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Why urban women prefer C-section

Health & Science - By Michael Ollinga and Silah Koskei and Maureen Odiwu | February 16th 2016 at 12:00:00 GMT +0300

More than 80 per cent of women in middle and high classes prefer Caesarean section for personal and not medically-justifiable reasons.

"It is becoming a craze that most affluent women will go for CS, first to avoid the pain and trauma of child birth and secondly to protect their birth canals, because they believe normal delivery would take away their vaginal elasticity and deprive them of sexual pleasure after delivery," said John Biiy, a nursing officer in Eldoret.

He said most expectant mothers they attend to prefer CS after making reference to advantages shared by their friends, who earlier on gave birth through the procedure, rather than normal child delivery.

"The urban setup is dominated by this craze, which I would not recommend myself. Many of these mothers are in good health and capable of delivering successfully without the operation. But sadly, they ignore the risks associated with the surgical operation like uterus infections," he said.

Biiy noted CS should be restricted to situations where lives of a mother and child may be at risk if a normal delivery is conducted, but reiterated that normal child birth is the best if handled by qualified practitioners.

"After two operations, it is safe for one to give birth normally or other complications may come up. Also, CS procedures are putting pressure on public health facilities where maternity services are free because one mother needs a surgeon, a scrub nurse to set up the theatre, a running nurse to work with the surgeon and an anesthetist, limiting others' access to medical personnel," said the officer.

According to WHO, C-sections are becoming common every day in developed and developing countries but in most cases, women do not undergo the procedure for its basic importance of preventing maternal and perinatal mortality.

Orango Omenge, a gynecologist at Moi Teaching and Referral Hospital, said CS must be discouraged unless it is medically justified and not for women who have a phobia for pushing the baby during delivery.

"Most women think it is the easiest method to escape from pain and tear but this procedure comes with life-threatening complications like wound infections and clots. Surgeries also predispose people to other wellness hurdles," he said.

Lorna Kipsum, a nursing officer at a private health facility in Eldoret, says CS procedures are costly.

"It is what women share among themselves. They begin saving for delivery just after conception because they would rather cough up huge amounts rather than feel the pain of pushing the baby. Their perception of normal delivery is however exaggerated and they coerce medics to do CS and not vice versa," Kipsum said.

Economic Gains

Dennis Khamisi, a clinical officer in Bungoma, said the high number of women going for CS should not be blamed on doctors but personal preference. However, he refused to rule out cases where medics recommend women for CS for economic gain.

"Other employed women may want to utilise their health insurance covers, which they feel they will never benefit from, thus choose to go for CS. It is difficult to advise them sometimes because they begin attending clinic when they have already made up their mind," Khamisi said.

Jane Akinyi is a nurse at a health facility in Kisumu. She has never given birth before but says she would confidently request to undergo C-section during delivery when she gets pregnant.

According to medical experts, more first-time mothers are opting to have their babies delivered by C-section. However, doctors advise that unnecessary operations should be avoided.

Akinyi might be one of the women referred to as tokophobic - those who have fear of pregnancy and child birth, which makes them get traumatised after hearing the horrific stories about child birth. Tokophobic women often tend to opt for CS.

"I wouldn't like to go through pain," said Akinyi.

Kisumu County's Health Chief Officer Ojwang' Lusi said it's no longer surprising to see some women opt for CS.

"This is rarely the case in public facilities but very common in the private sector. The excuse used is that they do not want to endure labour pain," he said. He noted some women believe normal delivery will stretch their pelvis and affect their sex life.

"Some believe when a baby passes through the birth canal, it will affect or hinder sexual pleasure. Many do not know that the vagina is elastic and that there is a hormone that makes the birth canal elastic. After delivery, the hormone goes down and birth canal comes back to the normal size," he said.

He said CS should be done during emergencies only because it comes with many risks.

"It is desirable to have people give birth normally. CS has risks like excessive bleeding, wound infections and it takes a long time to heal. It should be done only when necessary," he said.

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