C-sections in Colombia surpass World Health Organization recommendations
While the WHO suggests a rate of 15%, in Colombia the amount of C-section births reaches 47%.Bogotá D. C., 22 de marzo de 2016 — Agencia de Noticias UN-
Jorge Andrés Rubio Romero, Professor of the Department of Obstetrics and Gynecology. Photo: Nicolás Bojacá
According to Universidad Nacional de Colombia (UNal) Department of Obstetrics and Gynecology Professor Jorge Andrés Rubio, the group that most contributes to C-sections are first pregnant women, followed by mothers who had a previous cesarean procedure.
Between 2012 and 2014, Rubio headed a research project at the Engativá Hospital in Bogotá, and of the 1,190 births during the aforementioned period, 36.97% were births by C-section.
“For women that previously had a C-section, they think they need the procedure once again. But this is not always true, the risk of a woman to have her uterus break during labor is the same as if she’d not had a C-section,” he said.
However after two or more C-sections this risk increases and in these cases there are clear indications to perform this procedure.
In the case of a woman that has only had one C-section it is possible for her to have normal labor. “Despite the preceding, the trend in Colombia is that almost all women that have had a C-section will have it again and this group represents 36% of the births,” said Rubio.
What happens with labor?
First time mothers also represent a high percentage with 38.5% of the births, whether they have it spontaneously or because it was necessary to end labor.
“This group contributes to the third of the C-sections and we need to assess what is happening with labor in these women, how they are cared for and why they are not having natural births,” he added.
Furthermore patient fear, wrong pain management or waiting times for normal labor have an impact on the decision to anticipate a C-section.
There is the perception that a C-Section is safer than normal birth; however this procedure could have anesthetic risks, greater health impacts on the fetus, increased care costs, hospital stay and future risks for the mother.
The third group is mothers with premature babies and for these cases there is a medical indication to give birth. This means that if the mother has high blood pressure or premature water breakage it is more beneficial for both mother and child for the birth to take place as fast as possible.
However this does not mean that a C-section is in order but that they need to begin birth induction procedures to allow the baby to be born.
“For a premature baby to be born by C-section the weight of the fetus must me at least 1,500 grams, but if it weighs more it is possible to have a vaginal birth,” he said.
Another significant group are fetuses that are sitting or with multiples pregnancies, in these cases C-sections are always necessary. But the total amount of cesarean births of this group only reaches 7%; therefore they do not significantly contribute to the high C-section rate.
With the results of this research project they hope to reduce these percentages. Also educate expectant mothers and increase fetal welfare supervision during birth, offer greater availability of analgesic drugs to control pain and correct induction protocols.
“We need to call upon physicians and patients because C-sections are not void of risks and are not the best option to vaginal birth. Normal babies have the capability to be born by natural means and we should encourage that,” he said.(Por: Fin/VC/DMH/APBL