Someone asked me why I was so sure I was having a C section – my answer is because I have had two C sections before and in my last pregnancy, my uterus starting rupturing during labour at the C section scar. So I am pretty sure I will have a C section, and I am totally ok with that, no regrets what so ever (that shit just does not bother me), but I thought I would share something that will alarm some of you ‘push out the vagina’ types – C section rates for the wealthy in South Africa.
Please note, I have nothing against people who choose to do C sections - even if I didn't have to have my first two, I might have chosen to do them anyway. Natural child birth terrifies me.
In South Africa there are two health systems. One is for the masses – it is free, sponsored by government, and while the doctors are excellent, the facilities are appalling. Run down, grotty, horrible. Long queues, no appointment system. You take what you can get.
The other is the private system – the ‘medical aid’ system. If you are wealthy in South Africa, you have medical aid. Like your medical insurance, but different. Here in South Africa, if you have medical aid, you can get to see the best doctors. No waiting, you call the shots. You want an appointment? You can have an appointment whenever it suits you. I can have weekly scans, because I want to and because I can – I am on medical aid. I can choose my doctor, I can choose my care. Our hospitals are like hotels, really luxurious and top class. My monthly medical aid payment is more than most South African earn as their full salary. It isn’t fair, and it isn’t just, but that is how it is here. The government is talking about making the health care system more equitable, but there is such huge disparity between the haves and the have nots, that there is a long way to go. Public health care is one of the biggest issues on Government’s agenda, and there is still so much to do.
Anyway, I wanted to share with you these statistics about how high the C section rate is for the private medical aid patients. Taken from this website here which is a natural birthing lobby group thingy, so take this with a bit of a pinch of salt, but they are probably not too far off the truth
South African rates for c-section as provided by various organisations:
Free health care service:
Government Department of Health in the Western Cape:
19.6% (Reason why it is so ‘high’ is because of the
problem with HIV positive mothers passing on the virus to their babies during
Private medical services:
Board of Health Care Funders in South Africa: 65%
Largest Medical Aid Scheme in South Africa: 70%
Council of Medical Aid Scheme’s in South Africa: 82%
There is currently no protocol in South Africa which governs the use of C/S surgery. This means that women must base their decisions on how their baby is born purely on what their doctor advises (or what they request themselves!).
Why is the C/S rate in SA rising?
- Defensive medicine
- Medical aids pay out for C/S without requiring a medical necessity
- Art of normal delivery is being lost
- Casual attitudes about surgery
- Fear of natural birth: “Baby is too big”
- Growing belief that C/S is "safe"
- Side effects of other common procedures
- Failure to support normal physiologic labor
- C/S chosen before less interventive methods
- Women are having c-sections for HIV+ status; National HIV rates = 30% KZN = 39.1% WC = 15.5%.
- Increased use of epidural anaesthesia
- No VBAC policy