Experts now warn women of health risk after ‘unnecessary’ C-sections
Unnecessary Caesarean sections could increase the risk of women developing maternal sepsis during childbirth, the World Health Organisation has warned.
Sepsis is the complication of an infection and becomes life-threatening when the body’s response to the infection causes injury to tissues and organs.
“When health facilities are overcrowded and poorly resourced, women are at greater risk of infection and sepsis. Women who undergo Caesarean sections in such conditions are at even greater risk,” said WHO’s director-general, Dr Tedros Ghebreyesus.
Locally, National Health Insurance Fund (NHIF) records show it paid out Sh714.7 million for 24,492 women who underwent C-sections in the first six months of 2016, and the payment went on to cross Sh1 billion that year.
UNNECESSARY
This reflects a 2014 WHO prediction that more women would prefer C-sections if they could afford them, despite the procedure being unnecessary in some cases.
Since the NHIF board increased the amount allocated to C-section from Sh18,000 to 30,000, women going for the procedure have increased from 22,411 during a similar period in 2014.
According to a 2003 Demographic and Health Survey study, Caesarean section rates in sub-Saharan Africa were lower than five per cent in all countries in the study (Burkina Faso, Cameroon, Ghana, Kenya, Madagascar, Niger, Tanzania, and Zambia) except Kenya, with a 6.7 per cent rate.
In a video message marking the World Sepsis Day on September 12, Dr Ghebreyesus said there was need to ensure health facilities and specialists eliminate conditions that make mothers and babies catch the infection.
A 2013 WHO report showed that countries in southern Asia and sub-Saharan Africa countries account for 85 per cent of all maternal deaths worldwide.
PREVENT INFECTIONS
“We know that most infections can be prevented and what can be done to prevent them, including providing access to quality health care during pregnancy and childbirth, responsible and timely access to the right medicines, proper infection prevention and control in hospitals and clinics, said Dr Ghebreyesus.
The director lamented “the tragedy of deaths due to sepsis that could have been avoided” saying the world needed to devote more resources and skills to eliminate the sepsis menace.
“WHO recognises the need to pay more attention to this life-threatening but not so well known condition. We are working with partners to support a large, multi-country study covering more than 500 maternal health facilities in 54 countries,” he said.
Dr Ghebreyesus used the occasion to call for greater measures to be taken to improve recognition, diagnosis and treatment of sepsis, and particularly maternal and neonatal sepsis.
In May, the 70th World Health Assembly passed a resolution to address the prevention, diagnosis and treatment of sepsis.
BETTER UNDERSTANDING
Dr Ghebreyesus expressed confidence that the initiative would lead to better understanding and international cooperation
“As infections frequently complicate serious diseases, sepsis is a final common pathway to death from both communicable and non-communicable diseases around the world,” says the WHO website.
If sepsis develops during pregnancy, while or after giving birth, or after an abortion, it is called maternal sepsis, while the condition in newborn babies is called neonatal sepsis.
Despite being preventable, maternal and neonatal sepsis continue to be major causes of death.