I want to begin this piece by raising an important question.How is it that almost every woman that gives birth these days in Kashmir doesso through a cesarean section? Cesarean section births are recommended onlywhen the life of the mother or the baby would be endangered by normal delivery.It has to be medically proven to be the safest option and only under suchcircumstances must the operation be conducted. The World Health Organisation(WHO) has put an upper limit of 10-15% on the cesarean sections i.e. in apopulation, the number of cesarean births should be between 10-15%, at themost. Shockingly, in Srinagar, according to the National Health Survey datafrom 2016, the number is a staggering 74.7%. The overall average in Kashmir is41%, it is diminished because the numbers from rural and far-flung areas arelower, however, this is still nearly 3 times the global upper limit. Also, thisis the combined data from both Government and private hospitals. If one looksonly at private hospitals, then it is a whopping 94.6% for Srinagar i.e. 94.6%of the times Kashmiri doctors in private hospitals have knifed the women. Onewould be stupid to believe that all those 94.6% cases would be medicallyjustified. The numbers for Shupyan, Pulwom, Baramulla are 90%, 89.6%, and 86%,respectively.
Considering Srinagar, if we take out the 15% (as, let’s say,medically justified cases), it still means that the remaining nearly 80% womenwere cut open un-necessarily, risking the life of the women and the child.There are various scientific and medical reports that establish an increasedrisk of respiratory distress, surfactant deficiency and pulmonary hypertensionsamong the children born via Cesarean sections. In addition, the Lancet, thepremier medical research journal published a series of papers last year thatindicated increased risks of morbidity among women following un-necessarycesarean sections. To quote one such paper by top-notch doctors andresearchers, “The prevalence of maternal mortality and maternal morbidity ishigher after CS than after vaginal birth. CS is associated with an increasedrisk of uterine rupture, abnormal placentation, ectopic pregnancy, stillbirth,and preterm birth, and these risks increase in a dose–response manner. There isemerging evidence that babies born by CS have different hormonal, physical,bacterial, and medical exposures, and that these exposures can subtly alterneonatal physiology”. Such reports are indicative of the alarming muck thatthis uninhabited malpractice must have unleashed on our society’s overallhealth.
Further interesting is the fact that over the past decade orso we have seen a constant mushrooming up of private hospitals that providefacilities for child birth and concurrently there has been a sharp increase inthe C-sections. From nearly 13% in 2006 to 41% in 2016, the trend indicatesthat there might be a further increase in the overall numbers since 2016. It iscriminal that in Srinagar, there is nearly a 100% chance that any women to givebirth would be going through a C-section.
This blatant crime has been happening because doctors laytheir eyes on the extra money they make on C-sections. It is a kind of a cartelrun by doctors and hospitals which allows this misuse wherein no medicaljustification is sought to put a person under the blade. It seems C-sectionsare a money minting machine that both the doctors and the hospitals have abusedat the expense of general well-being of people. Also, the authorities whichshould have regulated this procedure seem to be completely oblivious to thefact that nearly each time a woman enters labour, she is directly operated uponwithout a need for it. As per some sources, some of the private hospitals inSrinagar don’t even have Labour rooms, therefore, their doctors lay sightdirectly on C-sections. Some doctors in public hospitals force women to deliverin private hospitals where they can use the blade and earn a few more thousandsof that cash. These actions, mind you, would be considered CRIME in other partsof the world. A doctor medically unjustifiably and without an informed consentof the patient, when goes for a C-section would not only lose his job but facecriminal charges. But in Kashmir, and particularly in Srinagar, the situationis such that there seems to be no issue at all and this seems to be the norm.No authoritative over-watch and more importantly no moral and ethicalconstrains from the doctors.
And when any woman loses her life after or during thisprocedure, the first question that must be asked is- was it medicallyjustified? If not, the doctor must be held accountable. For long we have heldthe doctors at a higher pedestal, where questioning seems to be questioning thedecree of the God. Like other professionals, some doctors are chin-deep into greedfor money and would give a toss to morals and ethics. When a doctor is foundnegligent or criminally motivated he/she must face the law. The muck that iswidespread in our health care system needs to be cleaned. The authorities mustwake up from their slumber and question the hospitals that allow thismal-practise and curbs could be brought about by imposing the law.
Ikram Ullah is a researcher at the University of Marburg,Germany. He tweets at @ullahi_