place in societies where healthcare is commercialized.

Apart from mis-prognosis and for economic gains, advancement in technology means that our life is becoming more and more sophisticated with time. Less effort is being invested and more keeps getting done. Processed food, pollution, etc., are the order of the day. New non-pathogenic diseases keep emerging and our resilience keeps diminishing. The implication is that a surge in the number of abnormalities relating to pregnancy becomes inevitable, and thus, an increase in the number of Caesarian sectioning.

What do you guys think?

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13 comments
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What I am trying to say in the essence is that wrong prognosis could be a major factor in the surge in the number of Caesarian sectioning

THIS! i mean from the get go my doctor told me i was too old to have a vaginal delivery, i was 30 years old like WTF, at the end of my pregnancy for money reasons we change doctors so i could deliver in the Red Cross the is way cheaper, here the doctor also told me my age was an issue, i was trying so hard to have a natural delivery and was annoyed by the fact that it seem like they wanted to do the C-Section cause that way they can actually charge more, at the end she said we need it since the baby had his arm in the way and the umbilical cord around his neck, to be honest to this day i still doubt this since my previous doctor never saw that in any ecosonogram.

At the end I'm happy i did get the c-section cause i got my tubs cut at the same time so i kill 2 birds with one stone but... i do feel like doctors like to do c-sections more than vaginal births. I think this should be a woman choice is our body and just cause you want to charge more for the procedure it shouldn't affect my decision.

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I thought this practice would be peculiar to Nigeria alone not knowing that humans are the same everywhere. Someone very dear to me was coerced into CS and she lost her life at the end of the day. The procedure still gives me ptsd till today.

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Some places really try and push c-sections while others are against it unless it's to protect the health and life of the mother and baby.

In New Jersey, USA, my sister kept getting offered C-sections by every doctor she met with. It was like that for both of her kids. In the opposite side of the country, in California, my wife is in labor for 40 hours and even when the c-section for our first boy was medically necessary, doctors were stressing the risks of the procedure.

In New Jersey, they were tossing out offers to do C-sections like it was a fast-food handout. It's amazing how something like this . can be handled so differently

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Another factor to consider is that Caesarian sectioning comes at a cost that is significantly higher than vaginal birth.

Indeed, most of the private hospitals are guilty of your allegation. My friend was recently charged to pay almost $1000 to have a CS, during the point of negotiation, her body started showing the signs and before we knew she delivered on her own. Imagine if we had enough cash with us, we would have rushed to pay the money. Hardly you will see a case like this in government hospitals.

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The allegation definite;y has a strong basis and it's something worth looking into by the government. Unfortunately, it does not look like our government gives a damn.

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From what told me, doctors also fear the unexpected. With a natural birth, the unexpected is still high. For a Caesarian things go more according to "the plan". This can also be a reason why doctors recommend so easy the surgery.

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You have a point though. But if the medical indicators are fine, I see no reason why CS should be recommended out of the fear of unexpected.

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First I think this is an excellent write-up.
The increase in the c section is almost alarming these days. While some women just opt for it based on preference, others are forced into it. Like you rightly said, it could be for economic reasons and prognosis but it still doesn't make it right.

I've heard many women say that they weren't even given a chance to try and push. I felt it should be a woman's choice because its her body.

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