This week the Ministry of Health released the sector performance report of Financial Year 2018/19 which showed that almost 50 per cent of the deliveries carried out in hospitals were through Caesarian Section (C/S).
The report again showed that at Health Centre IVs C/S conducted were 22,139 increasing from 17,729 in the year 2017/18. Mukono Town Council HC IV conducted the most C/S 1,708 cases.
At the level of Regional Referral Hospitals, S/Cs increased from 31 per cent to 32 per cent and Nsambya Hospital had 50 per cent of C/S cases, followed by Mbarara hospital with 46 per cent, Mbale at 41 per cent and Gulu.
C/S rate also increased slightly in General Hospital from 28 per cent to 29 per cent and Nakasero Hospital had the highest rate of 72 per cent whereby out of 747 deliveries it conducted 586 were of C-Section.
From the several interviews, Watchdog Uganda Conducted with doctors and midwives from different hospitals both private and public here are the 10 reasons why most women currently prefer C-Section to normal delivery.
1. Fear of too much Pain
According to Dr Ruth Ayuku from Mark clinic in Bwaise, natural birth has fewer complications thus quick healing process on the mother’s part but C-Sections take up to six weeks to completely heal, however when it comes to persistent labor pain women opt for C-section willingly to survive the pain.
Ajika caroline told this website that she came willing to push her baby but after almost 20 hours of labor pain her doctor advised her to take C-Section.
“I was injected at the back and the C-Section was done in less than an hour, and it was so easy and painless. I can never go through so much pain when there is a painless option,” she said.
2. Fetal distress-this refers to signs before and during childbirth indicating that the fetus is not well, this complication typically occurs when the fetus has not been receiving enough oxygen
If the fetus’s heart rate or control contractions are not effective, the baby must be delivered as quickly as possible through C-Section.
3. Contracted Pelvis.(Cephalo-pelvic disproportion)-This is when the capacity of the pelvis is inadequate to allow the fetus to negotiate the birth canal. This may be due to a small pelvis, a large fetus, an unfavourable orientation of the fetus, or a combination of these factors. The only way to deliver such a baby is by C-Section.
4. Doctor’s advice-A senior Midwife from Mulago National hospital whose name is withheld for the safety of her job told this website, that ethically a patient can be referred for a C-Section when abnormal developments have been registered but currently most hospitals, especially private ones, have made it a routine to intentionally advise C-sections to their patients even if she would have delivered normally.
“Since C-section goes for a higher bill than normal delivery many hospitals especially profit-oriented hospitals focus on C-Section and doctors usually advise patients to go for such,” she said.
5. Position of fetus
If a baby is in a breech position, it means his bottom or feet are facing down. A transverse position is when your baby’s shoulder is facing down. Some babies can be turned in the womb to move into a head-down position but a c-section may be safer for the baby.
6. Medical conditions such as High blood pressure
If a mother has medical conditions such as high blood pressure or diabetes vaginal birth can be risky for her. Since diabetes is when you have too much sugar in the blood, this can damage somebody’s organs like blood vessels and nerves during vaginal delivery. High blood pressure is when the force of blood against the walls of the blood vessels is too high. It can stress one’s heart and cause problems during pregnancy.
7. HIV issues
If a mother has an infection, like Human Immunodeficiency Virus (HIV) or other Sexually Transmitted Diseases (STDs) such as Genital Herpes or Syphilis she can pass these infections to he baby during vaginal birth. So a c-section is more safer for her baby since she will be protected from risks of getting mother’s infections.
8. Twins or more babies
According to medical officers from Mulago ,majority of twins, triplets and quads are delivered by c-section because monitoring more than two babies during labor can be logistically difficult, there’s more risk of maternal or fetal problems, such as high blood pressure for the mom or cord compression for the babies yet C-Sections quickens the process and babies are protected.
9. Size of the baby
It’s not very common for the size of a baby to increase the chances of needing a cesarean section (C-section) however it’s true that normally mothers find it difficult to deliver very large babies vaginally due to size limitations of the birth canal and the maternal pelvis which leads C-section.
10.umbilical cord abnormalities
A baby with such anomalies which include congenital heart disease, or trisomies, it’s is very risky to be delivered normally due to complication and the only way to save it is by the C-Section.
However, doctors advised that “If your pregnancy is healthy and you don’t have medical reasons for a c-section, it’s best to have your baby through vaginal birth.”
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