WHO issues guidelines to curb C-sections

On Thursday, women in labour should be given more time to give birth and have fewer medical interventions, while participating more in decision-making, said World Health Organization (WHO)

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  • Worldwide, an estimated 140 million births take place every year. Most of these occur without complications for women and their babies. Yet, over the past 20 years, practitioners have increased the use of interventions that were previously only used to avoid risks or treat complications, such as oxytocin infusion to speed up labour or caesarean sections.
  • WHO also rejected the dilation of a woman’s cervix at the rate of 1 centimetre per hour rule, saying it was ‘unrealistic’ and led to excessive caesarean sections
  • The increase in numbers of C-section deliveries had raised many eyebrows. The WHO has suggested that only 10 to 15 per cent of the total deliveries should be through a C-section.  Some states of India reported extremely high percentages. Tamil Nadu reported a figure of 34 per cent and Telangana 54 per cent.
  • The NFHS-4 data revealed that Telangana has the highest number of C-section deliveries in the country, with 74.9% babies born this way in private hospitals. Over 40% of the deliveries in Bihar were C-sections, while 58 % of the deliveries in Maharashtra were through C-section procedures.

WHO has issued new recommendations to establish global care standards for healthy pregnant women and reduce unnecessary medical interventions.

Dr Niranjan Chavan, Professor, Gynaecology Department at LTMG (Sion) Hospital said, “Yes, that is how woman should be given time so that proper labour is initiated. And then she goes on spontenous labour.  We should try to deliver a woman as an obstetrician spontaneously. So that the proper dilatation of cervix occurs and if required the labour pain also be augmented.”

He added, “But if there is any indication for section or if any intervention is required then in that case the labour has to be cut short depending upon the dilatation of the cervix. But, we would prefer woman undergoing a normal delivery to curb the incidences of C-section. So, an ample time should be given unless there is an indication for C-section.”

Dr Rishma Pai, President, the Federation of Obstetric and Gynaecological Societies of India, Secretary, the Mumbai Obstetric & Gynecological Society underscored, “Every patient in labour is an individual with a very different situation. Every single case has to be assessed and evaluated individually. So, should be surely given more time. Some have to be intervened very actively and rapidly or there will be problems to the mother or the baby. It has to be individual. A completely healthy patients labouring normally without any complications and expected to deliver normally can wait longer.”

She further said, “It depends on the situation, as the mother in labour has to be assessed and evaluated individually. And at that point, the decision has to be made whether to wait or to intervene.”