AN EXPONENTIAL increase in Caesarean sections, or C-sections, which should be reserved for high-risk pregnancies or medical emergencies, is highly worrying. The increase in C-sections is also evident in rural areas, where earlier natural birth mostly happened. A study, published in the international medical journal BMJ Open, based on a survey of new mothers in nine upazilas in Rajshahi, finds that 34.4 per cent of the deliveries made through C-sections. The rate is significantly higher than the World Health Organisation鈥檚 recommended threshold. The world agency recommends that C-section rates should not exceed 10鈥�15 per cent and should be used only when it is medically necessary. The overall rate of C-sections has also multiplied drastically. The overall rate was only around 4 per cent and the rate in rural areas was 2 per cent in 2004 while the overall rate is now exceeds 51 per cent, according to the Bangladesh Institute of Development Studies. The study also shows that cases of Caesarean section increased five times more in rural areas, with a 1,381 per cent increase, than in urban areas, with 277 per cent, in 15 years, in 2004鈥�2018 financial years.
The profit-mongering attitude of private healthcare facilities, where about 84 per cent of Caesarean sections are conducted, is believed to have contributed to the exponential increase. Experts say that surgeons and clinics manipulate expectant mothers and their families to go for C-sections not for any medical reasons but also to make profits. A 2018 study by the World Health Organisation and UNICEF says that about 77 per cent of the Caesarean sections that took place in Bangladesh that year were unnecessary and about 95 per cent of the income of private hospitals and clinics had come from Caesarean sections. What is further worrying is that there are court orders and specific bodies to look into the issue, but the situation has not changed as the authorities have failed to comply with the court orders and prevent unnecessary C-sections. In October 2023, the High Court asked the government to take steps to make it mandatory for all hospitals and clinics to follow the guideline on the prevention of unnecessary Caesarean sections. The Bangladesh Medical and Dental Council, mandated to regulate and inspect hospitals and clinics against their wrongdoing, has hardly done anything to prevent such manipulation.
Non-medical factors such as poor nutrition, lack of sleep and insufficient care of expectant mothers are also believed to have increased the rate of C-sections. The authorities need to take steps to strengthen antenatal counselling, regulate private health facilities and create awareness of the risks to prevent unnecessary C-sections.
