Dhaka, Bangladesh
Rate of caesarean births drops

Impact of COVID-19

Rate of caesarean births drops

News Report: Amid spread of corona-virus across the country, the rate of caesarean birth in Bangladesh has dropped in last two months, sources said. Sources said the number of outdoor- and indoor-patients has dropped by a substantial number as patients and their relatives are avoiding hospitals unless diseases become serious. Professor Md Abdul Aziz MP and former director of the Dhaka Shishu Hospital in a talk-show said the number of non-covid patients has dropped nearly 80 per cent during this pandemic period, and laid emphasis on rendering treatment to covid and non-covid patients in every specialized hospitals. While talking to staffs of different hospitals, a good number of gynecologists of the country now prefer to remain at home rather than doing surgery at private clinics. Excessive greed of a good number of gynecologists of the country leads to rise of the rate of caesarean birth in Bangladesh. Professor Rowshan Ara, a member of COVID-19 national committee, said some 400 new born babies are born in every hour in Bangladesh. Before this pandemic period, some 50 per cent of total babies are born in the hospitals. During this pandemic, this the number of new born babies dropped nearby 35 per cent rising the life of mothers. Although reliable statistics are not available now, Dr Tablu Abdul Hanif, professor, department of neonatal and pediatric surgery of Dhaka Medical College, has expressed the views that the rate of caesarean birth in Bangladesh has dropped during pandemic period. The rate of caesarean birth in Bangladesh was 4.0 per cent in 2001 that increased to 12 per cent in 2010. But since then, the number of women going through caesarean section (C-section or caesarean delivery) has recorded a phenomenal growth. The rate of caesarean birth soared to nearly 32 per cent in 2016, says Lancet, world's most prestigious medical journal, quoting a survey finding. Thus, every third baby in Bangladesh does have a caesarean birth. The rate is unusually high, both in regional and global context. Globally, according to Lancet, the caesarean birth rate went up twofold between 2010 and 2018. The changing lifestyle may be one of the reasons for the rise in rate of caesarean births. But it is unlikely to push up the rate to such a high level. Greed to earn more money by any means, fair or foul, among a section of doctors and owners of private hospitals and clinics, it is widely believed, is largely responsible for this unusual rise in birth of babies through C-section. At private health facilities, 80 to 90 per cent of the babies are born through caesarean delivery. The rate is far low in the case of government hospitals. Doctors concerned should be knowing it very well that caesarean birth could have been avoided in many cases. Yet, it is alleged, they very often indulge in unfair practices for financial gains for themselves as well as hospitals. In the process, many families suffer psychological trauma and financial loss. More importantly, most families remain oblivious of the possible consequences of births through caesarean section. Researchers have found that the rate of mortality and susceptibility to diseases among mothers undergoing caesarean section are high. Also babies born through caesarean delivery might experience a few physical changes that have long-term effect on their health. Doctors and hospitals, mostly the private ones, are least interested in such issues. In many cases, the expectant mothers, once admitted to hospitals and clinics, are asked by attending doctors to be mentally prepared for caesarean section. Caesarean delivery is performed these days even in rural health facilities. At times, poorly trained medical attendants at ill-equipped facilities perform C-section, putting the life of both the mothers and the baby at stake. There is no denying that the caesarean section performed under the guidance of qualified doctors has been saving lives of thousands of mothers and their babies every year. But it is often abused by a section of people just to earn money unduly. In the event of their sickness, people seek doctors' help and submit themselves to their caring hands. The ethics of the medical profession delineate clearly how doctors should deal with their patients. Deviation from the ethical standard only invites all the troubles for patients and also physicians. Patients do suffer physically and financially and physicians earn bad names for their profession. However, the dishonest section of doctors and hospitals resort to unethical practices not only in the case of childbirth. There are many other grey areas in the medical profession. Notable ones include the use of stents and bypass surgery in the case of cardiovascular diseases and placement of patients in intensive care units (ICUs) and life-support tents in private hospitals. Studies at home and abroad