Invest more in staff, update protocols and improve information about caesarean sections. These are some of the main aspects indicated by the experts consulted, which serve to reduce the caesarean section rate in Spain. A study published this Monday by elDiario.es, which collects data from hospitals in our country, shows that 28 hospitals triple the recommended rate of these interventions, which the World Health Organization (WHO) indicates at 15%.
In Spain, the average cesarean rate in public hospitals is 21.9%, while in private centers it reaches 37%. There are great differences between the autonomous communities. The highest rates are found in the Community of Valencia, Extremadura, Catalonia, Castilla y León and Andalusia. The lowest was recorded in Euskadi, whose rate is below the threshold indicated by WHO.
The director of the Women’s Institute, Antonia Morilas, linked this data to the concept of obstetric violence, with which the Ministry of Equality has been working for some time, and one of the fundamental elements of which is respect for childbirth.
The situation worries public health associations, which believe that greater investment, for example in midwives, would significantly reduce the number of instrumental deliveries. On the one hand, there is a general situation, admits Pilar Serrano, vice president of the Madrid Public Health Association (AMASAP) and professor at the Autonomous University of Madrid; and on the other hand, causes which may occur between communities and provinces. Either way, the data shows that “public facilities are doing better because there are fewer C-sections,” Serrano notes.
The growing preference for caesarean sections has been a prominent feature of the association El Parto es Nuestro since its birth. The organization, which is a pioneer in raising awareness and condemning obstetric violence, calls for greater transparency as a first step and regrets that the elDiario.es investigation is “the only complete database” where caesarean section rates can be consulted by the center. considers it “unacceptable”.
With this in mind, it calls for the data to be “published and accessible” on a mandatory and regular basis, to know how the indicators are developing in each hospital and to have all the information, as well as to extend transparency to other interventions. These include inductions, for which there is no public data, or Christeller maneuvers, a practice discouraged by the WHO that involves applying pressure on the abdomen to try to push the baby down the birth canal.
Data published this Monday by elDiario.es show that there is a huge variation in the number of cesarean sections, depending on the center. “It’s that in Spain, a caesarean section for a woman does not depend on her or the baby’s health, but on the hospital where she goes. And it’s terrible,” condemns Francisca Fernandez Guillen, a lawyer who has filed several cases of obstetric violence at the United Nations. “Major operations are performed on women without a valid medical reason,” he adds.
Protocols, inspections and information
“For some time we have noted that the caesarean section rate is higher than that indicated by the WHO,” says Marciano Sánchez Bailey, a physician and representative of the Federation of Public Health Associations. For Sanchez Bailey, this is because although there are protocols that indicate when a caesarean should be performed, “they are not done carefully.”
“What needs to be done is to establish the professional criteria, which have already been established by the Ministry of Health, and to check those centers that deviate too far from what is reasonable to understand the circumstances and reasons,” advises the health worker. “In some cases it may be justified because there were more pathologies, but in some cases it is not.
Serrano also calls for better information for women who are about to give birth, as there may be a sense of “false security” in the private sphere of C-sections. “Caesarean section is a very significant risk in terms of bleeding, second birth, delayed recovery or skin-to-skin contact,” she warns. “There are many side effects that may not be explained in detail, and that’s why many women choose it.” Something like a fake security,” ditch.
According to Serrano, the fact that Euskadi, Navarre and Asturias are the only communities with an average of less than 20% is due to the fact that “with all precautions, there are health services that are healthier than others”. “There is evidence that the number of midwives determines that fewer caesareans are performed because they are not interventionist and can give the woman time to dilate.
Source: El Diario