At 43 weeks of her pregnancy, Terry Nyambura, 21 years old, walked into Thika Level 5 Hospital for a checkup seeing that normally, most pregnancies run to a maximum of 40 weeks.
“It seemed to me like I was pregnant for a whole year. At 43 weeks, I had neither labor pains nor any signs of giving birth, which I thought was abnormal and led me to Thika Hospital for an extra checkup,” Nyambura opened up to Scholar Media Africa in an exclusive interview.
An ultrasound was done, and after several assessments, she was immediately admitted to the theatre for an emergency Caesarian Section (CS).
She would go ahead to welcome her baby on the same day regardless of her psychological unpreparedness.
Lonely, depressed
Her pregnancy journey was not all roses; as a university student, Nyambura explains that her pregnancy was in solitude; her friends isolated her, thus neither emotional nor psychological support whatsoever.
“2021 was not my best year. I knew I’d be a young mother when I was one month pregnant. It took a toll on me seeing I was a young girl who had neither finished school nor started to realize my life goals. I fell into depression and had to deal with it all singlehandedly,” the young mother reveals.
An emergency delivery
In the wee hours of October 15, 2021, Nyambura delivered a healthy baby boy through an emergency cesarian birth.
“My baby was 4.7kgs heavy, which is too big for a natural birth. The doctors, therefore, advised me to be taken to theatre for an emergency CS, which I never thought would happen to me, more so, in an emergency state,” says Nyambura.
One and a half years down the line of parenthood, Nyambura reveals that she would go for a CS again and again if she were to give birth again.
Her experience was easy. She terms the C-Section pain as ‘manageable’.
Her wound healed about two weeks after delivering her baby.
“I am unsure of the other route, but the C-Section worked well for me because I had no complications thereafter. I followed the doctor’s guidelines to the latter, and within six months, I could do absolutely everything without assistance. I would vouch for the method over and over,” says Nyambura.
She urges society in the contemporary world to accept C-Section moms as it does not make one less of a mother but instead makes one a strong woman, tending to a newborn and nursing a wound all at once.
The red line in the country
According to research from the World Health Organization (WHO), the average C-Section rate in Africa is 9.2 percent.
Further studies also place it at less than 15 percent in most Sub-Saharan countries.
However, Kenya has surpassed this number and hit double digits, with its prevalence progressing notably over the years, with women in urban centers and those from the central region leading the graph.
The international public health body research further reveals that by 2030, nearly a third (29%) of all births globally are likely to be through a C-Section.
What has shifted in modern-day women?
A Lancet study themed How to stop the caesarian section epidemic shows the global increase in C-Section births from 6 percent in 1990 to 19 percent in 2014.
The rise results from the modernization of health services to well-equipped hospitals compared to the old-fashioned way where midwives would deliver infants naturally and traditionally at home.
The report notes that this ‘epidemic’ cannot be reversed by the medical profession alone but by joint actions with governmental bodies, the healthcare insurance industry, and women’s groups.
“Optimization of C-Section use is needed, underpinned by a better understanding of demand and supply factors that drive the overuse of CS and by greater efforts to ensure universal access to CS for all women,” notes part of the study.
Closer home, a whopping 20 percent, meaning one in every five pregnant women, gives birth through a Caesarian Section.
The focus is to save both the mother and the child.
However, it has undoubtedly not failed to have its share of challenges.
A different approach
Unnecessary surgical procedures are not advised, as Dr. Lorraine Muluka, an obstetrician and gynecologist at Nairobi Hospital elucidates.
“There is a notion that the modern woman does not have to be a martyr to be a mother hence opting for an elective C-Section as the simpler and less painful delivery plan.
But just like any other body incision, it can shift one’s life completely,” she explains.
Dr. Muluka also explained other petty reasons why women go for C-Section, such as parents wanting to have a baby at their chosen date and time, among others.
“I have always advised against elective C-Section because this way of delivery can only be validated if there are complications with the mother, such as stalled or prolonged labor or if the baby is not breathing properly.
Otherwise, vaginal birth is the most natural, ideal, and the utmost recommended method,” she continues.
She noted that this option could also lead to long-term complications, especially for the mother.
“C-Sections can be dangerous if incorrectly done. We are talking of postpartum hemorrhage, infections, the slit might open regularly if not properly treated and once a mother has given birth through a C-section, they can never give birth naturally,” Muluka explained.
Dr. Muluka is also a co-founder and CEO of Malaica, a Nairobi-based foundation started in October 2021 to drive strategic direction with the goal of creating impact through reducing maternal mortality.
The initiative has built the largest pregnancy and parenting community in Kenya with exclusive groups moderated by experts ranging from nurse midwives, gynecologists, biologists, and computer scientists who are passionate about improving a mother’s pregnancy journey.
Government’s concerns
Kenya’s Ministry of Health has concerns over the rising cases of C-Section births. Data shows that more Kenyan women are opting for elective C-Section compared to natural (vaginal) births.
MoH further observed that the Kenyan government’s numerous campaigns, such as the Linda Mama, Boresha Jamii Initiative that encourage free natal care, have led to a rampant increase in cases of incision births as most hospitals take advantage of the massive government funding.
The Linda Mama scheme is a publicly-funded initiative that targets to ensure that all pregnant women in the country and their newborns have access to quality and affordable health services.
The initiative has been running since 2013, when all user fees were removed from all public health facility deliveries.
Scholar Media researched C-Section rates compared to natural births and established that in private hospitals, one would pay between KSh120,000 to KSh200,000 compared to KSh45,000 maximum charge for a natural birth.
In public health facilities, Scholar Media discovered that vaginal birth is free after the Government of Kenya abolished user remuneration for maternity care under the Free Maternity Services (FMS).
However, C-Section can get to KSh40,000, which can be covered by the mother’s health plan, such as the National Hospital Insurance Fund (NHIF).
While opting for a C-section is greatly determined by socio-economic factors, teenage pregnancies in Kenya have also increased their pervasiveness as young girls are unable to deliver naturally.
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In Kenya, the ‘epidemic’ is prevalent in Kirinyaga County, with more than 31 percent, followed by Kiambu County, and Nairobi County comes third.
It is trailed closely by Tharaka Nithi, and Embu County holds the fifth position. All counties with the highest prevalence are in the Central Region of Kenya.
Good read.