Women cannot opt ​​for a cesarean section: they say they resort to both deliveries “through acquaintances” and

Bribes to doctors, deliveries “through acquaintances” or surgeries that cost more than 4 thousand euros in a private clinic, all this is said to be women in need, who for one reason or another want to give birth by cesarean section.

Offered to obtain a psychiatrist certificate

Alga, who lives in Marijampolė, underwent an emergency cesarean section almost a decade ago due to the danger to herself and the life of her newborn.

According to the woman, she felt great at the time, the operation and recovery went smoothly, so she decided that she would also like to give birth a second time surgically.

However, he faced a categorical refusal by doctors to issue a referral for a cesarean section. In addition, even the proposal of a gynecologist to obtain a certificate of surgery from a psychiatrist.

“My first child when I gave birth was a caesarean section for me. The second pregnancy was very difficult, with two miscarriages. I really thought that a woman could choose to even pay for the surgery if necessary. However, they told me very clearly that this was not possible ”, said the interlocutor.

The gynecologist who supervised the pregnancy suggested that the woman go to a psychiatrist to make a diagnosis and write a certificate indicating that she could not give birth on her own. However, this path was unacceptable to him.

“I started looking for acquaintances who could do the surgery. I agreed to a cesarean section. I bought, in other words. It is true that after all the doctor decided not to take away the agreed amount. However, I was very grateful to have offered as much as possible, ”says Inga, who gave birth to her second child with the help of a cesarean section.

Although she was sent to give birth to a tertiary hospital in Kaunas due to possible complications, she chose Šiauliai Hospital.

The woman emphasizes that the operation was performed in maturity.

In addition, the specialist held a long interview to explain the possible complications and benefits of natural childbirth, and only convinced that this would not change the opinion, he performed the operation.

I had to give birth naturally

Another interlocutor, Lina from Vilnius, says she wanted to give birth surgically due to possible complications.

For most of her pregnancy, the woman suffered severe pain due to her symphysitis, a pelvic ligament relaxation syndrome.

This condition is special because during natural childbirth, the pelvic ligaments can become so loose that the mother can be threatened by long months in bed and a complicated rehabilitation process.

Although the woman expressed concern about possible complications to more than one gynecologist she visited, she did not receive a referral for elective caesarean section.

“There was a huge panic that the doctors completely ignored. They said this was not a sufficient indication for surgery. They explained to me that if the exact condition of the pelvic bones was determined, if the exact condition of the pelvic bones was determined, if the exact condition of the pelvic bones was determined, I could get a recommendation for surgery, but it is only possible to do this by MRI, and this procedure is not done for pregnant women ”, the interlocutor said.

She considered giving birth in a private clinic, where the cesarean section is performed in a simpler order, but more than 4.5 thousand. The amount of 1 million euros was unbearable for the family.

Finally, without receiving the referral, Lina gave birth to the baby naturally. However, the woman who is currently pregnant is not sure whether she will also be able to give birth a second time.

Negotiations after heart surgery

The third interlocutor, Laura, who lives in the capital, revealed that she had enough indications for a caesarean section: the woman underwent heart surgery before pregnancy and suffered from tachycardia during pregnancy.

However, after hinting that she would like to give birth surgically, she received medical objections and the power to deliver a natural birth.

“They threw me like a hot potato, from a gynecologist to a cardiologist. All the gynecologists I visited explained to me that I should bring a cardiologist referral for a cesarean section. And the latter explained that they could not instruct doctors in another field on how to adopt a baby because their specialization is different. During that time, just for the referral for the operation, I visited many private consulting physicians and spent countless amounts of money, ”says Laura.

Eventually, the woman was able to find specialists who agreed to consider planned surgery.

“I made it very clear that I would not want to be traumatized during labor to be allowed to take medication to keep my heart working. There has also been a suggestion from doctors to apply electrical impulse therapy in the event of a heart attack during natural childbirth. It may be possible to give birth this way, but I don’t understand why it is necessary if there is a safer and more normal way, ”the woman considered.

After a long search in the Santara clinics, Laura underwent a cesarean section, but the woman does not hide that she had to “thank” her for it.