have found that doctors in many cases could avoid the use of stents and bypass surgery. A study carried out in the USA found that 40 per cent of bypass surgery were redundant. If such things can happen in a country like the USA, one can well imagine the situation in Bangladesh. The people concerned are well aware of the situation with the use of stents and other heart implants in hospitals. Following a number of media reports on financial irregularities involving stents, popularly known as 'rings', the government some months back fixed prices of stents on the basis of their quality. But allegation about unfair practices involving the same is still there. Since this particular implant is not found in any drug store and is controlled and supplied to the physicians or hospital authorities directly, there exists strong suspicion about foul play. It is often alleged that private hospital authorities, at times, keep patients in the ICU or under life-support facility unnecessarily just to squeeze out some extra money. May be such allegation is baseless in many instances. But it certainly demonstrates lack of faith in both physicians and hospital management. Unfortunately, neither the relevant health authority nor the Bangladesh Medical and Dental Council (BMDC), the watchdog body for medical professionals, have ever tried to look into the authenticity of such allegations and address those. Over the years, country's health services have expanded both in the public and private sectors. The public health facilities have been meeting the medical needs of the poor and lower middleclass. Middleclass and affluent section of society are taking services from the private ones. Deficiencies in the public health services are well known. The private hospitals and clinics are better-equipped, in terms of medical manpower and equipment. But in the absence of any regulatory mechanism, the service takers often make allegation of over-charging and cheating against those facilities. The government should evolve some ways to look into those allegations and redress grievances. The COVID-19 has claimed over 500 lives and infected some 50,000 people during the last three months, according to information of IEDCR. Bangladesh saw its biggest daily jump in new coronavirus cases to 2,545 with an alarming number of 40 people dead in an unwanted coincidence when the country reopened almost fully. "The death toll stood at 650 as Bangladesh has recorded 40 deaths in the last 24 hours, and it is the highest-ever figure of deaths in the country," said Additional Director-General of the Directorate General of Health Services (DGHS) Prof Dr Nasima Sultana in its daily health bulletin . The health authorities confirmed the detection of a record 2,545 new cases that took the number of confirmed cases in the country to 47,153. In the last 24 hours, 52 coronavirus- testing laboratories across the country tested 11,876 samples, she added. Bangladesh broke the previous record of highest death count in a day within 24 hours as on Saturday the country saw the death of 28 patients. Previous highest number of detections in a day was 2,523 recorded. The detection rate of new cases on Sunday was recorded at 21.43 percent. Across the country 406 more patients made recovery, she said, adding that so far 9,781 people have recovered from the disease that has wrought havoc all over the world with infection and death and disruptions to traditional ways of life and livelihood. Against the total number of detected cases, the recovery rate is 20.74 percent and the mortality rate is 1.38 percent in country. Among the deceased, 33 were male and seven female. "Of them, 28 died in Dhaka division, eight in Chattogram division, two in Khulna division. one in Rajshahi division and another died in Rangpur division," said Dr Nasima in their postmortem of the corona casualties. According to age-based statistics of the newly deceased one was aged between 21 and 30 years, five were aged between 31 and 40 years, 11 between 41 and 50, eight between 51 and 60, 11 between 61 and 70 and four more between 71 and 80 years. Across the country, 281 more people were taken to isolation in the last 24 hours while 126 were released. Currently 5,794 people are in isolation. During the same period, another 2,947 people were home and institutionally quarantined and 3,042 were released. At present 60,181 people are quarantined across the country. Even though the government had extended a general holiday until May 30, it has decided not to extend it further--and all sectors but education opened on the day in what government authorities are calling a fortnight trial run up to June 15 to see if it is possible to navigate through the health emergency to strike a 'balance between life and livelihood'. Meanwhile, the public-transport services also resumed Sunday as government and private offices opened their doors for staff.

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