- Nagham Qasim
- BBC News Arabic
“They were pushing me towards a caesarean section as if it was the only, best and most suitable solution.” Mai Shami told the BBC about her experience of giving birth to a son two years ago.
A year ago, My Shami started a Facebook initiative called “Stop Medical Uninspired C-Sections”, which is followed by more than 12,000 people worldwide.
“During my pregnancy, I saw multiple doctors and most of the time they pushed me to have a caesarean section for a reason, some of which were male-powered, because [ils disaient] That normal birth can affect a woman’s sexuality after birth. There is an incision in the vaginal area called “perineum incision” [selon eux] It can affect men’s sexual satisfaction, “he explained.
Most of the doctors the BBC spoke to have denied the allegations, as the change in the vagina is expected to return to normal within a few weeks of delivery.
“Sometimes they will encourage me to have a caesarean section because it will be easier and less painful than a normal delivery.”
Mai Shami insisted on giving birth vaginally and spent a lot of time reading about the pros and cons of natural childbirth and cesarean section as well. She was encouraged to do so by a third doctor who treated her in the final stages of delivery. After making sure that she did not need a caesarean section because of the treatment, she chose to have a normal baby.
Multiple obstetricians and gynecologists have told the BBC that claims that vaginal delivery affects a woman’s sexuality are incorrect, especially since vaginal dilation is temporary and only during childbirth to facilitate childbirth. .
Cesarean section in number
In many parts of the world, including Egypt, it is common for women to be encouraged to have a caesarean section without the need for medical treatment.
The World Health Organization (WHO) recommends that no more than 15% of births in a country occur by caesarean section, but most countries in the world have exceeded this limit.
The number of caesarean sections worldwide has tripled in three decades, according to the World Health Organization.
The global caesarean section rate has increased from 7% in 1990 to 21% in 2021, which means that one in five babies worldwide is born by caesarean section.
According to the World Health Organization, Egypt ranks fourth in the world in the number of caesarean sections.
According to the latest WHO survey, the top five countries in terms of caesarean section rates are: Dominican Republic 58.1%, Brazil 55.7%, Cyprus 55.3%, Egypt 51.8%, followed by Turkey with 50.8%.
This survey is almost consistent with the percentage announced by the Egyptian Ministry of Health during the last health survey in 2014.
A study by the Ministry of Health indicates that the rate of caesarean section in Egypt is about 50%, which means that 5 out of 10 Egyptian women give birth by caesarean section.
Physicians make economic profits by encouraging millions of women worldwide to have children by caesarean section.
Cesarean section is a more expensive procedure, and a doctor can do more in one day than in a normal vaginal birth. It is also affordable for the hospital where the operation is performed, as evidenced by the rate of different cesarean sections between public and private hospitals.
According to the Egyptian Society of Gynecologists, private hospitals benefit from the higher cost of caesarean section compared to normal delivery, where the rate of caesarean section reaches 80%, whereas university hospital is only 40%.
When is cesarean section treatment required?
Dr Randa Fakhruddin, a consultant in obstetrics and gynecology, confirmed to the BBC that there were some cases where a caesarean section required an essential treatment, such as when “a normal delivery poses a risk to the mother or when the fetus has difficulty conceiving. The head, the size of a small fetus, the fibroids attached to the uterus, or the tight pelvis of a pregnant mother. ”
But according to Dr. Fakhreddin, there are some gray areas where caesarean section is performed without the need for treatment, such as the doctor being busy and pressuring the mother to deliver on time and not waiting for the normal stage of birth. Over
A clinically unexplained C-section can cause long-term complications for both the mother and the fetus.
“For the mother, this is a big procedure and so you have to have an operation under the influence of anesthesia, so there can be complications related to anesthesia. If the mother does not move after the surgery, it can clot. The mother may also have heavy bleeding, which can lead to anemia in the long run, through a cesarean section. One can see that the mother’s uterus and tissues are usually weakened by a cut during a cesarean section, “said Dr. Fakhreddin.
