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Times of India
14 January 2010
By Kounteya Sinha
New Delhi, India

60% Of Reviewed Hospitals Carried Out Procedure For Financial Gains And Not Because It Was Required: Study
Caesarean Experts say the boom in unnecessary C-sections is jeopardising women’s health
Birth by Caesarean sections, many of them unnecessary, have started to increase, globally. While nearly one in every two births in China are delivered by C–section, the rate is around two in five in Thailand and Vietnam and nearly one in five in India.

According to World Health Organisation, which reviewed 110,000 births from nine countries in Asia during 2007–2008, 27% births were delivered by C–section. A similar survey conducted in Latin America found that 35% of pregnant women were delivered by C–section.

Shockingly, more than 60% of the hospitals studied where these C–sections took place did it for financial gains and not because it was required.

Experts say this boom in unnecessary C–section surgeries is jeopardising women’s health. “Fear of labour makes these women opt for a C–section. The morbidity and mortality rates are much higher in such cases,” they say.

Unnecessary C–sections are not only costlier but more dangerous. In India, a Caesarean delivery costs an average of Rs 20,000 more than normal. Some estimates say C–sections have risen from 5% to almost 65% in some private hospitals in India.

According to a study published in the ‘Lancet’ on Wednesday, women who undergo a Caesarean without requiring it were 10 times more likely to be admitted to ICU those who gave birth normally.

Where labour had already started, women who had a surgical delivery despite not requiring one were 67 times more likely to be admitted to ICU than those who had a natural birth.

The Asian survey looked at around 24,000 pregnant Indian women in Gujarat, Delhi and Madhya Pradesh. Deliveries were examined in 122 randomly selected public and private hospitals across Cambodia, China, India, Japan, Nepal, the Philippines, Sri Lanka, Thailand and Vietnam. All the hospitals had recorded more than 1,000 births a year.

China recorded the highest number of C–sections (46%) followed by Vietnam and Thailand with 36% and 34%, respectively. The lowest rates were in Cambodia, with 15% and India with 18%.

According to the ‘Lancet’ study, C–sections have reached epidemic proportions in many countries worldwide.

It said that in Asia, some women opt for the surgery to choose their delivery day after consulting fortune tellers for lucky birthdays or time of birth. Others fear painful natural births. Some women undergo an operation wrongly believing that it is less risky.

Dr A Metin Gilmezoglu, from the Department of Reproductive Health and Research in WHO, who carried out the study, said, “Caesarean section should be done only when there is a medical indication to improve the outcome for the mother or the baby.”

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