The Tribune, Chandigarh, India - Chandigarh Stories

HEALTH

Caesarean deliveries on rise; docs blame
it on patients
Chitleen K. Sethi
Tribune News Service

Chandigarh, June 7
In many city-based private nursing homes, the rate of Caesarean sections in the past 10 years has gone up from 18 per cent to 35 percent, far beyond the WHO guidelines of 11 to 15 per cent.

While city-based private gynaecologists blame pregnant women for refusing to tolerate labour pains and demand Caesareans, young women allege that private practitioners conduct unnecessary Caesarean operations, do not counsel properly and are not ready to listen. While confirming that more women are asking for painless deliveries, government hospital gynaecologists say that the doctors concerned are not being true to their profession by giving into the patients’ demand and perform unnecessary surgery.

Dr Pushpa Bhargava, who runs a nursing home in Sector 8, states that a Caesarean is done only when the patient asks for one. ‘‘The patient is not counselled against it. If they have decided, it is their wish. There are some advantages of a Caesarean to a normal delivery like things are under control and both the patient and the doctor get free within an hour. But then normal deliveries remain and should remain the first choice of any gynaecologist. A painless normal delivery is also being preferred now. However, Caesarean sections are still being demanded from richer and sophisticated women of the city.’’

Dr Mangla Dogra, who runs a nursing home in Sector 19, claims that the women go in for elective Caesarean operations to avoid pain. ‘‘In fact anyone would. That is why women are going in for painless deliveries. A Caesarean delivery has definite indications. But then when a patient comes and says that she wants a Caesarean for whatever reasons, even when it is not required medically, there is hardly anything a doctor can do. Mothers and mother-in-laws are an most important factor which stops women from going in for more comfortable ways of deliveries.’’

According to another leading gynaecologist of the city in sector 44, Dr Nirja Chawla, ‘‘Normal deliveries are better since nature designed it like that. Our job as obstetricians is to provide as much comfort as is possible. Advances in research should be transferred to the patient. Managing labour in pregnancy is scientifically possible. A gynaecologist should be adept in drawing partograms mentally and monitor constantly the way the patient is progressing in labour. We have to be on standby and take a decision about a Caesarean only when something goes imminently wrong. Women are scared no doubt but then they can be assured. I inform my patients about yoga techniques and breathing exercises to help in easy delivery. But if someone has decided on elective Caesarean, one has to respect the patient’s decision. But personally I think Caesarean sections should be avoided specially in the first pregnancy as the chances of having a normal delivery the next time drop to 30 per cent.’’

Considering that there is no single opinion on the matter even among the city’s private practitioners, perhaps a study done in Hyderabad holds true for this city also. ‘It is indeed interesting, that nursing homes concentrate primarily on providing obstetrics and gynaecological services for which there is considerable demand. At the same time the potential for making profits is unlimited. In the case of pregnancy, the use of ultrasound for testing, use of instruments and Caesareans for conducting deliveries, all provide scope for tremendous profits. This is mainly because it is the doctor who decides about the number of tests required; whether a patient can have a normal delivery or needs a Caesarean; how long she has to stay in hospital after the delivery. In such a situation, the woman who is hospitalised has little say in her treatment process.’ In the end it the gynaecologist’s personal ethics on the matter which are the deciding factor.

1. Indications of a Caesarean:

* The mother has a successful previous Caesarean.
*When the baby’s head is too big to pass through the pelvis-this is called Dystocia.
*Where the baby’s feet or bottom appear first-this is a breech birth and while they can be delivered normally in some cases, the majority are delivered by Caesarean
*Where there are foetal problems such as a lack of oxygen to the baby.
*Caesarean deliveries may also be advantageous when the mother has other abnormalities which makes a normal birth too risky for mother or baby.

2. Caesareans vs normal deliveries:

* As normal births are natural but Caesarean deliveries are surgical, it is clear that there may be slightly higher risks associated with Caesarean births. Importantly, recovery time after surgery is understandably longer than normal delivery.
* Normal delivery requires more effort and involvement from the mother and the doctor than Caesarean and some people feel it is more participative for the mother.

