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An Obstetrician and Gynaecologist, Prof. Adekunle Sobande, on Wednesday advised medical practitioners to focus more on safe vaginal deliveries rather than Caesarean Section (CS).
Sobande of the Faculty of Clinical Science, Lagos State University College of Medicine (LASUCOM), Ikeja, gave the advice in a lecture at the college auditorium in Lagos.
The obstetrician and gynaecologist, who recently retired from the college, said that safe vaginal deliveries would help to reduce Maternal Mortality Rate (MMR) in the country.
The lecture was entitled: “That They May Bring Forth Safely Through the Natural Route: The Push and Pull Route.’’
The World Health Organisation (WHO) defines Maternal Mortality as “the death of a woman, while pregnant or within 42 days of termination of pregnancy.
“This is irrespective of the duration and site of the pregnancy, from any cause related to or aggravated by the pregnancy or its management, but not from accidental or incidental causes.”
Sobande said that obstetricians, especially in the developing world, had expressed concern on the numbers of women who died avoidable death during pregnancy and childbirth.
According to him, the aim of CS, performed on a dying pregnant woman, is being defeated by ‘social reason’.
He said that CS was meant to save the baby or as a post-mortem for separate burial.
Sobande said that social reasons such as wanting a baby to be born on a particular date to mark an anniversary or memorable event had slowly crept into the list of reasons for CS.
He said that some women also prefer “elective CS’’ because they feel they could not cope with labour pains, even when given pain relief.
“Others want to avoid complication of vaginal delivery, which usually occurs with unsupervised vaginal delivery or untrained attendant.
“Inability to control passage of urine and faeces, sexual dysfunction and uterovaginal prolapse, are other reasons why some people prefer CS.
“WHO in 2014 recommended 10 to 15 per cent as the upper limit at the population level; we have since progressed from not doing enough to doing too many.
“A group of experts brought together by WHO in 1985 concluded that there is no justification for any region to have a CS rate higher than 10 to 15 per cent,’’ Sobande said.
The obstetrician said that Nigeria recorded very wide variation in the rates of CS in institution survey, varying from 5.39 per cent in Calabar to 44 per cent in Lagos.
“Unfortunately, the upward general trend of CS is going on unabated,’’ he said.
Sobande said that while it was possible to perform a CS in 15 minutes to avoid possible complications, “we tend to forget its immediate and future complications’’.