Financial incentives might be influencing doctors and obstetricians to perform more caesarean sections in the country than that are medically necessary, observed a group of doctors in a meeting in Dhaka on Sunday.
At present more than 80 per cent birth delivers in private hospitals were performed through unnecessary c-section, they added.
Doctors at the consultation meeting, organised by Save the Children and ICDDR,B, expressed concern over rising trend of doing caesarean section as the current caesarean section rate is far above the World Health Organisation’s recommendation. According to the National Institute of Population Research and Training’s Bangladesh Demographic and Health Survey 2014, the percentage of births delivered by caesarean section had been increasing over time, from 4 per cent in 2004 to 9 per cent in 2007, to 17 per cent in 2011 and to the current level of 23 per cent in 2014.
According to the Institute of Public Health Nutrition’s National Low Birth Weight Survey Bangladesh 2015, which was released in April 2017, showed that the rate of caesarean section had risen to 35.5 per cent.
WHO-recommended ideal rate for caesarean delivery is 10-15 per cent.
Giving an overview of caesarean section in Bangladesh, Save the Children deputy country representative Ishtiaq Mannan said while caesarean section rate in government hospitals was 38 per cent, the rate in private hospitals was more than 80 per cent.
He said the caesarean section in private hospitals was largely unnecessary and financial interest was behind the high rate of such deliveries.
Ishtiaq also said in some cases, the clients, especially educated and well off families chose caesarean section.
ICDDR,B senior research investigator Masum Billah said some mothers have misconception that led them for choosing caesarean section.
The mothers believe such deliveries are less painful and safer, he said.
Bangabandhu Sheik Mujib Medical University obstetrics and gynaecology professor Fawzia Hossain said a guideline or protocol should be made to check caesarean sections.
Another obstetrics and gynaecologist Maliha Rashid said there were some traditional midwives, mostly women of old age, in the country, who largely helped giving birth through normal deliveries in the past.
She said the government should focus on graduating midwives to decrease caesarean sections as there were only 1,000 midwives in Bangladesh against the demand of 20,000.
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