For health's sake, make caesarean sections the last resort

Four in 10 babies born in Hong Kong are delivered by caesarean section, but that figure dramatically spikes when a lunar new year is approaching. Parents want their new child to have an auspicious start in life and mothers-to-be are eager to avoid the pain and spending the festive period in hospital. But some private doctors also prefer the surgical procedure to natural birth as it gives them control over their working schedule and there is more money involved. Clearly, the message that the method, unless absolutely necessary, could carry serious risks for mother and child is not getting through.

Caesarean sections were once only performed to save the life of a mother or baby. They are, after all, major abdominal surgery and that involves risks like infection, the baby getting hurt and a weakened uterine wall for the mother that can cause problems in later births. The procedure also increases the possibility of a mother being readmitted to hospital after giving birth and the baby having breathing problems that require spending time in intensive care. Research also shows the child has an increased chance of asthma.

The World Health Organisation advises that when C-section rates rise above 15 per cent of total births, the dangers of surgery outweigh the life-saving benefits. Despite that, they are now common-place the world over, especially among Chinese; the mainland has the highest global rate, at 47 per cent. Fung shui is in part to blame; the surgery allows the baby to be born at a date and time believed to offer the best chance of a fortunate and meaningful life. Paying customers in private hospitals are often able to dictate what they want.

But this should not be the case where medicine is involved, and especially so where life could be on the line. Doctors should never unnecessarily advocate a caesarean; they should put their oath to practice medicine ethically first and foremost to educate and if necessary, discourage. Public awareness of the risks has to be strengthened and psychological support to help women prepare and cope with childbirth improved.