According to the World Health Organization, the number of caesarean sections worldwide is expected to reach one-third by 2030, equivalent to 29% of all births worldwide.
This means that by 2030, there will be 38 million caesarean sections performed worldwide, mostly in the poorest countries.
After East Asia, Latin America, and East Asia West, North Africa, including Egypt, will be responsible for the most, with cesarean sections expected to reach 48% by 2030.
Cesarean section, a woman’s choice
On my journey to find the cause of the high rate of clinically unspecified caesarean section in Egypt, I met Marwa Diab, who voluntarily chose to have a caesarean section.
Marwa Diab, a radiologist, said she chose to have a caesarean section and did not regret the decision, despite opposition from her family at first and her mother in particular.
“From medical school, I have seen natural childbirth with my own eyes. I know the pain that a mother feels during the normal process of childbirth, and I see no reason to tolerate that pain until” there is a possibility that I will do it. Don’t tolerate it. And without counting the humiliation that the mother endured during the preparation for the normal delivery and during the normal delivery. The normal stages of waiting for the baby to come out of the head go on for hours and the mother will be examined. Many times. ”
According to Ms Diab, the 32-year-old, there are actually pains, subsequent problems and complications through cesarean.
“But emotional pain associated with natural childbirth cannot be treated with analgesics.” He says.
Media and social networks can play a central role in some women being intimidated by the normal delivery process and seeing it as painful and unbearable.
“The doctor didn’t tell me about the alternative.”
The creator of Stop Medical Unjustified C-Section says lack of documented information forces many women to make wrong decisions. This is why the initiative aims to provide information on caesarean section and normal delivery.
The initiative relies entirely on the personal efforts of Mrs. May, a gynecologist and obstetrician, as well as a language reviewer. He and his team publish information based on internationally recognized medical standards that are reviewed by medical experts.
During my research, I encountered many women whose lack of information led them to respond to pressure from some physicians to perform caesarean section without the need for treatment.
“The doctor didn’t tell me about the options. He didn’t tell me about the options available to me. He just told me about the cesarean section and asked me when I wanted to give birth. He didn’t tell me anything. I didn’t even talk about how to deal with them, “said Salma, a 32-year-old mother.
She told the BBC that if she had known all the details of the situation in which she could have given birth normally, she would have been able to assess the situation better and make a choice in the interest of her and her two children.
Doula, a new concept in Egypt
Doula is a profession that has become associated with pregnancy and normal delivery in Egypt.
Dula is someone who helps a pregnant mother prepare for normal delivery, breastfeeding, and motherhood.
Doa rented a dowry for the birth of her second child. She wanted a normal birth after her first cesarean operation.
“My cesarean section was not due to any treatment according to the doctor’s schedule. But for the second delivery, I went to a douler who helped me get the information and exercises I needed to practice during pregnancy to be able to give birth normally.” Doa told the BBC.
It is commonly said that women who go through a cesarean operation for the first time are often unable to give birth normally in later pregnancies. Hind Abdesalam claims that this is a lie and there is no reason to prevent women who have had a caesarean section to give birth to a normal child in the next pregnancy, which happened in the case of Doa and others.
“I couldn’t move after the cesarean, not even kiss my daughter, which made me feel guilty because I couldn’t be by her side in the first moments of her birth to reassure her, but I was able to do it later. My second normal delivery,” she said. Said.
Millions of people around the world
C-sections can make women feel guilty, as if they failed to give birth normally and their body failed to adjust to a natural thing that should be done without intervention.
This feeling prompted her to pray for Hind so that she could give birth naturally, and Doa took a training course with Hind so that she could give birth naturally.
“Without all the information from the training sessions, she would not have been stuck with normal delivery, when she was exposed to information about her body, the birth process itself and how the body prepares for a normal birth. Obstetricians and gynecologists do not have time to give this to their patients. , Said Doa.