Unnecessary caesarean births: What private hospitals won't tell you

One troubling aspect of our society is the presence of a host of mafias which have cropped up as a result of wrong and unimaginative policies of successive governments. These mafias are so well-entrenched and strong that even the state seems helpless before them. The cost of this inaction by the authorities is that ordinary people keep facing problems.

A big mistake that the government made was to allow the private sector to set up hospitals and clinics in various areas of the country. The negative effects of this decision are visible today: a case in point is childbirth. Due to a small number of government hospitals, inadequacy of the required medical equipment there, and none to few midwives in the country, many people go to private clinics and hospitals to consult gynaecologists. Some of these hospital and clinics have gynaecologists and surgeons on their panel who are not their employees, but are available to assist the staff in childbirth.

Gynaecologists at these private clinics and hospitals ask pregnant women to visit them bi-weekly during pregnancy and invariably prescribe different tests which are either performed at their own pathological labs or referred to other labs that have some sort of financial arrangement with the clinics. Each visit to a gynaecologist costs between Rs4000 and Rs5000 including consultation fees and tests.

At the time of delivery, these gynaecologists take pregnant women to the hospital with which they have made arrangements for delivery.

Till the time these women are taken into the labour room, the impression given is that it is going to be a ‘normal’ delivery. But after a few minutes, these gynaecologists inform the women’s family members that due to some complications developed suddenly, they will have to have a caesarean delivery if they want to save the child.

They are also told to immediately deposit between Rs80,000 and Rs100,000 at the cash counter and show the payment receipt to the doctor so that the procedure is carried out. So the total cost of childbirth through a caesarean delivery at mid-tier private hospitals and clinics is around Rs200,000.

A caesarean delivery is normally required when there are serious complications or when a woman who had already had a caesarean delivery cannot deliver a child through normal birthing process. But these hospitals and clinics have ended the culture of a ‘normal’ delivery altogether. A c-section involves surgical procedures through incisions in the abdomen and uterus. Apart from leaving permanent c-section scars, the procedure is also risky.

Recently, I visited a private hospital where, I met a visibly tensed woman who had no idea how to arrange for the huge sum that the hospital had been asking for her daughter-in-law’s urgent caesarean delivery. According to the woman, the gynaecologist who was handling the case never hinted at the possibility of the c-section. The hospital administration was strict about the payment and didn’t show any leniency in this regard. I pleaded with the hospital’s administrator to at least start the process. In the meantime, the woman went to the nearest jewellery shop and sold her earrings. But even that amount was not enough to cover the cost. It was half of it. The woman gave a written undertaking to pay the rest of the amount as desired by the hospital.

It was really shocking for me to witness that alarming situation. In my view, what is happening in these hospitals is a white collar crime against the nation. These hospitals and clinics are commercial ventures that have nothing to do with humanitarian considerations.

When the state abandons its responsibilities towards its citizens, such crimes become inevitable. Once, I had the opportunity to visit the gynaecology department of CMH Rawalpindi and was pleased to see a notice there which said that the hospital encouraged patients to go for normal deliveries.

I am not suggesting the closure of private hospitals or clinics but want their activities monitored and regularised. Women’s health is being compromised due to the greed and lust for money of some hospitals and gynaecologists.

However, the preferred suggestion is that the capacity of the existing government hospitals to handle childbirths may be enhanced. The authorities should also establish birth centres manned by trained midwives and supervised by specialist gynaecologists at a number of places in cities and rural areas. In case of complications, the c-section should be carried out. I invite debate on this subject with hopes that some people may come up with valuable suggestions in this regard. The government needs to be shaken out of its slumber.

The writer is a freelance contributor and can be reached on [email protected]

Originally published in The News