Caesarean births a cause for concern

PUBLISHED : Thursday, 26 May, 2011, 12:00am
UPDATED : Thursday, 26 May, 2011, 12:00am


Medical tourism has been identified by the government as pillar of our city's economic prosperity. Ironically, it is the demand from mainland mothers wanting to give birth in Hong Kong hospitals that has fuelled the growth in this area. But it has created problems. The misuse of obstetrics services by both local and mainland mothers has prompted the Hong Kong College of Obstetricians and Gynaecologists to call for hospitals to make sure they comply with rules for delivering babies before term by Caesarean section without medical justification.

Though Hong Kong has one of Asia's best health systems, the incidence of premature births sets it apart from the rest of the developed world.

A neonatal specialist says parents choosing an early Caesarean section before 38 weeks for non-medical reasons, and the doctors, hospitals and agents who accommodate them, are creating man-made premature babies needing special treatment. He describes it as a kind of child abuse because some of the babies retain fluid in their lungs and need at least a week of intensive care, which places extra demands on health-care resources.

The non-medical reasons for early delivery by Caesarean section include the convenience of parents and doctors and giving the newborn an auspicious birth date, if not an auspicious start in life. In the case of expectant mainland women, an intensive care consultant says many agents bringing them here book the operations for 37 or even 36 weeks for convenience. They were avoiding natural births in order to control the time and cost of the mothers' stay in Hong Kong. Little wonder Hong Kong has a Caesarean section rate of more than 40 per cent of births, almost double that of other developed countries. The World Health Organisation says that when the rate rises above 15 per cent, the dangers of surgery outweigh the life-saving benefits.

Thankfully, Baptist Hospital and now Union Hospital have banned Caesareans before 38 weeks. The college of obstetricians and gynaecologists says it will soon require all obstetric units to spell out rules for elective (non-medical) Caesarean sections. That is an overdue measure that should be strictly enforced.

If Hong Kong is serious about making medical services a pillar of economic growth, it must be as a centre of excellence that upholds the highest standards, not as a place known for bending the rules of best medical practice.

Prospective parents, agents and even some doctors need to be convinced that cultural preferences and convenience do not justify bringing a child into the world at unnecessary risk.