C-section deliveries in Uganda : why you should get concerned

Abstract

Cesarean delivery (C-section) is a surgical procedure used to deliver a baby through incisions in the abdomen and uterus. The World Health Organization (WHO) suggests that a cesarean delivery rate of 15% of all births should be taken as a threshold that should not be exceeded rather than a target to be achieved (WHO, 2009). However, studies show that in High-income countries and other middle-income countries, C-section is being provided at a higher rate above what is recommended and in most cases when there is no medical or obstetric indication (Thomas J & Paranjothy, 2001). For example, Cesarean birth rates continue to upsurge globally with recent (2016) reported rates of 24.5% in Western Europe, 32% in North America, and 41% in South America. In Africa, it stands at a rate of 7.3 % (Betran AP et al., 2016). In Uganda according to recent statistics from Uganda Demographic and Health Survey (UDHS, 2016), 7% of all live births are C-section deliveries. Most C-section deliveries have been reported in Kampala at 14%. C-section deliveries stand at 13% in urban residences of Uganda as compared to 5% in rural residences and 16% of the richest use C-section deliveries in relation to 3% of the poorest (UBOS 2016). Concerning timing on the decision to go for C- section according to UBOS, (2016), 33% of women decided to go for C-section before labor started as compared to 67% who decided to go for C-section after labor had started. Among those in urban residences, 40% decided to go for labor before labor begun compared to 29% of women in rural residences. 45% of the richest decided to go for C-section before labor begun compared to 20% of women who belonged to the poorest category. Among those with higher education, the timing of the decision to go for a C-section stood at 47% compared to only 19% of those without formal education. While pregnant women are usually well-advised of the short-term outcomes of having a cesarean, they are less informed about the long-term impact of a C-section – not only on their health and that of their baby but also on their ability to carry future pregnancies. It is revealed that children delivered by cesarean are 21% more likely to develop asthma within the first 12 years, and 59% more likely to become obese by the age of 5. Planned deliveries seem to be safer than emergency caesarean section, when medically indicated; but in case they are not medically recommended, they should be highly discouraged due to major risks involved as discussed earlier. This can be done in many ways mainly at a health facility setting.