C-sections getting common in Kashmir is a dangerous trend and the expecting mothers, doctors, and government all are responsible for it, Ajaz Rashid reports.
What do call an expecting mother who does not want to bear labour pain for the birth of her child? What do call a doctor who recommends caesarean sections instead of normal deliveries to earn more even when the C-sections are not needed? And what do you call the government that lets the mother and the doctor shy from their responsibilities?
Mahira Khan confesses that she urged her gynaecologist to go for a caesarean fearing that she would have to go through unbearable pain in case of a normal delivery.
“These days most women prefer C-sections over normal delivery,” she says. “It’s not only to avoid pain but also to escape the experience of delivering a baby in government hospitals, which are filthy and packed.”
While expecting mothers visiting government hospitals usually deliver babies through normal delivery in almost all the private hospitals, there is no concept of delivering a body through normal delivery.
In private hospital of Kashmir, almost all expecting mothers deliver babies through C-sections.
Resultantly, Kashmir is witnessing an alarming surge in the number of caesarean sections, a dangerous trend according to the world health norms.
A gynaecologist, who prefers not to be named, says it is usually the expecting mothers who urge them to go for C-sections instead of the normal delivery.
“In the government hospital, where I am posted, I usually oversee expecting mothers giving normal delivering but the private hospital where I work as a consultant, I recommend caesarean sections because the mothers ask for,” she says.
However, a paramedic working at a private hospital says that the C-sections means more money for both the gynaecologists as well as the hospital as the patient has to stay for treatment for more days.
Besides, he says, the cost of the operation and medication for caesareans is higher than a normal delivery.
All this is happening under the nose of the government, which prefers to overlook the fact that the private hospitals almost witness 100 percent C-sections and zero percent normal deliveries.
“This is alarming,” says Dr Anwar Ali, a gynaecologist who works in the Boston, United States. “Apart from answering the moral question of why an expecting mother would want to escape the labour pain, they also need to answer why they are putting the health of both themselves as well as their babies to risk.”
According to Dr. Ali, the government should crack a whip on the private hospitals unnecessarily carrying C-sections instead of normal deliveries.
“The governments are responsible for the larger good of the people, and in a welfare state it is a moral obligation of the government to see to it that neither the mothers nor the doctors have the choice to take a short cut to avoid the pain or to make more money,” he says.
One more reason for Kashmir witnessing a rise in C-sections is that most peripheral hospitals continue to remain in shambles.
The use of caesarean sections to deliver babies at Kashmir lone maternity hospital, Lal Ded continues to witness a rise.
As per the figures maintained by the hospital’s record section, from April to December 2018, it received 1.40 lakh patients in the Out Patient Department (OPD).
“At least 25,447 patients were admitted in the In-Patient Department (IPD) between April and December 2018,” the report reads.
The hospital, according to the report, conducted 12,000 c-section surgeries and 7626 normal deliveries in the past nine months, a figure higher than previous years.
The fresh figures reveal that the c-sections are on a rise compared to the year 2017 when only 10,722 C-section surgeries were conducted at the lone maternity hospital in the Valley.
In the hospital, a total of 14,920 caesarean sections were conducted in 2016 and 15,570 in 2015.
On an average 70-80 major surgeries and 10-15 minor surgeries are conducted in a day at the maternity hospital which faces manpower shortage, leaving the existing manpower overburdened.
According to the doctors at the hospital, more needs to be done to raise awareness among the women, their families and medical professionals of the potential risks of caesarean sections.
Over the rise in C-section surgeries, senior gynaecologists at the facility said for caesarean section cases, there are 50 percent chances that a woman could deliver next baby normally.
“A woman giving birth normally isn’t at risk but those who go through caesarean become ‘high risk’ for the next delivery. That is a negative impact of C-section,” a gynaecologist said.
However, the hospital authorities said it receives 50 percent patients as referrals across the Valley each day, putting a huge burden on the lone maternity facility.
A doctor at the hospital said if 120 expecting women are admitted in the IPD a day, half of them are referral cases.
“C-sections are increasing because all the high-risk patients are directly referred to our hospital due to inadequate facilities in districts and they have less chance to deliver baby normally,” he said.
The doctor said after 4 pm, the referral load increases as patients even with minor abdominal pain come for treatment at the overburdened hospital.
“The district hospitals need to be streamlined by way of making available gynaecologists decrease the referrals and patient quality will improve after that,” he said.
The hospital is grappling with a shortage of doctors and for the 200-bedded block – made functional in 2012 – no staff had been posted as per the officials of LD Hospital.
The services at the new block are being provided by the existing staff on an interim arrangement, leaving them frustrated.
“We are asked to go to one block and within days to another block. If the authorities increase bed strength, why can’t they appoint the staff,” a doctor said.
The available manpower in the maternity hospital is not in tune with the standards set by World Health Organization (WHO), National Accreditation Board for Hospitals and Health Care Providers (NABH) and Medical Council of India (MCI).