A Terrible Dilemma

The government of Uzbekistan has forbidden doctors to perform C-sections without a serious indication. Apparently, doctors in the state-run hospitals have been performing unnecessareans because their salaries are “too low” for them to spend so much time labor-sitting. So, now the government has made a law to keep them from doing that, because it is damaging to women’s health. Yippee? Not quite so fast.

Apparently, these doctors are now turning to drugs which speed up labor (so that their main objective — as little time waiting on the baby’s birth as possible — is still reached), but of course these drugs carry threats to women’s health, as well as to the baby’s health and well-being as well! So, maybe these women aren’t getting cut open at the drop of a hat, but they’re being given Cytotec, or Pitocin at possibly dangerous levels, or some other drug which is causing fetal distress and/or uterine ruptures, and then possibly damaging both mother and child, or at least necessitating a C-section to save the baby and/or mother. And then if the C-section rate has been unnecessarily and artificially high, then there are probably a lot of women who will now be trying to have a VBAC, and we all know the much higher rate of complications from an artificially induced or augmented labor (especially with Cytotec, but even with the milder prostaglandins and Pitocin) of uterine ruptures in an already-scarred uterus! Sigh….

And to make matters worse, if a lot of women or babies become damaged or even die because of this “C-section ban,” then the anti-vaginal-birth folks will triumphantly point to the statistics that are to come from Uzbekistan and say, “SEE!! This is what happens when you try to reduce C-section rates! — women and children die!! We can’t know what a good C-section rate is, anyway, so it’s ridiculous to try to make it some arbitrary rate. And look at how many uterine ruptures there were when they forced VBACs on everyone!”

Um, no. While this may indeed happen, it will not be “VBAC” or “reduced C-section rates” per se that are the problem. The problem in Uzbekistan will be the same problem that currently exists in many hospitals in the United States — doctors unwilling to work with natural processes, and insisting on speeding up labor, or other interventions, that are not medically indicated. And of course, when medical processes are introduced without any indication for it, nor any medical benefit from it, medical risks are elevated for no good reason. And women and children are hurt, and may even die.


5 Responses

  1. Oh my, that is horrifying! And I thought we (in the U.S.) had it bad…

  2. Oh, I thought this was about America at first! 😉

    Seriously, anyone else see the path being travelled here? We don’t have to leave home to visit Uzbekistan.


  3. Having worked in maternal child health in American hospitals for over 16 years, I find it a bit of a stretch to compare American maternity care to that of Uzbekistan. I mean really. Uzbekistan has been cited by Amnesty International and Human Rights Watch as being one of the world’s most repressive societies in the world. I think you know from my comments and reading my own site, that I believe in natural childbirth, and in child birth choices for women. That’ right choices! There is no such thing in Uzbekistan. I also have personally had a C/S and a VBAC, so you know my position on VBAC’s. There are definitely individual doctors and hospitals in the U.S that are rigid in their treatment of women, and have very high induction and C/S rates. But they are no Uzbekistan. I have traveled all over the world, and have worked in many hospitals. I can honestly say there is no where in the world I would rather give birth to a baby than here in the U.S of A. , flaws and all. (I will look for my suit of armor now, because I have a feeling I will need it!) P.S Kathy, you know I love your blog, and Happy Mother’s Day!

  4. RR — you don’t see *me* flying out of the country to give birth, do you? 🙂 We have our faults here, but I did not mean to imply that our problems here are of the same magnitude as those in Uzbekistan — just that they are of the same type.

    But I do hope that women who are taken aback by the situation of their Uzbek sisters will take a close look at their own doctor & hospital, to see if their own doctors are uncomfortably close to being inflexible. It’s kind of like needing to lose weight — someone who is very overweight may need to cut his calories in half, but just because someone doesn’t need to lose a massive amount of weight doesn’t mean there is no room for change. My heart goes out to all women who have been forced into unnecessary procedures by inflexible doctors (or other care providers), here or abroad.

  5. What a crazy situation! You’re quite right…. It’ll be interesting to see updates on that.

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