In what can only be termed as unethical medical practice, doctors at state-run hospitals are performing increasingly more number of C-section deliveries with the sole intention of avoiding emergency duty calls after their regular shift between 9 am and 2 pm.
Take for instance the Nampally area hospital. Records accessed by TOI show that the doctors at the 100-bedded hospital carried out 196, 100 and 93 C-section deliveries during June, July and August respectively. On the other hand, only 63, 91 and 74 normal deliveries were recorded in the same corresponding months.
“Only one normal delivery each was recorded in the last two days at this hospital. I am a little afraid for my daughter-in-law who is expecting her first baby and was admitted here three days ago,” said Beena Gupta, a resident of Goshamahal, who is now waiting for the new mother-to-be to go into labour at the post operative unit at the hospital.
What’s actually spurred her worries is that the hospital’s team of four civil assistant surgeons and one civil surgeon specialist handling gynaecology and obstetrics performed six C-section deliveries on Tuesday and three on Wednesday.
“My sister delivered a healthy baby girl through C-section at 10 am on Wednesday. When we took admission on Tuesday, the doctors told us that it is the only option left as they could not detect movement of the baby inside the womb,” said Fatima Begum, a resident of Asif Nagar, whose elder sister Mallika Begum was one of the three patients who had a baby on Wednesday.
Before leaving for the day at 2 pm on Wednesday, the hospital doctors performed two more C-section deliveries on Puja, a resident of Katedan, and Arifa Begum, a resident of Karwan.
“We had been waiting for five days at the hospital since Friday, hoping for a normal delivery for my daughter, but we were told that she cannot. The C-section delivery was done at noon, following which the doctors left,” said Munni Begum, mother of Arifa Begum. Under the existing rules, after finishing their general shift from 9 am to 2 pm, all doctors working in departments like surgical, general medicine, paediatrics and gynaecology obstetrics have to respond to ‘call duties’ on rotation basis to handle emergency cases.
However, this is not the case with the maternity wing at Nampally area hospital. Apart from a lone duty medical officer handling all departments in the evening shift, no gynaecologist or obstetrician turns up for call duties.
“I do not exactly understand the technicalities that makes an obstetrician decide to perform a C-section delivery, but it is true that maternity wing doctors are not attending their call duties after completing their 9 am to 2 pm shift,” said Dr A Shyam Mohan, medical superintendent at Nampally area hospital.
In fact, the superintendent revealed to TOI that he had issued memos to the erring doctors in the past, but they reportedly did not take them seriously.
Worryingly, the scene is said to be similar in other state-run city hospitals including the 350-bedded King Koti district hospital, 100-bedded Malakpet area hospital and 100-bedded Vanasthalipuram area hospital. Top officials confirmed that in these hospitals too, C-section deliveries outnumber normal deliveries.
“The ratio of C-section to normal deliveries at these three hospitals is 100:70,” admitted Dr K Veena Kumari, commissioner, Telangana Vaidya Vidhana Parishad (TVVP). When asked about the collapse of the shift system at the Nampally area hospital, she said it needs to be investigated.
In fact, in April this year, the TVVP commissioner had issued memos to 30 government hospitals in the state after C-section deliveries in these hospitals were found to be exceeding 50% of all deliveries. “Generally , when we look into the causes for high number of C-section deliveries, it is often found that most of these patients are referred from other private hospitals where the cost of performing such procedures is costly . So, they land up in the government hospitals,” she explained.
C-SECTION A MISUSED SURGERY, SAY EXPERTS
According to many experts, normal delivery is the healthier option for women and C-section deliveries are conducted only in certain cases. “The thumb rule for performing C-section is when there are issues with passage (pelvis), passenger (foetus) or if the expectant mother’s medical condition is complicated,” says Dr Manjula Anagani, head, women and child centre, Maxcure Hospital. In fact, Dr Achanta Vivekanand, retired head of gynaecology and obstetrics department, Kakatiya Medical College, adds, “The female body is built for normal delivery and not C-section, which is the most abused and misused surgery. It needs to be carried out only in the following conditions: If the baby is big, the patient is having continuous convulsions, the placenta is low lying or there is no progress in labour.”