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Moms-To-Be Are Increasingly Opting For Going Under The Knife. But Here’s The Thing

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By Rakesh Kalshian

Note: This article has been republished from Down To Earth.

Not so long ago, newborns were ushered into the world naturally. Just as in their mammalian cousins, both the expectant mother and child were subject to the cold logic of natural selection— some survived, while others were not so lucky. Then, around the mid-19th century, science rigged the rules by delivering babies through a knifed abdomen.

pregnant-woman baby bellyThe new surgical intervention (known as the caesarean section, or C-section for short) was meant expressly for pregnancies in which the life of the mother or child or both was in danger. There is little dispute that in such cases, C-section has been a life-saver. However, in low-risk pregnancies, it is, by most accounts, an unkind cut. Studies have shown that it renders the mother vulnerable to debilitating, if rare, complications, such as haemorrhage, blood clots, and bowel obstruction. Lesser risks like bladder damage, infection and nagging pain are not uncommon.

There are downsides for babies too. Compared to naturally-born children, they are more likely to suffer from asthma, allergies, autism and even obesity. In his recent book, ‘Childbirth And The Future Of Homo Sapiens’, Michel Ordent, a maverick obstetrician based in London, suspects that these anomalies may have something to do with synthetic oxytocin, anaesthetics, and epidurals that accompany a C-section. Some researchers speculate that it might be because caesarean babies are deprived of the gift of immunity boosting microbes that a vaginal baby comes wrapped in. Besides, there is a belief, as yet untested, that natural birth makes for greater intimacy between mother and child.

This, one would imagine, would scare any expectant mother away from C-section. On the contrary, there has been a dramatic surge in its popularity around the world in recent decades. Currently, it ranges from 12 percent in Sweden, 32 in the US, 41 in Iran, and a staggering 52 in Brazil, to cite a few. Most exceed the World Health Organization (who) recommended limit of 15 percent.

India is still at modest nine percent but in some states like Kerala and Tamil Nadu, it has assumed epidemic proportions— around 60 percent.

There are several reasons for this upswing. For one, C-section costs twice of natural birth; hence private hospitals tend to do them more. Two, C-section has become the default option for most obstetricians, as they are not trained in alternatives like forceps delivery and ventouse. Three, many well-off women opt for it in order to avoid labour pain. Besides, as more women are having their first child in their 30s, they don’t want to take any chances.

Like many controversies surrounding modernity, the one on C-section too is couched as the “nature versus technology” argument. Pro-caesareans ridicule pro-vaginal births as essentialists and, in turn, are accused of technological triumphalism.

The UK Supreme Court added a new knot to the imbroglio this March when it indicted a doctor for recommending natural birth to a woman (she lost her child) even though she deserved a C-section (she was short and diabetic). Denouncing it as “medical paternalism”, the court ruled that henceforth, all doctors in the UK will have to explain the pros and cons of both choices. Ideally, that might seem like the most rational thing to do—let the would-be-mother take the final decision after she has been informed of all the potential risks of either option. But in developing countries like India and Brazil where healthcare is an increasingly private (and shoddily regulated) business, and where illiteracy abounds, it would take far more to stem the tide.

A greater obstacle perhaps, is the prevalent culture of risk that makes people trust technology and professional expertise more than the skills of a midwife. Better regulation of nursing homes and well-informed birth specialists would surely help. But a sustained, enlightened public discourse on the science and politics of birthing might go a much longer way.

You must be to comment.
  1. Jigsaw

    Having a mother deliver through caesarian is good business these days, a profiteering scheme. Even under perfectly normal conditions, doctors put mothers under the knife for the extra income.

  2. indian girl

    Are you kidding me? Science has evolved enough that there are now ways to go through labor without experiencing any pain. Whether it be C-sections or vaginal birth with usage of drugs, science has helped our lives immensely. A “normal” delivery doesn't mean “problem-free” delivery. There are complications that occur during normal deliveries as well. Stop trying to vilify science and place some goddamn trust on our doctors. They know what they are talking about! If it was unsafe in the long run, millions of people wouldn't be embracing C-sections and labor-pain-drugs; and doctors across the world won't be prescribing it. We have a lot of measures and steps in place that ensure that the drugs we use are safe for us.

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Now as an MH Fellow with YKA, she’s expanding her impressive scope of work further by launching a campaign to facilitate the process of ensuring better menstrual health and SRH services for women residing in correctional homes in West Bengal. The campaign will entail an independent study to take stalk of the present conditions of MHM in correctional homes across the state and use its findings to build public support and political will to take the necessary action.

Saurabh has been associated with YKA as a user and has consistently been writing on the issue MHM and its intersectionality with other issues in the society. Now as an MHM Fellow with YKA, he’s launched the Right to Period campaign, which aims to ensure proper execution of MHM guidelines in Delhi’s schools.

The long-term aim of the campaign is to develop an open culture where menstruation is not treated as a taboo. The campaign also seeks to hold the schools accountable for their responsibilities as an important component in the implementation of MHM policies by making adequate sanitation infrastructure and knowledge of MHM available in school premises.

Read more about his campaign.

Harshita is a psychologist and works to support people with mental health issues, particularly adolescents who are survivors of violence. Associated with the Azadi Foundation in UP, Harshita became an MHM Fellow with YKA, with the aim of promoting better menstrual health.

Her campaign #MeriMarzi aims to promote menstrual health and wellness, hygiene and facilities for female sex workers in UP. She says, “Knowledge about natural body processes is a very basic human right. And for individuals whose occupation is providing sexual services, it becomes even more important.”

Meri Marzi aims to ensure sensitised, non-discriminatory health workers for the needs of female sex workers in the Suraksha Clinics under the UPSACS (Uttar Pradesh State AIDS Control Society) program by creating more dialogues and garnering public support for the cause of sex workers’ menstrual rights. The campaign will also ensure interventions with sex workers to clear misconceptions around overall hygiene management to ensure that results flow both ways.

Read more about her campaign.

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A student from Delhi School of Social work, Vineet is a part of Project Sakhi Saheli, an initiative by the students of Delhi school of Social Work to create awareness on Menstrual Health and combat Period Poverty. Along with MHM Action Fellow Sabna, Vineet launched Menstratalk, a campaign that aims to put an end to period poverty and smash menstrual taboos in society.

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Find out more about the campaign here.

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Read more about the campaign here.

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As a Youth Ki Awaaz Menstrual Health Fellow, Nitisha has started Let’s Talk Period, a campaign to mobilise young people to switch to sustainable period products. She says, “80 lakh women in Delhi use non-biodegradable sanitary products, generate 3000 tonnes of menstrual waste, that takes 500-800 years to decompose; which in turn contributes to the health issues of all menstruators, increased burden of waste management on the city and harmful living environment for all citizens.

Let’s Talk Period aims to change this by

Find out more about her campaign here.

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A former Assistant Secretary with the Ministry of Women and Child Development in West Bengal for three months, Lakshmi Bhavya has been championing the cause of menstrual hygiene in her district. By associating herself with the Lalana Campaign, a holistic menstrual hygiene awareness campaign which is conducted by the Anahat NGO, Lakshmi has been slowly breaking taboos when it comes to periods and menstrual hygiene.

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Bidisha was selected in Change.org’s flagship program ‘She Creates Change’ having run successful online advocacy
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