Doctors warned against performing caesarean sections too readily
It has become the vogue even in developing nation like Nigeria, which has one of the highest maternal mortality ratios in the world.
Until now, several unpublished studies have shown that most doctors in Nigeria prefer to cut open pregnant women rather than allow them have vaginal delivery.
But the World Health Organisation (WHO) has warned that doctors are putting the health of women and their babies at risk by performing caesarean sections too readily.
Officials of the United Nations Apex Health body in a new statement published Monday said the procedure should only be carried out when ‘medically necessary’ because it can lead to infections and even death.
Indeed, caesarean section is one of the most common surgeries in the world, with rates continuing to rise, particularly in high- and middle-income countries. Although it can save lives, caesarean section is often performed without medical need, putting women and their babies at-risk of short- and long-term health problems.
The new statement from the WHO underscores the importance of focusing on the needs of the patient, on a case-by-case basis, and discourages the practice of aiming for “target rates”.
The WHO Statement on Caesarean Section Rates is based on two studies carried out by the United Nations Development Programme (UNDP)/United Nations Population Fund (UNFPA)/United Nations Children Fund (UNICEF)/WHO/World Bank Special Programme for Research, Development and Research Training in Human Reproduction. This programme is the main instrument within the United Nations system for research in human reproduction, working within the Department of Reproductive Health and Research of the World Health Organization.
According to the statement, caesarean section may be necessary when vaginal delivery might pose a risk to the mother or baby – for example due to prolonged labour, foetal distress, or because the baby is presenting in an abnormal position. However, caesarean sections can cause significant complications, disability or death, particularly in settings that lack the facilities to conduct safe surgeries or treat potential complications.
Since 1985, the international healthcare community has considered the “ideal rate” for caesarean sections to be between 10 per cent and 15 per cent. New studies reveal that when caesarean section rates rise towards 10 per cent across a population, the number of maternal and newborn deaths decreases. But when the rate goes above 10 per cent, there is no evidence that mortality rates improve.
Director of WHO’s Department of Reproductive Health and Research, Dr Marleen Temmerman, said: “These conclusions highlight the value of caesarean section in saving the lives of mothers and newborns.
“They also illustrate how important it is to ensure a caesarean section is provided to the women in need – and to not just focus on achieving any specific rate.”
Across a population, the effects of caesarean section rates on maternal and newborn outcomes such as stillbirths or morbidities like birth asphyxia are still unknown. More research on the impact of caesarean section on women’s psychological and social well-being is still needed.
Due to their increased cost, high rates of unnecessary caesarean sections can pull resources away from other services in overloaded and weak health systems.
International use of Robson classification
The lack of a standardized internationally-accepted classification system to monitor and compare caesarean section rates in a consistent and action-oriented manner is one of the factors that has hindered a better understanding of this trend. WHO proposes adopting the Robson classification as an internationally applicable caesarean section classification system.
The Robson system classifies all women admitted for delivery into one of 10 groups based on characteristics that are easily identifiable, such as number of previous pregnancies, whether the baby comes head first, gestational age, previous uterine scars, number of babies and how labour started. Using this system would facilitate comparison and analysis of caesarean rates within and between different facilities and across countries and regions.
Temmerman explained: “Information gathered in a standardized, uniform and reproducible way is critical for health care facilities as they seek to optimize the use of caesarean section and assess and improve the quality of care. We urge the healthcare community and decision-makers to reflect on these conclusions and put them into practice at the earliest opportunity.”
Get the latest news delivered straight to your inbox every day of the week. Stay informed with the Guardian’s leading coverage of Nigerian and world news, business, technology and sports.
1 Comments
These doctors recommending ceacearean section for innocent pregnant women so that they can make money always instil fear into the women send they have forgotten. That God’s Vengeance will be Heavy upon them their family It All about sowing and reaping the Harvest will not stop upon them and their family , the few sincere Doctors and genie ones should sing it write Nd sensitze. The money mongrel ones ,and most Especially training should be recommended to all medical personnel constantly because they are dealing with life , but some don’t care to them should note this God shall judge every evil act of men and “SINNERS WILL NOT GO UNPUNISHED “”
We will review and take appropriate action.