Caesarean sections rates in Egypt are much higher than elsewhere in the world. Some doctors have been accused of directing expectant mothers to choose this method for their convenience and to make more money.
Mai Shami said that the doctor decided not to interrupt his annual leaves by having a C-section. She was referring to the experience of a mother in her group. According to Mai Shami, the doctor she was referring to decided to have the baby delivered at a time that worked for him rather than let it happen naturally.
Caesarean sections are when a baby’s birth is performed by a surgeon in the abdomen or womb. There are three types:
- elective – At the mother’s request, and sometimes for other reasons
- Planned – This is usually done for medical reasons. For example, if the baby is in a very bad position or too large.
- Emergency – Usually due to complications during labor
Mai started a Facebook campaign called Stop Medically Unjustified Caesarean Session a year ago. It is being followed by over 12,000 people all around the Arab World.
Her personal experience of giving birth two-years ago inspired her to create the initiative.
She said, “Doctors were pushing my towards Caesarean section like it was the best and most appropriate way of giving birth.”
“During my pregnancy, I saw more than one doctor. Most of the times they pushed me towards Caesarean Section for reasons that were male-motivated. They said that a normal delivery could affect a woman’s sexual relationship after birth.
Although the evidence is not consistent, gynaecologists and obstetricians who spoke with BBC said that doctors often use this claim to encourage women to have a C-section.
Mai was told by a doctor to have a C-section because it was quicker, easier, and less painful than normal.
According to Dr Randa Fakhreddin (a consultant obstetrician/gynaecologist from Cairo), some doctors made money by encouraging women who wanted C-sections because it was more expensive than natural birth.
A doctor can perform multiple C-sections in one day. Natural births, however, can take up to hours.
According to the Egyptian Society of Gynacology and Obstetrics (ESGO), C-sections performed in private hospitals make more than natural deliveries because the fees are higher.
This could explain why C sections are used in 80% of these births, while they account for only 40% in state-owned hospitals.
Mai decided to give birth naturally after reading a lot about both birth methods and making sure she didn’t need a C section for medical reasons.
The doctor who helped her during the last stages of labor supported this decision.
Many countries encourage women to have a C-section if they don’t feel it is necessary.
According to the World Health Organization (WHO), a maximum 15% of births should be by Caesarean section. However, most countries exceed this limit. The number of C-sections performed around the globe has tripled over the past three decades. One in five children is born via it.
According to the Egyptian ministry of Health, 72% of Egyptian women will have C-sections by 2021. It has taken steps towards reducing unnecessary C-sections. This includes raising fees to match natural births and giving financial incentives for medics to encourage natural births.
Mai claims that the problem is due to the inability of the health system to monitor doctors and hospitals.
Mai Shami believes that women can be influenced by lack of information and make poor decisions. Her initiative is to address this issue.
Salma, a 32 year old mother, supports her campaign. She had a C-section a few months ago, and claims her doctor didn’t explain the options.
“He didn’t talk to me about my options. She said that he only talked to me about Caesarean sections and asked when I wanted to have children.
“He didn’t tell me about any complications that could occur following C-section, and how I can handle them.”
Salma stated that she would have been able to assess the situation more accurately if she knew all details about natural birth.
Mai claims that women are also part and parcel of the problem. They encourage one another to have C-sections because they lack information or fear natural birth. This is not helped by soap operas and doctors.
Dr Fakhreddin said that doctors were afraid to take risks because of the country’s health system. Therefore, they chose C-sections over other procedures. Doctors who make mistakes could face prosecution, which could end their career.