Vaishnavi Maternity Home
Accepts the Initiative to Display its Caesarean Section Rates
In a recent petition to the Ministry for Child Development, Ms. Subarna Ghosh has collected nearly a lakh of supporters who want to make it mandatory for all doctors and hospitals to declare the percentage of Caesarean delivery rates to patients.
Ms. Ghosh felt that the C section that she personally underwent was “misleading and manipulated and her choice was overridden”. According to Ms. Ghosh, to discourage the trend of indiscriminate conducting of C sections, women need to be made aware of C section rates of different hospitals and maternity homes so they can choose their hospital carefully.
Caesarean Section Rates (CSR) have increased exponentially worldwide. India, with its varied levels of maternity services, is also facing an epidemic of CSRs. We, at Vaishnavi Maternity Home have tried to maintain an appropriate CSR ratio.
We are a tertiary referral centre. While this increases our patient volumes it also brings in a variety of challenges, some of which are:
- Advanced maternal age with medical complications
- Increasing incidence of morbid obesity with co-morbidities
- Assisted reproductive techniques with couples not open to vaginal births
- Maternal request for ‘Muhurtham’ C Section
The most common reasons for CSR and our efforts to minimize the rates are :
- Presumed fetal compromise: It is the most common indication for an emergency C section. We have the option of doing a fetal blood sampling, fetal scalp electrode for better monitoring and decisions. Training and certification in fetal monitoring techniques for all doctors working in the Labour Ward is mandatory.
- Failure to progress: This is explained better as a caesarean done when the cervix fails to dilate despite good labour pains. New guidelines from the American College of OBGYN1 have suggested a more conservative approach with reference to definition, (cervix dilated to 6 cm) and intervention that follows. These protocols have been adopted by us.
- VBAC and ECV Option: We offer the option of VBAC (vaginal birth after caesarean section), and ECV (external cephalic version – turning the baby to head-down position) for breech presentation.
- Multifetal pregnancy: Vaginal delivery is becoming rare in twin pregnancies in India. We have the facilities to monitor both babies throughout labour, so we try to deliver twins vaginally.
- Induction of labour: Reducing inductions would lead to a reduction of overall caesarean section rates. We have a protocol and definite indications for induction of labour, with a constant watch on the rates, averaging 25% currently.