The concern caused by Caesarean births

PUBLISHED : Wednesday, 24 March, 2010, 12:00am
UPDATED : Wednesday, 24 March, 2010, 12:00am

Doctors take an oath to practise medicine ethically. They vow to do the best they can to care for patients and pledge not to harm them. Yet the dangerously high number of babies born by Caesarean section in Hong Kong calls that promise into question. Too many lives seem to be needlessly put at risk in the name of good luck, avoiding pain, convenience and making money. A Caesarean section is major abdominal surgery. It should be turned to by doctors as a last resort in births that endanger the life of a mother or her baby. The risks and complications mean that it should be used sparingly. Yet World Health Organisation statistics show that in Hong Kong it is routine - and indeed, in some cases, the method of birth of choice.

The UN agency says that when Caesarean section rates rise above 15 per cent of total births, the dangers of surgery outweigh the life-saving benefits. Hong Kong's rate is 41.6 per cent, almost double that of developed countries. The figure for private hospitals, where mothers can choose how they wish to give birth, is even higher: 62 per cent. Now it is true that paying customers can often dictate what they want, but where medicine is involved, and especially so when lives could be on the line, doctors are obliged to educate and discourage. Clearly, they could be doing more of both. The evidence is that they are not. When approached to perform a Caesarean at a time and date that has been determined to be lucky, many are more than happy to oblige. The practice also means less time spent in the theatre, hospital beds are more quickly vacated and, of course, a more predictable schedule. Mainland women who trust our hospitals more than those at home add a perplexing twist - they are on visa schedules that require they have their babies on time or preferably, sooner. Medical advances have greatly reduced the dangers associated with Caesareans. All surgical procedures have risks, though. Among them are infection, the baby getting cut and the mother having a weakened uterine wall that can cause problems in later births and surgery. A baby born in the absence of labour pains can develop breathing difficulties.

Clearly there are doctors who put medicine ahead of patients' demands and desire to increase their personal income. But not all seem to. And the numbers indicate that, at least as far as Caesareans are concerned, the balance is tipping, adding even greater risk and danger. In the interests of community health, doctors should put their medical oath first. And patients should think twice about their preferred method of childbirth.