What is the condition of C-sections and the conundrum of giving birth in India

Seher could not have been happier when she found out that she was pregnant in February 2017. As is often the case with overwhelming news, her delight soon turned to confusion. Is maternity leave enough? Where would she find a nanny she could trust?

Breast milk or not? Her mother, mother-in-law, and aunts, however, had a question that needed an answer before the baby was born. How would Seher give birth?

Choice of the birth

Each one of them attempted to talk her into choosing natural, i.e. vaginal, birth.

It is one of those things, says Seher, where everyone has something to say. Who should she listen to? And whom to block out? Also, were natural births really better than surgeries?

A number of Google searches later, she concluded they were right. Caesarean deliveries, or C-sections, could be life-threatening for the mother. The chances were minuscule, but that wouldn’t matter if she was one of the unlucky few. “My research also suggested that the babies born naturally are exposed to minerals during delivery that is good for them,” says Seher. (Not quite accurate, but we’ll get to that in a bit.)

There was just one catch as far as she could imagine. Women in their 30s are more likely to deliver via a caesarean surgery due to higher chances of medical complications than women in their 20s. And Seher was 36.

Unlike her, N—who asked not to be named—had age on her side, when she discovered that she was pregnant at 28, in July 2015. Like Seher, though, she was anxious about the manner in which she would give birth, after hearing her sister-in-law’s suspicions that she underwent a C-section because her doctor had movie tickets for the day her labor pains began.

Medical Complications

The doctor had cited medical complications, but her sister-in-law said she had heard the doctor talking about catching the movie.

N trusted her sister-in-law, and her biggest worry then was to find a doctor whom she could trust.

A couple of thousand kilometers and a year and a half apart, Seher in Bengaluru and N in Delhi were sold. Science and tradition were in consensus. Both of them decided that they would take every call over their nine months with one goal in mind—a natural delivery. And both needed to find a doctor.

Seher’s sister, who had had a baby three months earlier, recommended her doctor. Seher was initially hesitant, as her sister had undergone a C-section herself, though she knew that in her sister’s case, diabetes was the reason. And when they met, her sister’s doctor convinced Seher that her body would not be cut open just for the sake of higher revenue.

N, on the other hand, discovered her physician on television. One day, her mother called her to listen to a doctor talk in favor of natural births on the tube, vehemently railing against C-sections. N looked at the doctor up and discovered that he practiced in South Delhi. She immediately approached him.

Claims by the reports

The doctors soon told them that natural births were easier said than done.

In India, just 17% of births are C-sections, according to data from the latest National Family Health Survey (NFHS-4), but in private hospitals, the rate is much higher at nearly 41%, which is up from just under 28% a decade ago.

From 1985 up until 2015, the World Health Organisation (WHO) recommended that the rate for cesarean sections should ideally be 10-15%. Although in 2015 WHO did away with the recommendation, it did conclude that while C-sections are effective in saving the life of the mother and the child, they could also cause complications, disability or death.

Thus, it said, C-sections should only be carried out when medically indicated. Additionally, some research has shown that vaginal births are correlated with better health outcomes for the child as it is exposed to bacteria (not “minerals”, as Seher had said) in the vaginal canal (though scientists have not established a causal relationship).

 

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