U V Kini: Unnatural Births

I was a visiting a friend of mine in the hospital and was witness to a scene, which made me write this article. An anxious husband was berating a Doctor about his wife’s labour pains. Apparently the doctor was hesitant about making a Caesarean Section (CS), a rare case nowadays as I will elaborate later. The man was angrily questioning the doctor as to why he was not making the CS as his wife’s labour pains were unbearable.

About 15 – 20 years ago, we would feel sorry for the mother who had to go through a CS. People used to shudder at the thought of anesthesia, post operative complications etc resulting from a CS. But not anymore. So many CS’s are being performed, that it is gradually being accepted as the norm and people are starting to think that it is normal! CS is recommended only when normal delivery is not possible and when it can pose a danger to the baby or the mother. While many families themselves opt for “painless labour” in the form of CS, some doctors are of the opinion that the post-operative complications outweigh the advantages of opting for a CS.

In many affluent families, where the parents do not want to go with the process of waiting and enduring the labour pains, it is said to be the preferred method. Even many doctors are said to be impatient nowadays who do not want to wait for a normal delivery which can drag up to 6 - 8 hours.

Pulling out the baby at the exact time decided by the family astrologer is also a cause for many families opting for CS. Whether astrology is accurate only for natural birth forecasts and not where you intentionally cut open a woman’s abdomen and pull the baby out at the time decided by you, is not known.

There have been articles in newspapers and magazines which say that many hospitals actually “prefer” to have CS. Some say many doctors actually advise the couples to go for a CS even when it can be avoided, because it is easy for them. A normal delivery costs about Rs.5000 to 8000 while the cost of a CS can be anything between Rs.25, 000 to Rs.40, 000/-. In some super-specialty private hospitals, some gynaecs’ earn about Rs.25, 000 to Rs.40, 000 a day from CS. Moreover, with CS, the hospital management can plan in advance the number of deliveries in a day, since the births will actually take place at the Hospital and Doctor’s convenience.

Just imagine the “predicament” of the hospital management. Which will they prefer? A normal delivery where the pregnant woman will be occupying the bed for 6 to 8 hours and paying just Rs.6000/- OR a CS (even when it can be avoided) which will be over in an hour (max.), for which they can charge Rs.35000/- or more? A clear case of conflict of interest influencing medical judgment, if a commercial decision is taken.

If you are running a hospital, what kind of a decision will you take? Will it be a commercial decision? Or will it be the one which will be influenced by Medical Ethics, the Hippocratic Oath, and Non - malfeasance etc?

If you ask any doctor why has there been a rise in CS in present times, you will hear some stories like “women of yore were more sturdy; they were doing all the household chores themselves; there were no washing machines or mixers then etc etc.” But then there were middle and upper class women in those days also who had housemaids to do the various household chores and would not do a single chore themselves. How come they had normal deliveries?

In ancient India, so much importance was given to the physical well being of the pregnant mother and the healthy development of the foetus, that they became religious rites in themselves called “Punsavana”, “Simanta” and “Jatakarma”. Ayurveda prescribes a regulated diet and routine for pregnant mothers along with herbal medicines and application of oils. Medicinal oil enemas were also administered to make the birth canal, pelvis, waist etc suppler so as to ease the child birth. All this to ensure the smooth downward flow of “Apana Vayu”, (one of the pancha vayu’s in the human body) and tackle common pregnancy related problems like abdominal pain, cramps, fever, back pain etc and also to ensure an easy delivery.

Our ancient Yogic Gurus also recognized the importance of the physical well being of the pregnant mother and had developed many yogic exercises both for pre and antenatal care. But in modern times it has become the fashion to scoff at these “ancient and out - dated” methods by our own modernized Indians. In contrast, yogic exercises are becoming increasingly popular among pregnant mothers in the West.

For the record, both my wife’s deliveries were normal. She was advised total bed rest for the whole of her first pregnancy and for the 1st and 2nd trimester of her second, because of some complications. Even with this, her deliveries were normal.

If you are in favour of natural delivery but your wife’s gynec advises a CS for her, even when you think it is not required, what will your reaction be? Will you go for a second opinion? When you are admitted to a hospital, you are at the mercy of the resident doctors. You are not in a position to contradict their decisions. “Voluntas aegroti suprema lex” i.e., “Patient autonomy” or the right of the patients to choose or refuse their treatment is either not present in many hospitals or the patients are scared of antagonising the doctors.

U. V. KINI, a Qualified Company Secretary is currently residing at Margao, Goa, with his wife, son and daughter. He has printed and published two books. "Sanathana Dharma - An introduction to Hinduism" (English) and A compilation of Kannada, Marathi, Hindi and Konkani Bhajans printed in both Kannada and Devanagari scripts.

He has currently commenced work on a third book.

Mr Kini, a member of the Executive committe of GSB Samaj, Goa, was born and brought up in Mangalore and has done his schooling at St. Alosius, Mangalore.

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