SA's high caesarean birth rate: 'If the spiral continues, we're in for a huge problem'

John Perlman interviews Dr Priya Soma-Pillay, Chair of the School of Medicine and Head of Department: Obstetrics and Gynaecology at the University of Pretoria.

Listen below.

A cesarean section, a crucial surgical procedure, serves as a lifesaving measure for both the mother and the infant, particularly in complex childbirth scenarios like prolonged or obstructed labour, or foetal distress.

The World Health Organization suggests that cesarean rates in a country should ideally fall between 10% and 15%.

However, in South Africa, both public and private hospitals exhibit significantly higher rates.

Between 2020 and 2022, cesarean deliveries constituted 28.8% of all births in public hospitals, while in private hospitals, the rate soared to 75%.

The prevailing justification for these elevated rates is the perception of cesarean delivery as a safer birthing method.

Nonetheless, the excessive dependence on this procedure poses substantial risks to both mothers and infants, including mortality and potential adverse impacts on neurological development, which could profoundly affect the child's future, specialists in obstetrics and pediatrics argue.

To address this 'spiral', Soma-Pillay emphasises the importance of the following measures:

• Implementing evidence-based labour management practices
• Ensuring an optimal nurse-to-patient ratio of 1:1 to guarantee high-quality care and individual attention
• Reviewing healthcare policies to better align with the current challenges and needs

"If the spiral continues, we're in for a huge problem."

- Dr Priya Soma-Pillay, Chair of the School of Medicine and Head of Department: Obstetrics and Gynaecology – University of Pretoria

Scroll up to the audio player to listen to the interview.