Rising Rate of Ceserean Section in Nepal

Abstract

Caesarean section is one of the most common and lifesaving surgeries performed in modern obstetrics. In a developing country like Nepal where health care resources are limited, this rising trend definitely has major implication but it is essential to perform when complications arise during pregnancy and labour without this large number of women and their unborn babies die every year, especially in low-income countries. The World Health Organization suggests 10-15% cesarean section rate and has suggested to be done only when justified by a medical condition 2 . It states that, at a population level, if cesarean section rates higher than 10% does not reduce the maternal and neonatal mortality rates, and it should be performed only when medically justified. Otherwise unnecessary health of mother and babies including social and economic implications would challenge childbearing women, babies, their families and the state. Recently in Nepal there is a sharp rising trend of cesarean section rates from 20 to 81% in different hospitals especially in the private setting indicating over-medicalization of childbirth unnecessarily performing without medically justified. This arise the issue of human rights violence of childbearing women and professional integrity of a practitioner and safety of the clients. The World Health Organization recommended use of the Robson criteria which would be one of the best strategies in reducing the frequency of the procedure that should include avoidance of medically unnecessary primary cesarean section and improving case selection for induction and prelabour cesarean section besides educating childbearing women and their families about the consequences of unnecessary request of the procedure.