A new trend has appeared in the last few years within private hospitals, doctors delivering children through caesarean-sections (C-sections). This procedure is very expensive, and it’s becoming a heavy burden for families to bear.

An employee in the information division of a private hospitals in Sana'a stated, “Out of all our childbirths, C- sections are used for about 70 to 75 percent of them.”

“Sometimes parents celebrate their child’s first birthday while they are still paying off the debt from the C-section,” Salwa Sallam, a teacher who works in the University of Sana'a, said.

Some women avoid going to private hospitals when going into labor and attempt to deliver the baby at home simply due to fear of the procedure.

“I prevented my sister from going to a private hospital when she was in labor because I know that doctors would have told her to have a caesarean-section. They would have said it was an emergency” Hamoda, a housewife, said.

In private hospitals, it all comes down to cost. “Is it cheaper for a hospital to wait six or seven hours for a natural birth or to finish everything within thirty minutes with a healthy profit for the hospital?” she said.

“The cost of the procedure is approximately YR 180,000 in a private hospital,” Samira Ahmed, a doctor in a private hospital in Taiz, said. “These accusations are an affront to doctors and hospitals. If you compare the rate of infant mortality before using C-sections to the results now, you would see that complications causing the baby or mother’s death, rupture of the uterus, labor obstructions and other types of complications are all clearly reduced by the extensive use of C-sections. Doctors know the circumstances where a C-section is needed, and they’re saving lives by using it.”

According to the World Health Organization, statistical reports show that Yemen has the highest childbirth mortality rate in the Middle East. Data from 2010 shows that for every 10,000 infant born, there are 43 mortalities.


Public hospitals

The situation is different in public hospitals, where people are usually not being pushed to have a C-section. However, their more pressing fears are that they will receive sub-standard medical care.

“There is an apparent lack of doctors in public hospitals. For instance at night, there might be only four doctors responsible for more than 40 women in labor. Therefore many of the children end up being delivered by nurses,” Amani Al shar'abi, a medical trainer in a public hospital, said.

“Sometimes doctors are forced to turn away women in emergency situations because the equipment hasn’t been disinfected because of an electricity blackout. Some of these women end up having the baby in the car, on the street, or in the hall while they try to find a hospital that will admit them,” she said.

When asked about C-sections in public hospitals, she replied that they’re only performed under extreme circumstances and only after a specialist is consulted.

A number of mothers consider the current situation in private hospitals tantamount to extortion, from the first moment of pregnancy untill the last minutes of labor.

“When you enter the clinic, you have to pay YR 1,500 for admission,  YR 2,500 for the ultrasound, YR 700 to be examined, and if you are in rush, there’s an extra YR 1,500 to pay,” Sara Karim, an expectant mother, told Yemen Times.

“When you are about to deliver, they tell you that you need a C-section when you really  know that it would just take longer to give birth naturally. Then you are forced to pay between YR 150,000 to 200,000. How we can we live after that?” Karim said.

Dr. Samira Ahmed pointed out that a C-section is sometimes necessary in various situations, but she also stated that it is always a choice, and if the family doesn’t feel comfortable with it, they can check with other hospitals to be sure.

“In the end, the family makes the decision. It’s always their choice.”