Tuesday, December 1, 2009

Iranian women shun natural birth and choose cesareans

This article in The National (dated Nov 29, by Maryam Sinaiee) discusses the situation in Iran, where it is reported that in some private clinics, the cesarean rate is 'as high as 100%'.

The article begins with two interesting statements: 'Some obstetricians in Iran are advising women to give birth by caesarean section' and also: 'Many pregnant Iranian women are choosing caesarean section over natural childbirth, according to health officials.'

Doctors' observations
Says Dr Nahid Khodakarami, a member of the Iranian Medical Council: 'More than 75% of all C-section operations are elective and not required medically.'

Says Dr Mina Afkham, an obstetrician based in Tehran: 'They hear a lot about the pain of natural delivery from their mother and other women and can’t be persuaded to have natural birth, but fear of the pain of giving natural birth is not always their only reason to choose C-section... Giving natural birth has somehow become synonymous with lower social stature for some women. Some others even ask to have their babies on a certain date they choose themselves. I agree that some of my colleagues are reluctant to assist natural deliveries but pointing the finger at them only is far from being fair.'

Women's personal views
Sara Namazi, a 23-year-old pregnant woman in Tehran explains her reasons for choosing surgery: 'I have seen horrible scenes of natural childbirth in movies where women writhe in pain and moan and scream and sometimes even die. Only women who can’t afford the high cost of a C-section now have to go through that pain... Having a C-section will mean that if there are no complications I will walk into the hospital on my own feet to give birth which is much better than being carried there crying in pain.'

Samaneh Fadaie, a 39-year-old mother, describes her natural childbirth experience: 'All my friends thought I was mad and the obstetrician was visibly unhappy with my decision, but I wanted to experience what nature has ordained for women. I endured the pain for nearly two days before I could hold my child in my arms. Not even a single friend of mine has since chosen to do the same.'

I don't necessarily foresee rates of this level in the UK and North America, but I do understand why many doctors have said that national cesarean rates are more likely to increase rather than decrease as we move forward into the future.

Well, apart from increases in the emergency and planned cesarean rates for medical reasons (due in part to a continued increase in older, larger mothers and larger babies), I believe that word of mouth will become an increasingly powerful force.

Almost everyone's seen or heard a traumatic vaginal delivery 'horror story', and it is only a matter of time before women realise that they see and hear far fewer horror stories that relate to a woman who chose and planned a cesarean delivery.

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