The number of mothers undergoing caesarean sections (C-section) in Bahrain has significantly increased in recent years, top maternity medics have revealed.
Fear of litigations, privatisation of care, patient requests, increasing maternal age and demographics are amongst the most likely factors.
A C-section is the surgical procedure by which one or more babies are delivered through an incision in the mother’s abdomen. The operation is usually performed because a natural birth risks putting either the mother or child, or both, at risk.
“There has been a rise in caesarean sections in Bahrain - and the world - due to a number of reasons,” said Gulf University assistant professor Dr Zainab Aljufairi during her session ‘C-Sections in Focus: Why are the Numbers Increasing?’ at the third edition of the Bahrain International Women’s Health Conference and Exhibition.
The event was organised by BDA, alongside the Bahrain Obstetrics and Gynaecology Association and Bahrain Medical Society, at the Diplomat Radisson Blu Hotel, Residence and Spa, Manama.
“Privatisation of care is one reason why numbers have increased,” she said, adding that patients may express their preferences and request certain types of care. “Studies have also shown that more C-sections are performed in the private sector, compared to the public sector.”
Dr Aljufairi added that the advancement of medicine could be another factor, as countries such as Brazil and Turkey are recording high rates of the procedure, while the lowest rates of C-sections have been recorded in countries in the sub-Saharan Africa at less than five per cent, where access to modern health care is limited,” she said.
“Patients may opt for a C-section due to labour pain. However, whatever the reasons may be, we should work to bring these numbers down, and we can do this by avoiding the first C-section in a patient, as the patient could request another for their second and third birth.”
A Bahrain study, titled: ‘The Rising Trend of Caesarean Sections, Are They Justified?’, evaluated data from Salmaniya Medical Complex, collecting information on 3,385 women who underwent a C-section between 2008 and 2018.
It found that Bahrain’s rate has risen from 22.4 per cent in 2008 to 32.8 pc in 2018, which is double the World Health Organisation’s (WHO) ideal rate of 15pc.
The study also found that the largest prevalence of the procedure was among those aged 26 to 30, ‘raising concerns that rising numbers could be due patients demanding a C-Section, because they are afraid of having a natural birth’.
It recommended medical professionals to work to minimise fears among pregnant women by discussion, recognise their concerns and explain the risks, as well as been offered a second opinion.
UAE-based obstetrics and gynaecology (OBGYN) senior consultant Dr Shamsa Al Awar stressed that doctors should use their medical expertise to determine whether the procedure was needed rather than only listening to the patient.
“We must remember that OBGYN is personalised, reproductive care and each woman and case is unique, as is the care, which is influenced by social, religious and cultural norms,” she said.
According to 2023 figures, the National Health Regulatory Authority (NHRA) received 210 complaints, with 32 against obstetrics and gynaecologists.
“We all want to decrease the C-Section rate because of known complications that can arise,” she said. “You need to way the benefits and consequences. It is important to assess the situation and use your medical skills.
“The patient is the first to blame you when something goes wrong, so be careful and document everything to keep yourself and the patient safe.”
The level of risk of a C-section depends on factors such as whether the procedure is planned or carried out as an emergency.
Risks include infection of the wound or the womb lining, excessive bleeding, blood clots and damage to bladder or the tubes that connect the kidneys.
According to the WHO, C-section use continues to rise globally, now accounting for more than one in five (21pc) of all childbirths. This number is set to continue increasing over the coming decade, with nearly a third (29pc) of all births likely to take place by caesarean by 2030.
C-sections are typically recommended for expecting patients that have a high-risk pregnancy, deliver multiple babies, or have a baby in a breech position.
The recovery time for natural births is typically shorter than C-sections. A birth recovery can be anywhere from two to six weeks, whereas C-sections can take up to six to eight weeks for a full recovery.
julia@gdnmedia.bh
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