KOTTAYAM: High risk factors notwithstanding, the rate of Caesarean section (C-section) in the state’s government hospitals is on the rise alarmingly. As per a statistical report availed from a reliable source, the rate of C-sections in government hospitals in the first six months of 2016 is 43.49 percent.
Out of the 41,884 deliveries conducted in government hospitals under Directorate of Health Services (DHS), 18,218 were C-sections. Alappuzha tops the list with 63.71 percent C-sections and Ernakulam comes a close second with 61.03 percent, while the rate is on the higher side in Kottayam (56.06 %) and Pathanamthitta (55.01%). The international healthcare community has fixed the ideal rate for C-sections between 10% and 15%.
Raising serious concerns, the report, which is in possession of Express, exposed that some speciality cadre gynaecologists in DHS did not even conduct a single normal delivery. In Women and Child (W&C) hospital in Alappuzha, two doctors, who conducted 152 and 219 deliveries respectively in the past six months did not lead any normal delivery so far. Out of the 388 deliveries at District Hospital Aluva, 315 were C-sections (81.8%). The situation is not different in many govt hospitals in Central Kerala.
According to a WHO report, C-section can be performed when the vaginal delivery may pose a risk to mother or baby such as prolonged labour, foetal distress, abnormal position of baby. Even the surgery can cause serious complications, including disability and death, particularly in settings lacking the facilities to conduct safe surgeries or treat potential complications.
These risks are higher in women with limited access to comprehensive obstetric care. “The figures are not showing a healthy trend. Those who undergo C-section are prone to life-long complications,” said C P Vijayan, additional professor at Obstetrics and Gynaecology Department, Government Medical College, Kottayam.
Medical experts listed various reasons for higher rate of C-sections in government hospitals -
Medical experts cited several reasons for higher rate of C-sections in government hospitals - lack of adequate number of doctors, ‘monetary interests of doctors,’ superstitious beliefs of people etc. “Each hospital needs 24 hours service of gynaecologists and anaesthesiologists to ensure maximum number of normal deliveries. Presently, none of the government hospitals have these facilities. It may take 12-14 hours for a normal delivery. Both doctors and bystanders are not at all patient enough to wait for it,” he said.
Medical activist P S Jinesh demanded a retrospective study into the reasons behind the trend. “Superstitious belief of people to ensure the birth of baby on a particular zodiac star, the delay in implementing speciality cadre in DHS and some unethical activities of doctors engaged in private practice are the major reasons behind the issue. Steps should be taken to rein in such practices,” he said.
Health Minister K K Shylaja is yet to respond to the queries posed by Express in this regard.