TEHRAN // Many pregnant Iranian women are choosing caesarean section over natural childbirth, according to health officials. The national figure is three times the average of between 10 per cent and 15 per cent for developed countries, according to the World Health Organization, which recommends that the rate of C-sections should not exceed 15 per cent in any country. Twenty years ago just 10 per cent of all children were born by C-section in Iran. At the time, caesarean section was usually only recommended when natural delivery might pose a risk to the mother or baby.
Today, the rate of C-section is as high as 100 per cent in some private clinics, an alarming statistic, Dr Nahid Khodakarami, a member of the Iranian Medical Council, was quoted by IRIB News as saying last week. More than 75 per cent of all C-section operations are elective and not required medically, she said. Obstetricians are sometimes blamed for encouraging women to have C-sections for their own convenience as well as for being rewarded with much higher fees compared to natural delivery births.
The cost of childbirth, whether by natural method or through C-section, varies from hospital to hospital but a C-section on average costs at least 10 million rials (Dh3,700) more than a natural delivery. "My wife's obstetrician simply couldn't be bothered with a middle of the night call to the hospital. He said that expressly and made it clear my wife was going to have a C-section. I'm sure getting higher fees and the fact that natural delivery is so much more time consuming and messy was a very important factor," Naser Abdollahi, a 38-year-old civil servant, said.
Some obstetricians argue that they are wrongly accused of encouraging women to have C-sections for higher fees when many women insist on the surgical method of delivering their baby. "They hear a lot about the pain of natural delivery from their mother and other women and can't be persuaded to have natural birth, but fear of the pain of giving natural birth is not always their only reason to choose C-section," Dr Mina Afkham, an obstetrician based in Tehran, said.
"Giving natural birth has somehow become synonymous with lower social stature for some women. Some others even ask to have their babies on a certain date they choose themselves. I agree that some of my colleagues are reluctant to assist natural deliveries but pointing the finger at them only is far from being fair," she said. Sara Namazi, a 23-year-old in Tehran who is four months pregnant, said she is determined to deliver her baby by C-section and that she could not be persuaded to give natural birth.
"I have seen horrible scenes of natural childbirth in movies where women writhe in pain and moan and scream and sometimes even die. Only women who can't afford the high cost of a C-section now have to go through that pain," she said. "Having a C-section will mean that if there are no complications I will walk into the hospital on my own feet to give birth which is much better than being carried there crying in pain."
Women who say they are convinced of the merits of giving natural birth and choose it for reasons other than avoiding payment of high fees seem to be in the minority, at least in the upper social classes and among the educated. Samaneh Fadaie, a 39-year-old engineer, said she opted for natural childbirth when she had her son eight years ago despite her obstetrician's insistence that she could choose a quick and easy way not to suffer the pain of natural delivery.
"All my friends thought I was mad and the obstetrician was visibly unhappy with my decision, but I wanted to experience what nature has ordained for women. I endured the pain for nearly two days before I could hold my child in my arms. Not even a single friend of mine has since chosen to do the same," she said. email@example.com