KENYA – Kenya has raised concerns over the rising numbers of cesarean deliveries, also referred to as C-sections, in the country which puts women and babies at unnecessary risk of short- and long-term health problems if performed when there is no medical need.

According to a recent Ministry of Health report, the rate of cesarean deliveries in Kenya is almost double the average for Africa and the prevalence of C-sections has increased progressively from 14.5 per cent in 2017 to 16.4 per cent in 2021.

The number of Kenyans delivering babies via caesarian section has crossed the World Health Organization’s (WHO) recommended limit with the average C-section rate for Africa estimated at about 9.2 per cent.

WHO reports that caesarean sections are absolutely critical to save lives in situations where vaginal deliveries would pose risks but not all the caesarean sections carried out at the moment are needed for medical reasons.

The 15 per cent upper limit is based on the following statement by a panel of reproductive health experts at a meeting organized by the WHO in 1985 in Brazil: There is no justification for any region to have a rate higher than 10-15 per cent

Unnecessary surgical procedures can be harmful both for a woman and her baby including the potential for heavy bleeding or infection, slower recovery times after childbirth, delays in establishing breastfeeding and skin-to-skin contact and increased likelihood of complications in future pregnancies.

The Ministry of Health observed that the Kenyan government’s campaign encouraging women to give birth in health facilities dubbed ‘Linda Mama’ has contributed to the high number of C-sections, adding that the changing trend is not homogeneous across the country when compared across the 47 counties.

The Ministry of Health further cautioned that some hospitals maybe taking advantage of vulnerable pregnant women, noting that part of the reason medics recommend caesarean sections is because they earn more money from them.

Meanwhile, the WHO recommended non-clinical actions that can reduce medically unnecessary use of caesarean sections within the overall context of high-quality care such as educational interventions that engage women actively in planning for their birth such as childbirth preparation workshops.

The international public health body stressed on the importance of using evidence-based clinical guidelines, performing regular audits of caesarean section practices in health facilities and providing timely feedback to health professionals about the findings.

Other interventions piloted by some countries for the sole purpose of reducing caesarean sections but require more rigorous research include a collaborative midwifery-obstetrician model of care, for which care is provided primarily by midwives, with 24-hour back-up from a dedicated obstetrician

In addition, financial strategies that equalize the fees charged for vaginal births and caesarean sections will significantly compliment the requirement for a second medical opinion for a caesarean section decision in settings where the option is possible.

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