C-Section deliveries: Financial hub for ‘rogue doctors’

Caesarean Section delivery commonly known as C-section have been used as a medicinal procedure used to save a baby or an expectant mother during a complicated delivery.

As years go by, many doctors have found various reasons to perform this surgical procedure, something that has led to a significant rise in cases of C-section deliveries in Kenya.

According to the data from the Kenyatta National Hospital (KNH), out of 1,204,012 children that were delivered in the country between July 2021 and June 2022, around 207,257 were delivered through C-section.

This implies that out of the deliveries that were performed during the said duration, 16 per cent were done through C-section.

This per cent is slightly higher than the average number of women who delivered their babies in an operation room globally. Reports show that of all the deliveries that were made worldwide within this period, only 15 per cent were done through c-section.

Why is the rate of C-Section deliveries high in Kenya?

Though cases of these procedures are increasing, Dr Dennis Miskellah, a gynaecologist at Kenyatta National Hospital notes that the situation is not alarming, yet.

He, however, attributes the increasing number of these deliveries to various factors which include financial motivation from "unscrupulous doctors".

According to him, some doctors prefer a C-section delivery to a normal delivery to get more money because the cost of performing a C-Section delivery is higher than that of a natural birth.

Dr Miskellah noted that these kinds of unwarranted C-section deliveries are mostly done by private doctors who target patients who have insurance coverage or have the ability to pay for the procedure.

“This happens two ways, for example, if I am a private doctor and I have a patient who has medical insurance or can pay with cash, I can choose to deliver her normally and charge her about Ksh.30, 000 or deliver her through C-section and charge her maybe Ksh.90 000," says Dr Miskellah.

“It can also happen when a doctor works in an unscrupulous hospital that insists that they want more money so they pressure their doctors to deliver their patient through C-section."

Other than the financial gain, Dr Miskellah noted that there are other reasons a doctor might opt to deliver a patient through C-section. He notes that a high number of women opting for CS to avoid labour pains have also contributed to the huge numbers of these deliveries.

He went further to say that doctors might also opt for this surgical procedure to avoid any complication that might arise while delivering a patient through vaginal deliveries.

“CS deliveries have increased locally because there are more hospital deliveries and because doctors are practising what is known as medicine of fear. Doctors fear that when going for vaginal delivery, their patients might have some complications a situation that may lead to their mitigation,” he said.

“Nowadays we have more women who are enlightened who can choose to deliver through CS or not. It is a right of a woman to choose the kind of delivery she wants to go through.”

Regardless of the motive behind it, C-section delivery has many side effects that might affect both the baby and the mother.

According to Dr Miskellah, women who undergo C-section deliveries are at risk of dying on the operation table, having bladder and intestines injuries, having blood clots and constant headaches among others.

Fredrick Odhiambo is one of those people who have been negatively impacted by the procedure after his wife, Colastica Awuor died on an operating table during a C-section delivery.

On the day of her death, Odhiambo reveals that Awuor, who was nine months pregnant had visited Inuka Hospital, a private facility located in Madeya, a trading centre along Kisumu-Busia road for consultation after noting that she had not experienced any labour pain yet her due date had passed by eight days.

“My wife was expected to deliver on December 25, 2022, but when the time came we didn’t see any sign of labour. So after eight days of waiting, she decided to go for a check-up at the facility.

 Two hours after arriving at the hospital, she called to tell me that she had been administered intravenous therapy at the facility,” Odhiambo said adding that that was the last conversation he had with her.

Two hours after the call, Odhiambo said that he received another phone call from the hospital but this time around it was not his wife speaking to him but a nurse who was asking him to rush to the facility where Awuor had been admitted to there was an emergency needing his attention.

When he got to the hospital he found his wife had already died on the operation table under unclear circumstances. When he inquired what had caused her death, Odhiambo says the medics at the facility were not willing to provide information on what happened to his wife.

 “A young female doctor who had operated on my wife only told me that she had done several successful operations but my wife’s condition was an extreme case,” he says.

Odhiambo further notes that local authorities including the police and the Directorate of Criminal Investigation are unwilling to help him find answers revolving around his wife’s death.

“When I reported the matter to the DCI and the officers told me that I will not succeed in following up with the case and therefore I should only concentrate on planning funeral arrangements for my wife,” he said.

Adding: “The hospital did not tell me why they took my wife to the C-section nor explain why they took my wife for an operation without my consent.”

Our efforts to reach out to the hospital for a comment bore no fruit since the administrator failed to pick up our phone calls.

Though the cases of C-section deliveries have increased in the country, Kenya Medical Practitioners, Pharmacists and Dentists Union (KMPDU) Secretary-General Dr Davji Bhimji has dismissed claims that the rise in the number of these deliveries is related to financial benefits accrued by the doctors.

Dr Bhimji notes claims that doctors are seeking financial funds from C-section deliveries are unfounded and have no basis. He said that most hospitals in the country have limited resources, a situation that does not give them room to take a patient to their theatre without a solid reason.

“The claim about doctors wanting to get extra funds when they take a patient for a C-section delivery is unfounded. This is because doctors working in the public and private sectors do not get extra money for the work they do in a hospital apart from their salaries,” Dr Bhimji said.

“Most of the time doctors do everything that they have taken an oath of for the service to humanity the best way they can,” he added.