Caesarean Birth in Romania: Safe Motherhood Between Ethical, Medical and Statistical Arguments

Abstract

The number of caesarean sections increased significantly in Romania. In 2012, caesarean sections accounted for 41.2% of total births, according to a study of the Romanian National School for Public Health. This estimation is in agreement with the statistical data on caesarean sections recorded in one of the most important hospitals in Bucharest, Romania, Filantropia Hospital. Many factors have influenced the large number and sharply increasing trend of caesarean sections, from the historical ones, with roots in the communist regime, when abortions were outlawed, to current day doctors' medical practices and mothers' beliefs and fears related to the process of labor and the newborn's health. This paper aims to examine the pros and cons for caesarean birth. The analysis is presented from three perspectives: expressed by the doctor/medical caregiver, the patient/mother and some of the third parties indirectly involved in the medical decision: the foetus/newborn, the hospital/medical unit and the society as a whole, knowing that ethics is beyond the legal, economic or administrative frames.

FIGURE 1.

FIGURE 1. Comparative evolution of the number of vaginal births vs caesarean deliveries in Filantropia Hospital, 2003-2013. Data source: Filantropia Hospital, Bucharest

FIGURE 2.

FIGURE 2. Evolution of caesarean section percentage in total births, Filantropia Hospital, Bucharest, Romania, 2003-2013. Data source: Filantropia Hospital, Bucharest, Romania

FIGURE 3.

FIGURE 3. Live-births in Romania by assistance at birth, 2013 Data source: National Institute for Statistics, Romania, TEMPO database