After receiving a tour of the public hospital in Cabrera, I had the opportunity to speak with the nurse in charge of their programs for sexual and reproductive health, among other roles. She showed me the room where mothers give birth naturally and the one operating room in the hospital, functioning just two days out of the week.
On Wednesdays, the OR is used for cesarean sections; Thursdays are reserved for general surgeries and any cesarean sections that couldn't be performed on Wednesday. The hospital does not perform cesarean births for mothers who opt for one, but only on those mothers that need a cesarean section to give birth safely - mostly for mothers who have had a previous cesarean. Otherwise, mothers give birth naturally at the hospital.
She noted, though, how the percentage of cesarean births at the hospital are high; in fact, over 70% of the births at the hospital are cesarean. She provided insight into a major factor she believes is the biggest contributor to that troublesome number. Although public hospitals will not perform cesarean sections by request, mothers can pay to have a cesarean birth at private clinics. She said that many mothers will opt to pay for the operation, since there are beliefs surrounding natural birth that make it frightening or unattractive to mothers, such as the pain they would endure without epidurals not given at public hospitals.
She also pointed at the alarming maternal mortality rate that exists in the Dominican Republic. She believes that a contributing factor is that mothers who have already had a cesarean birth (who must now continue to have the surgery to give birth) that live in campos, or rural areas, with limited access to a clinic or hospital that aren't able to get the surgery in time. There are instances where women come into labor without time to make it to a hospital or clinic for a cesarean who have no other option but to give birth naturally, which places them at very high risk of death from the injuries they could suffer.
An intervention to alleviate this risk could be to design a better method for performing cesarean sections safely that promote quicker and fuller recoveries, but also, if not more importantly, an educational campaign for the benefits of natural births over cesarean sections and the risks the latter entails.
On Wednesdays, the OR is used for cesarean sections; Thursdays are reserved for general surgeries and any cesarean sections that couldn't be performed on Wednesday. The hospital does not perform cesarean births for mothers who opt for one, but only on those mothers that need a cesarean section to give birth safely - mostly for mothers who have had a previous cesarean. Otherwise, mothers give birth naturally at the hospital.
She noted, though, how the percentage of cesarean births at the hospital are high; in fact, over 70% of the births at the hospital are cesarean. She provided insight into a major factor she believes is the biggest contributor to that troublesome number. Although public hospitals will not perform cesarean sections by request, mothers can pay to have a cesarean birth at private clinics. She said that many mothers will opt to pay for the operation, since there are beliefs surrounding natural birth that make it frightening or unattractive to mothers, such as the pain they would endure without epidurals not given at public hospitals.
She also pointed at the alarming maternal mortality rate that exists in the Dominican Republic. She believes that a contributing factor is that mothers who have already had a cesarean birth (who must now continue to have the surgery to give birth) that live in campos, or rural areas, with limited access to a clinic or hospital that aren't able to get the surgery in time. There are instances where women come into labor without time to make it to a hospital or clinic for a cesarean who have no other option but to give birth naturally, which places them at very high risk of death from the injuries they could suffer.
An intervention to alleviate this risk could be to design a better method for performing cesarean sections safely that promote quicker and fuller recoveries, but also, if not more importantly, an educational campaign for the benefits of natural births over cesarean sections and the risks the latter entails.