Rally Demands Strict Enforcement of International Standards for Cesarean Deliveries

A rally has been held demanding strict enforcement of international standards in the case of cesarean, or C-section, deliveries. The participants in the rally raised the demand that unnecessary surgery be stopped and cesareans be performed only on the basis of medical need.

There has long been debate over the rate of cesarean deliveries in Bangladesh. It is alleged that in many cases babies are delivered through surgery even when there is no medical emergency need. This puts both mother and newborn at additional health risk, and on top of that, extra treatment costs press upon the family.

The international healthcare community has long been saying that if cesareans account for 10 to 15 percent of all deliveries in a population, the need to save the lives of mothers and babies is met. Research has shown that good results can be obtained if this rate goes up to a maximum of 19 percent — beyond that, extra cesareans bring risk rather than benefit for mother and child.

Statistics say that in 2012, about 23 million cesarean operations were performed worldwide. While in more than 45 countries of the world the cesarean rate is below 7.5 percent, in more than 50 countries this rate has exceeded 27 percent — which experts believe is far more than necessary.

According to doctors, a cesarean is a major operation and it has its own risks. After the operation, it may take up to about six weeks for a mother to recover fully. The risks include excessive bleeding during delivery, infection, the baby's breathing problems, and in rare cases complications such as amniotic fluid mixing into the mother's blood.

According to international guidelines, without a reasonable cause, a cesarean should not be performed before 39 full weeks of pregnancy. Yet in reality, allegations arise that the decision for surgery is often taken early, in choosing a convenient time, from fear of labor pain, or under institutional pressure.

However, experts also say that in necessary cases a cesarean saves the lives of mother and baby. The placenta covering the cervix, the baby in a reversed or transverse position, prolonged labor, eclampsia, or a sudden deterioration in the condition of mother or baby — in such cases, operating without delay is the right decision.

From the rally came the demand that the medical justification for every cesarean be documented and that hospitals and clinics be brought under accountability through regular audits. Alongside, there was also talk of raising awareness among expectant mothers and families about the benefits of normal delivery.

According to health experts, to bring the cesarean rate under control, strict enforcement of rules and regulations is needed on the one hand, and on the other, the expansion of skilled midwives and delivery-support services in hospitals. Ensuring that mothers receive an environment for safe normal delivery is also essential.

It is learned that the rally's demands have been conveyed to the relevant authorities. Now it remains to be seen whether effective steps are taken to implement the international standards for cesarean deliveries.