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C-section cuts past natural delivery

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Over the last decade, the trends in baby birth have undergone a sea change. In both public and private hospitals, the number babies born through natural delivery has seen a decline, whereas caesarean section procedures have close to doubled.

The data from the health department of the BMC states that over the past eight years, number of babies born through natural delivery in Mumbai has seen a dip of 16% from 1, 44,633 in 2007-08 to 1, 20,196 in 2013 – 14. As opposed to that the number of babies delivered through caesarean section has seen a stark increase. While in 2007, 26, 537 babies were delivered in both public and private hospitals due to C-section, between March 2013 to April 2014, 43, 803, that is almost double the number of babies were delivered through C-section. The data was obtained through a RTI query filed by activist Chetan Kothari.

1, 63,999 children were born in the last financial year. Of 43, 803 babies were born through C-section, a whopping 67% or up to 29,464 of these C-section deliveries were conducted in private hospitals and nursing homes.

A large chunk of this, doctors said are parents, who schedule deliveries of their children according to an auspicious date or time. "I was once called by parents to conduct a C-section at 4am, as their pandit contended it to be auspicious for baby's birth," said a reputed gynaecologist from a south Mumbai-based privately run hospital.

Dr Rekha Daver, head, department of gynaecology at JJ Hospital, Byculla, said that it needs to be studied that if conducting C-sections has actually led to decrease in mother and child mortality, which could reflect on the fact that it was conducted for all the right reasons.

Public hospital doctors have contended that over the past decades cases of pregnancies turning complicated have increased, leading to a higher number of C-sections. "In medical colleges, referral cases of complicated pregnancies has increased. If a C-section is conducted to save a mother or a child, there is nothing wrong in it," said Dr Daver.

More doctors from private hospitals opt for C-section as compared to their government counterparts, reveals the data. Between April 2013 to March 2014, 17% of all deliveries in government hospitals including BMC-run KEM, Sion, Nair hospitals, 16 BMC-run peripheral hospitals and other maternity homes as also state-run JJ, Cama, St George and GT Hospitals were C-section based. However, at the same time 37% of all deliveries conducted in private hospitals were caesarean.

The trend veering towards C-section deliveries has caught up significantly after 2010, statistics point out. While in 2010, 1, 47,049 babies were delivered naturally, from 2011 onwards, it gradually started dipping. At around the same time, C-section deliveries in public and private hospitals increased from 30,892 in 2010 to 43,803 in last year.

Daver strongly asserted that arbitrary wishes of parents for the baby to arrive on an auspicious muhurat or a woman's wish not to deliver vaginally, should not be entertained by doctors. "Vaginal delivery has more advantages over C-section. When a baby passes through the maternal uterine passages it acquires more immunity against diseases including respiratory and digestive troubles," explained Dr Daver.

About 35 in every 1,000 babies have breathing problems after C-section. This compares with five in 1,000 babies born vaginally.

You have a higher risk of complications after a C-section if you:
Are overweight or obese
Have had previous surgery on your stomach
Already have a medical condition

Risk to women, who go for planned C-section -
ICU admission
Longer hospital stay
Bleeding after the birth that may needs hysterectomy (removal of the womb)• Heart attack

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