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Three in 10 babies in Singapore delivered by Caesarean section
By Hasnita A Majid, Channel NewsAsia

SINGAPORE : Three in 10 babies in Singapore were delivered by Caesarean section, and while the public sector Caesarian rate is comparable to other countries, the private sector figures are higher.

But doctors still prefer their patients to go through normal deliveries, where possible.

Legal officer Rohana Saharom had four of her five children by Caesarian section; only her second daughter was delivered normally.

After her second Caesarian delivery for her third child, her gynaecologist advised that subsequent births should be done via C-section too.

Ms Rohana said, "I have this condition called placenta previa, where the gynae found that the placenta is close to or covering my cervix. And because of that my gynae advised me that if I were not to go for C-section, this may harm both my baby and myself."

Caesarian deliveries are offered for cases like hers and other complications like breech babies.

But such procedures come with higher risks.

"You have obvious C-section (effects) like wound breakdown, urinary tract infection and later of course scar pain," said Dr Fong Chuan Wee, consultant and obstetrician at Gleneagles Medical Centre.

"After surgery they need to rest in bed and are less mobile, have a higher chance of embollism -- clots in legs that later spread to lungs -- and this is a very dangerous condition."

Hospitalisation costs are also higher and the recovery period is longer than a normal delivery.

The 50th percentile bill for a normal delivery without complications is between S$1,970 and S$4,029, while for Caesarian deliveries it is from S$4,331 to S$6,381.

While the number of Caesarian deliveries has increased, it seems that the private hospitals are seeing more babies delivered via C-section.

And leading these hospitals is Thomson Medical Centre, where more than 14,600 babies were born through this method over a three-year period since 2001.

The Centre says one of the reasons is that the hospital is seeing more complicated cases, such as older pregnant women with diabetes and high blood pressure.

"The doctors in private practice who come to TMC are all senior doctors who have been consultants or senior consultants in government hospitals, so they attract people who have problems to come and see them. So there's a little bias down here," said Dr WC Cheng, chairman and founder of Thomson Medical Centre.

While there are women who opt for Caesarian section for social reasons, including giving birth on an auspicious date, Dr Cheng says the numbers are small, about four in 500 pregnant women every month.

"The doctors will recommend natural delivery as far as possible, unless there are abnormalities that may require intervention and often discussed with patients from early pregnancy," Dr Cheng said.

Gleneagles' Dr Fong said, "Every patient is entitled to a normal vaginal delivery. We normally do not immediately ask or offer the patients a Caesarian unless there are obvious medical and obstetric reasons, for example if the mother suffers from diabetes or high blood."

Nation-wide, Caesarian deliveries made up about 31 percent of total deliveries between 2001 and 2003.

While the public sector Caesarian rate is comparable to other countries, the private sector figures are higher. - CNA

Gynaecologist . com