“It is clear that no one participates in the speeches until you mention ‘gratitude’.” Although he had to, he had to show that it was not a whim. Provide a package of documents, cardiologist transcripts, printed articles stating that cesarean section operations are performed abroad with indications like mine. I had to justify that I do not want to give birth sideways, receive a beta-blocker that acts on the child during delivery or that they shake me with electrical impulses ”, said Laura about the experience of childbirth.

Severe surgery

Vice President of the Lithuanian Society of Obstetricians and Gynecologists (LAGD) dr. Tomas Biržietis says that a cesarean section, like any intervention, is a very serious operation that requires indications.

Currently, about a fifth of newborns are born surgically in Lithuania, but this, according to the doctor, is a necessary measure.

Allowing mothers to choose whether to operate on them or not would create a dangerous precedent that raises many ethical and moral issues, T. Biržietis is convinced.

“Not only a caesarean section, no other operation, except beauty procedures, plastic surgeries, is performed according to the wishes of the patient. A caesarean section is an abdominal surgery that is very risky and has a number of possible complications or effects secondary. Natural childbirth is a much safer and better way. As a result, we medical professionals do not waste left and right decisions about cesarean section, “explained the doctor.

According to T. Biržietis, Lithuania should be equal to the countries where the mortality of newborns and mothers is the lowest, and it is in them where the lowest percentage of caesarean section operations are performed.

“We can be proud that according to 2020 data, Lithuania is among the best and safest countries from a prenatal point of view, along with the Scandinavian countries, where the number of caesarean sections is around 17 percent. In Lithuania in 2020, this figure reached 19 percent. This is the first year with so little.

This figure is higher in Romania, where it reaches 44%. Also in Bulgaria, where 43 percent. delivery is surgical. We really shouldn’t be equating ourselves to Romania or Bulgaria, “said the LAGD vice president.

T. Biržietis emphasizes that liberalization of the decision to operate would cause a number of problems.

“There are many ethical niceties due to ‘voluntarily’ cesarean section. Who will be responsible if one or another complication occurs during it and surgery was not even necessary? Who should pay? Society or that person? Find out how much it costs a caesarean section in the only private institution in Lithuania. That’s all it costs, “said the doctor.

Currently, caesarean section, in the absence of serious indications, can be requested in the only private clinic in the country that provides this service. According to T. Biržietis, the failure of a private institution to follow the recommendations provided to state hospitals on the relationship between natural and surgical deliveries is a common practice in the world.

“It just came to our knowledge then. This is the case in absolutely all areas of society: a caesarean section is no different. There are certain rules in the activities of public authorities to provide supervision and assistance, they are the same and in the structures private can be different. This is not only in medicine, “explained the doctor.

Commenting on the desire of the women’s active gathering to legalize caesarean section as a free option, a LAGD spokesperson was skeptical of such an initiative.

“It just came to our attention then. And they will never be changed. The treatment is not regulated by law. It is governed by evidence, whether it is safe or not, necessary or not. The Seimas will certainly never tell you to perform one. Caesarean section in a woman as she wishes. It will not be and is not even recommended by the World Health Organization, “emphasized T. Biržietis.

According to him, any change in the descriptions of the procedures, even for doctors, would set a dangerous precedent.

“Understand, if we allow one operation to be selected, we will have to allow the other to be selected, whether it is necessary or not. A professional becomes a tool that does not solve anything ”, explained the obstetrician-gynecologist.

Speaking of referrals for a planned caesarean section, T. Biržietis emphasized that they were only of a recommendation nature. The final decision, after assessing the situation and condition of the pregnant woman, is made by the advice of gynecologists after delivery.

“Whether you are a cardiologist, a neurologist or a psychiatrist, the conclusions of all of them are recommended. However, in the end, the decision is made by the gynecologist, because he is responsible for the operation and the complications that occurred during it ”, explained the doctor.

“There is even such a disease: tocophobia. It is the fear of childbirth. But imagine: the fear of childbirth is treated with a scalpel. It is not necessary to perform surgery, but to treat that fear: communicate, speak. No psychiatric problem is treated with surgeries, “added T. Biržietis.

He stressed that in exceptional cases, after evaluating the condition of the pregnant woman, the possible consequences and other aspects, doctors can make the decision to perform a cesarean section and for fear of childbirth.

However, these are individual cases and, in exceptional circumstances, they are already being applied, so no additional regulation is necessary.