Sunday, July 17, 2011

Critics round on Turkey's 45% c-section rate but are they justified?

A report in Istanbul's Today's Zaman begins: Caesarean births in Turkey at 3 times WHO limit, and has been re-tweeted by critics of c-section surgery.

But aside from the fact that we now know the WHO has admitted it has no empirical evidence for ever having recommended a 15% cesarean rate threshold, this report is sadly lacking in its provision of a more balanced description of what's going on in Turkey.

For starters, there is no mention of the perinatal or neonatal mortality rates in the country, which from my reading of UNICEF and WHO data, have been falling during the last 20 years.


That's perhaps worthy of mention, no?

"How Many?" is not the only question

The report does provide detail about which regions of Turkey have a greater number of c-section births than others, and it also describes how "the Social Security Institution (SGK) reduced state support for Caesarean sections from TL 675 to TL 475 and increased state support for normal births from TL 250 to TL 400."

And yet: "For the time being, however, the high rate of C-sections persists."

It would be useful to know what women's attitudes are towards their cesarean births, and how many surgeries are emergency versus planned / primary versus repeat.

What are the views of the doctors who are evidently carrying out these surgeries?

Is any research being carried out to determine which groups of women are more likely to need and/or choose a cesarean - or indeed whether they are satisfied or unsatisfied with their birth experiences?

The story is NOT the headline % rate.

Unless cesarean rate stories are furnished with relevant background data and information, it's arguably pointless to criticize an average % number alone.

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