Guideline a must to stop unnecessary C sections

Published: 00:00, Jan 20,2020


PUBLIC health programmes for women are largely focused on family planning, pregnancy and childbirth services, but safe birth still remains a serious concern. The Maternal Mortality and Health Care Survey 2017 says that haemorrhage and eclampsia causes 55 per cent of maternal deaths. Another research of Bangabandhu Sheikh Mujib Medical University claims that there are 20,000 obstetric fistula patients and three-fourths of these cases are due to neglected, under-attended delivery. It is mostly because government facilities in the lowest tiers of administration are often without physicians, not always well equipped to ensure a safe delivery. The unregulated development of a healthcare industry that promotes unnecessary Caesarean sections has, meanwhile, further complicated the situation. In this context, the call for a round-the-clock care for pregnant mothers and no Caesarean sections at a workshop in Rangpur is promissory.

The burgeoning problem of C sections is placing mothers and children at a needless risk. A Save the Children study records that number of C sections has increased by 51 per cent in two years since 2016. Bangladesh had an estimated 860,000 unnecessary C sections in 2018 while up to 300,000 women who need C sections cannot afford or access it. While access to facilities for delivery has increased significantly, from 27 per cent in 2010 to 47 per cent in 2016, only 3 per cent of all facilities had service readiness to provide quality normal delivery. Insufficient readiness of facilities could be a significant contributor to a high number of C section deliveries in rural areas. In June 2019, the High Court ordered the government to form a committee in a month to formulate a guideline on the prevention of medically unnecessary Caesarean sections in all hospitals, public and private. Health experts and government officials attending the programme in Rangpur considered that the strengthening of local level health infrastructure was necessary for safe childbirth.

The government must, under the circumstances, allocate adequate funds and employ the required number of medical professionals to ensure quality normal delivery services and arrange medically required Caesarean sections for women, when they are necessary, irrespective of their socio-economic status. It must also adopt a protocol for childbirth to prevent unnecessary Caesarean sections and bring all health service providers under its purview. It must take initiatives to improve maternal health services at local level. Running community clinics or free treatment programmes as business-as-usual mode without monitoring efficacies of their initiatives in improving women’s health will only create a room for private entities to exploit the situation.

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