A cesarean section (C-section) is an obstetric surgical procedure meant to save the life of a mother and her baby.
However, the increasing prevalence of C-sections worldwide has raised concerns about their potential adverse effects on maternal and fetal outcomes.
According to the World Health Organization (WHO), C-sections have become increasingly common in developed and developing countries.
Kenya provides a striking example of the escalating C-section rates. Births by Caesarean section increased to about 17 per cent of all Kenyan births in 2022, a steady increase for much of the past 8 years, according to the Kenya National Bureau of Statistics (KNBS).
Out of the 1.24 million hospital deliveries in 2022 a staggering 211,227 were performed via C-section, compared to 110,900 in 2014.
This significant increase has raised concerns among health experts and organizations.
According to another study that compared Kenya and Tanzania: cesarean delivery rates in Kenya ranged from 5% among uneducated, rural Tanzanian women to 26% among educated urban women in Kenya to 37.5% among managers in urban Tanzania.
Overall findings indicated higher odds of cesarean delivery among mothers from the richest households, those insured, highly educated and managers compared to the middle class, no insurance, primary education and unemployed, respectively.
The WHO’s Concerns
In 2018, the World Health Organization issued a guidance note warning that the unprecedented rise in C-section rates poses a major public health concern.
The ideal rate for C-sections, according to WHO, should fall between 10 and 15 per cent, as there is no proven advantage to unnecessary procedures.
A 2015 WHO report concluded that cesarean section rates above 10 per cent did not lead to reduced rates of maternal and newborn mortality.
Medical reasons for C-section
Slow or difficult labour
If labour is progressing slowly or stops completely, a C-section may be necessary to ensure the safety of both the mother and the baby.
Fetal distress
If the baby shows signs of distress, such as an abnormal heart rate, a C-section may be performed to expedite delivery and prevent further complications.
Issues with the placenta or umbilical cord
If there are complications involving the placenta (such as placenta previa) or the umbilical cord (such as cord prolapse), a cesarean section may be the safest option.
Fetal size
If the baby is too large to be delivered vaginally, a C-section may be recommended to prevent injury to the mother or baby during delivery.
Previous C-section
If a woman has had a previous C-section and experiences similar complications in subsequent pregnancies, a C-section may be recommended
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Common non-medical reasons women prefer C-section
While it is essential for preventing maternal and perinatal mortality, most women are not undergoing this procedure for its fundamental purpose.
Access to information
Access to information plays a crucial role in shaping women’s decisions regarding childbirth, and various sources contribute to their perceptions and choices.
Social media platforms like Facebook, television, newspapers, and even movies have become influential channels for providing information about childbirth options.
Successful stories shared by others who have undergone C-sections can sway women’s opinions and convince them that it is the best choice for their childbirth experience.
Fear of childbirth pain
Fear of childbirth pain is another significant factor driving women towards choosing C-sections.
According to medical experts, more first-time mothers are opting to have their babies delivered by C-section, while others may have had traumatic birthing experiences in 2022, leading to fear, stress, frustration, and even depression.
This fear can heavily influence their decision to opt for a planned C-section, as they believe it will help them avoid the pain and stress associated with natural childbirth.
Too posh to push
The notion of being “too posh to push” has also gained prominence among certain middle-class women.
They perceive C-sections as a more convenient and glamorous option, aligning with their lifestyle choices and preferences.
This perception can stem from a desire to maintain a certain image or avoid the physical challenges that accompany natural childbirth.
Convenience
Convenience is another aspect that attracts some women to choose C-sections. They appreciate the shorter delivery time and the perception that C-sections offer a more controlled and predictable birth process.
Affordability
Additionally, economic factors come into play for employed women who seek to utilize their health insurance coverage.
In other ways, they view a C-section as a means to make use of their insurance coverage and ensure a potentially smoother and less physically demanding birth experience.
Risks
While the majority of mothers and babies recover well after a C-section, it is essential to acknowledge that it is a major surgical procedure carrying more risks compared to a normal vaginal delivery.
Potential risks associated with a C-section include Infection and heavy blood loss.