It is alarming that globally, approximately 6.2 million unnecessary caesarean sections are carried out.
When women who need a C-section for medical reasons cannot access the procedure, it leads to illnesses or death in mothers and their babies. Inversely, overuse can also cause harm or death.
When medically indicated, such as in the case of foetal distress, abnormal positioning and hypertensive diseases, the procedure saves the lives of women and babies.
Figures from the Statistical Review Towards the Mid-term Targets of the Kenya Health Sector Strategic Plan 2014-2018, indicate that one in four hospital births in Kiambu and Nairobi counties is by C-section. They were followed by Kirinyaga and Embu counties, where a fifth of deliveries were through surgery. Nyeri and Machakos counties, with 18 percent each, round off the top five.
Less than two percent of women who delivered in health facilities in Tana River, Wajir, Narok and Mandera underwent surgery.
Nationally, 13 percent of women who deliver in health facilities undergo a C-section, well within the recommended rate at the population level.
“In Kenya there are urban settings where we are doing too many C-sections, yet in the rural areas we don’t have enough to save women’s lives,” says series lead author Marleen Temmerman, professor of obstetrics and gynaecology at Aga Khan University.
Sometimes the influence of the baby’s father is the reason women opt for surgery. Prof Temmerman recalls a case where one of her patients insisted on giving birth through surgery. When she inquired further, she found out that it was her husband who wanted her to have the surgery.
In the media, births by C-section tend to be presented as controllable, convenient, fashionable, normal and modern. This influences some pregnant women to opt for the surgery.