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Cesarean section rate of 46_ of China_amp;_39;s pursuit of profit or public hospitals blind obedience

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					Cesarean section rate of 46% of China's pursuit of profit or public hospitals
blind obedience?
When She has two male nursing work was carried back to bed, she was still glad that
they are "a few days before giving birth to children without
howling." 2010 New Year, the 29- year-old mother Gyn Hospital in
Shanghai gave birth to a baby girl. Originally, the mothers of the indicators meet the
requirements of natural childbirth, but eventually opted for caesarean section.
In China, a growing number of maternal and She has made the same choice. February
6, 2010, the World Health Organization (WHO) in the famous medical journal
"Lancet" (Lancet) published a report that against China, India,
Japan, Vietnam, Thailand, the Philippines, Nepal, Sri Lanka, Cambodia 9 survey of
Asian countries, China in October 2007 to May 2008 the cesarean rate between 46%
and 9 countries on average only 27.3%.
The report also shows that in China, did not show indications of the conduct of
Caesarean section caesarean section caesarean section ratio of the total 11.7% of cases,
also ranked No. 1 in the sample of countries, while the caesarean section rate was
35.6%, ranking followed by China, Vietnam, does not appear surgery surgical
indications and only 1% of cases.
"This ratio should be there." Fudan University, Shanghai
College of Medicine students, said Su Yan. She is currently Gyn hospital practice,
several months will be an obstetrician.
Diffuse natural delivery phobia
In fact, She has no luck for too long. Night after surgery, anesthetics Jin later, she was
tortured wound pain can not sleep. Come into play until the pain pump, drug
"cool places along the tube into the body", the pain began to
ease. This time, she began to understand that doctors call "natural delivery
is a pain in the front of the caesarean section is the pain in the behind."
"It sounds like a minor operation Caesarean section, people think it is very
safe, even safer than vaginal delivery." Co-author of the report, WHO
Department of Reproductive Health and Research, Dr. Gulmezoglu said,
"but is not the case."
In the analysis of 110,000 cases of post-production, the Dr. pointed out that in the case
of no medical need for maternal choice cesarean sections than vaginal delivery of
maternal post-partum risk of serious complications increased by 3 times. Cesarean
maternal hemorrhage is more likely to accept increased risk of intensive ca re 10 times.
For newborns, the future risk of suffering from respiratory diseases than the cis to
produce the next baby is much higher.
However, these scientific data are often of maternal neglect. Many child-care forum in
the country, the spread of the mothers have many fears for the smooth production.
An article entitled "the room before the embarrassing thing, you know how
much" of the post in listed products may be encountered along dilemma,
including the maternal catheter was inserted, was sausage and perineum is cut back,
and incontinence . The person who posts a message after the addition to the
expression of the fear of foreign production, almost without exception, will add
"or cesarean forget."
"I heard that when the doctor easy delivery forceps to pull out the child
will hurt the brain." Between mothers also conveys a similar message each
other. They even believe that "more intelligent children caesarean
section."
In addition to the lack of mental capacity, many pregnant women and their families on
the baby's birth date has special requirements. Sometimes, in order to meet
the     families      of    the     "eight      characters"       and
"persistent", the doctor or even a specified period of time in any
rush to the hospital caesarean section on maternal, "Even in the morning
have to do."
At present, the Red House Hospital's Cesarean roughly in half the
proportion of cis products. However, sometimes still need a few operating rooms,
several doctors 24 hours Lian Zhouzhuan to meet demand.
"Fortunately, despite the high risk of Caesarean section, but the process is
often very quickly." According to Su Yan introduction, skilled doctors,
"a knife to cut down, two minutes a child came out," the
shortest operation time table surface 15 minutes . Disinfection from the maternal
anesthesia until the end of surgery done to prepare for the next cleaning station, the
whole process typically about 1 hour.
She has experience with this line. Her "post-diary" clearly
recorded in the process of their operation: 11:30 into the operating room, surgeon
doctors arrived about 15 minutes later, the baby was born in 12:03, was launched
operating room is 12:40.
In addition to about 400 ml blood loss, wound up in the Miss Luo in the caesarean
section was wholly unknown to the quick and easy satisfaction. This is now more and
more mothers choose to carry out the reasons for cesarean section. Although the
hospital will inform their natural delivery than cesarean slow postoperative recovery,
but professional women are more willing to accept one hour of "cut the
Gordian knot" rather than "may be a long wait for several days
and nights."
"After giving birth is supposed to be recuperating from childbirth, surgery
recovery and will not waste time." She has a lot of work, then the
representative may be busy, treasuring time and consider the reality of urban pregnant
women.
Hospital pursuit of profit pushing caesarean section?
5 years ago, WHO had for pregnant women in Latin America, a similar survey
showed that approximately 35% of pregnant women by laparotomy delivery, the
highest proportion of countries in which Paraguay, up to 42%.
Survey of Latin America, according to Dr. Shah reported that many pregnant women
who required cesarean section are for the selection of suitable days in hospital, some
even reckon when he will line up to participate in a decision date of operation.
Cesarean section rate was 26.3% in Canada and 31% of the U.S., the situation is more
older mothers and multiple births.
This time, WHO has not given the report on Asia clearly explained. They speculate
that "the proliferation of cesarean section rates," part of the
intent to reap more profits from the hospital.