Stress on healthy mother, child
Tribune News Service

Chandigarh, June 7
A two-day workshop for field NGOs implementing RCH projects in Punjab concluded at the State Institute of Health and Family Welfare, Kharar, on Wednesday evening. Discussions took place on services to promote safe motherhood and child survival, provision of nutritional inputs for vulnerable groups, prevention and treatment of reproductive track infection and sexually transmitted diseases, prevention and management of unwanted pregnancies (safe abortion) and provision of health services for adolescents.

During the training workshop it was observed that identification of pregnant women within 16 weeks of conception was essential, the health of women and girl child was not prioritised in most of the families, incidences of reproductive track infection and sexually transmitted infections were quite high, over 65 per cent of the deliveries were still carried out at home by traditional birth attendants, and low birth rate was the major cause of neo-natal deaths.

SPORTS

Yoga training camp for students
Our Sports Reporter

Chandigarh, June 7
A yoga training and treatment camp is being conducted here in Sector 30 under the guidance of Pradhan Yogacharya M. Lal. He advocated regular exercise of yoga which can cure backache, migraine, cervical spondylitis, blood pressure, sinusitis and nasal allergies.

Students of various schools and colleges of the city are taking part in the camp. A special workshop on yoga sports was held by Yogacharya G.S. Verma today. He told the students that yogasana was part of “Hatha yoga”. He said ancient yogis had named yogic postures after the names of various animals, birds and other natural positions of living and non-living things.

Mr Verma said yogasanas were getting popular as a sports activity. Yoga exercises activated and strengthened internal organs and muscles. Yoga exercises also improved the functioning of vital organs and different glands in the body, he said.

Comparing yoga with other sports, Mr Verma said yogasanas brought better forward and backward flexibility, developed balance, and stretched muscles enabling the spine to twist in any direction. Yoga exercises must be practised. Mr Verma said every age group could practise yoga while it was not possible in other sports.

He said now yoga had been included at school level and in inter college and inter-varsity programmes. In all, 167 students from various schools and colleges are learning yoga at the camp.

Inter-state badminton championship

The Chandigarh Badminton Association will hold the North zone inter-state badminton championships in September this year. This was stated by Mr TPS Puri, secretary of the association in a press release. He said this meet would have the participants from seven states of the region, Punjab, Haryana, Chandigarh, J&K, Delhi, Rajasthan and Himachal Pradesh. He also said that a two-day competition with visiting UK county badminton players for better exposure, was also mooted.

He said the junior boys would be taken to Shilaru (HP) for an high-altitude training camp. He further said other calendar of activities planned during the year included, preparatory coaching camp for sub-juniors, juniors, seniors to be held later this month,, The state championship for all events would be held at Sector 42 indoor badminton hall in July, as well as a coaching camp in advance for the North zone inter-state meet. UT teams would also participate in the national sub-junior and mini championships at Patna in October. The junior national would be held at Guntur in November and prior to that, a coaching camp of seven days would be held. The UT players will also take part in the two grand prix and prize-money tournaments in different parts of the country.

The senior nationals will be held at Guwahati in the first week of January 2003. The UT players will undergo a rigorous coaching camp before taking part in the above nationals.

Chess championship

The Chandigarh Chess Association will conduct the under-25 chess championship-2002 on June 15 and 16 at Jawahar Navodya Vidyalya, Sector 25, to select a team to represent UT in the XIth National under-25 chess championship going to be held at Bangalore from July 17 to 25. OSR

Table tennis meet

Sajal Kaushal of Government Model Senior Secondary School, Sector 35, in the boys section and Nadia Saini of DAV Public School, Sector 8, in the girls section emerged winners in the final of the first Kishan Lal Arya open table tennis tournament which concluded at DAV Public school here this evening.

Sajal was involved in a tie with Aditya Puri of Manav Mangal School, Sector 21, before the former won in a six-game thriller, 7-11, 13-11, 11-8, 11-9, 3-11, 11-1.

Nadia upstaged Ramanpreet Kaur of Ajit Karam Singh International Public School, Sector 41, in seven game 12-10, 11-3, 7-11, 11-2, 9-11, 7-11, 15-13.