Sunday, May 28, 2023

Concerned about cesarean deliveries in hospitals and clinics?

This week the Ministry of Public Health and Social Assistance reported that it will develop a monitoring and orientation plan in order to control the almost exaggerated frequency of cesarean deliveries in public hospitals, to the detriment of the traditional vaginal delivery.

The concern could have its origin in the economic aspect, since the cost for the State of a cesarean delivery is double and a little more than vaginal delivery. The same occurs in the Dominican Social Security System (SDSS), among women with health insurance in the contributory regime.

However, there are other reasons why the use of caesarean section has increased so much, which are not necessarily of an economic nature, but rather, for the convenience of doctors, fears or little interest of the mother in giving birth “normally”. and the risk factor.

Before going into details, let’s see the official statistics on births in the Dominican Republic. Initially the data is from public hospitals, since private clinics do not offer these statistics, although they should.

In 2022, 76,169 deliveries to Dominican mothers were registered in public hospitals, of which 35,623 were vaginal (46.8%), while cesarean sections, with 40,546, represented 53.2%.

In the same year, Haitian mothers accounted for a total of 37,874 deliveries, of which 25,612 gave birth normally, for 67.7%; while cesarean sections represented 32.3%, in 12,262 labors of foreigners.

As can be seen, in public hospitals, the majority of caesarean sections are applied to Dominican mothers, while it is less in Haitians. Haitian mothers are 33.2% of all deliveries attended by public hospitals in the Dominican Republic.

By adding all the deliveries, we have that in 2022 114,043 labors were registered, of which 52,808 were by cesarean section for 46.3%. The proportion is less than half, because Haitian mothers are more likely to give birth normally.

Now, how many deliveries were performed in private clinics? The data is not known exactly, but with the help of the data from the National Statistics Office (ONE), it can be determined that around 49,640 procedures were registered in private medical centers last year.

Of that amount, it is estimated that at least 99% are births of Dominican mothers, because they are women who are formally employed or are the spouses of men with formal jobs, which allows them to have health insurance in the contributory regime. with greater coverage.

Unofficial statistics indicate that in private clinics the proportion of cesarean deliveries exceeds 90%. The data is even conservative, because possibly when reading this article you are wondering when was the last time you met a lady who gave birth naturally in a private clinic and not by caesarean section.

About the above, the reasons for caesarean sections, are the aspects mentioned. But it is already common to see that obstetricians very frequently tell pregnant women in private clinics that their condition is “high risk.” That is where the “cuckoo” begins, which, naturally, scares the mother, who accepts the doctor’s version.

The point is that, with this argument, the doctor always announces that a date will have to be set for the delivery by caesarean section, because there is not much certainty that it will be successful through the vaginal route. But in reality, what the doctor is looking for is more comfort, avoiding many hours in a normal labor, which can occur any day and at any time.

For this reason, the frequency of caesarean sections in private clinics is more for convenience than for money. He does not belive me? Well, ask yourself the first question. When the doctor gives you the date of delivery “by caesarean section”, why does he always choose a day of the week and not a Saturday or Sunday?

To you mother who gave birth in a private clinic, answer this question: What day of the week was your child born? I’m sure it wasn’t Saturday, Sunday or holiday. Sees it? There’s the answer.


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