1 in the International Peace Maternity and Child Care (the mother and child for short)
for check-pregnant women told reporters after her own pregnancy, baby and woman
in the country for pregnancy checks, and all indications are good. To facilitate parents
to take care of, she was prepared to return home not far from the Shanghai production.
But in his hometown hospital, she was repeatedly recommended caesarean section
and even threatened to make an appointment. Finally, she decided to return to mother
and child are still to be produced. "In our children there, and almost all of
caesarean section." Asked about the probability or less, she said
"do not clear out," but "ninety always
there."
Red House Hospital to study some of the foreign doctors and hospital doctors chatting
laughing: "There is also some natural delivery, and we where out all day in
the profile control."
"Not so big city chaos." Su Yan's China Youth Daily,
explained, "an operation to be himself and family to sign an agreement, the
doctor can not force you to surgery, to make you sign."
Red House and the country in mother and child, more scenes begging caesarean
section for pregnant women, the doctors again and again to persuade "your
case for natural delivery," unsuccessful, eventually come up with a single
surgical procedure so that the other party to confirm the risks and sign.
"A Caesarean section, maternal required to pay 800 yuan, and finally to the
hands of a doctor have? Why this money to be induced by maternal cesarean section,
there is the risk of complaint." Su Yan said.
Who         was       home       that      hospital      maternity      hospital     scare
"marketing" Caesarean section will be profitable. In her affluent
home, after the operation in single room with separate bathroom and even a small
maternity ward of the few, this ward expensive. She also heard that doctors will
advise those who have lost pain after the anesthetic strength in the past the new
mother "shot to clonidine." She did not know, pethidine
prescribing in hospitals is extremely low prices, usually 1 to 5 per month, this
speculation is not a reliable profit.
More expectant mothers who are known as the "Legend" or
"hard to find a profile control." They whisper with a close
friend of the year for the sake of caesarean section to find the number of medical
officers to help the story, and resolutely set foot on the road to cesarean section.
Chinese characteristics, indication for caesarean section
Witnessed scenes of various types of delivery of Su-yin, on 46% have their own
views.
She has worked with a Europe and the United States attended. Pain when the
contractions, pregnant women "scream very miserable very
miserable,"         her      husband     repeatedly      asked    the     hospital
"Caesarean forget." Once the cervix, however, open on the
delivery table, the children came out blink of an eye. The presence of doctors and
nurses was felt, "great white skeleto n, the body structure are not the
same." Production of the red house with a lot of Europe and the United
States even 89 pounds heavier fetuses "at once natural delivery,"
"Even lateral do not have to."
Possible congenital conditions in China than in Europe and the United States are
suitable for the natural delivery, but only this still does not explain the persistently
high rate of caesarean section. Su Yan remember a Japanese mother. During
pregnancy, she strictly followed the guidance of Japan for all pregnant women to
ensure that nutrition, diet, weight gain during pregnancy will be firmly in control of
10 kg.
"China's rule is that pregnant women eat eat, eat whatever, try to
make up, this problem will be huge." Su Yan said. And what the Japanese
mothers in sharp contrast to China frequently weight gain during pregnancy,
"more than 30 pounds," the longer the fetal head and large,
new-born babies are often more than seven or eight pounds, or even more than 10
pounds. This is also a natural delivery risks.
11.7% for the report, there is no indication for caesarean section caesarean section to
be the case, the Red House and the State Women Infant and most doctors are,
"said mother to profile control, how's stopping her?"
According to Beijing Health Law Research Centre of medical dispute resolution data,
over the past five years, the department received nearly 6,000 cases of medical
dispute resolution, including disputes about 450 cases of obstetric, accounting for
8.6%, ranked No. 3. An obstetrician, said a doctor had to be careful to avoid wedding
become a bad thing, even to pregnant women recommended a Caesarean section,
"otherwise, a judge in trouble." After all, the vaginal delivery
unpredictable accident situation Many, but those in the middle of the night when
unforeseen circumstances occur. For the experience as not many young doctors, this
also means that challenge.
In fact, the health administrative departments have been aware of the caesarean
section rate is extremely high, huge risk. Tianjin, a midwifery organization requires
their cesarean section rate of 40% or less, secondary and tertiary obstetric institutions
were controlled in 50% and 60% less. This goal has been far higher than WHO
recommended 15% warning level, even so, it is difficult to achieve. Tianjin Public
Health Bureau on January 18 according to data released in 2009, the city level, the
actual caesarean section rate of obstetric institutions 65.6%, 2 66.9% 3 73.8%, none of
compliance.
Despite the hospital caesarean section have a detailed indication, clear that in addition
there such as "pregnant women of reproductive tract infections",
"pregnant pelvis narrow or deformed," "abnormal
fetal position," "the fetus is too large," and other
kinds of medicine indications, or "principle is better not to choose a
Cesarean section," but difficult to achieve.
She has that in normal circumstances, the indicators chosen Caesarean section. Work
in a well-known foreign companies before pregnancy, she often stays up late, she is
worried that their products so if Shun "in the end who could not withstand
the strain off." I heard many of the mothers in the delivery room along
their production to half cried, "to die" to seek a doctor
"or a caesarean section," is all the pain she felt with two kinds
of bear more controllable than the risk of caesarean section selection.
"WHO's caesarean section indications in will not include social
factors, but in China, accounting for a large proportion of human society."
Su Yan said.

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