The saying often goes that the end justifies the means. The “end” of improved maternal health seems a worthy candidate for sacrifice, but what if the “means” are denying women the right to choose how they will give birth? And what if the desired end of improved maternal health is actually just a disguised political agenda? This is essentially the current situation for women’s maternal care in Turkey. The book “Abortion Pills, Test Tube Babies, and Sex Toys: Emerging Sexual and Reproductive Technologies in the Middle East and North Africa” by Wynn and Foster shares research about this phenomenon. This post will share some of their findings and consider some implications a lack of autonomy in choosing maternal health care may have.
Since the discovery of caesarean sections many lives have been saved. According to the World Health Organization, caesarean sections can be life-saving in certain situations such as during abnormal fetal position, prolonged labor, or fetal distress. Furthermore, maternal and newborn survival rates are optimized when country’s caesarean section rate reaches 10%. However, there is no evidence that survival rates increase as the caesarean section rate surpasses 10%.
In fact, a scholarly review by Boutsikou and Malamitsi-Puchner found that caesarean sections increase the likelihood of respiratory problems for the baby. In addition, repeated caesarean sections increase risk for uterine rupture during a subsequent vaginal birth. This condition requires surgical intervention. Caesarean sections also increase the risk for placenta accrete which increases risk for premature delivery. Caesarean sections also tend to limit the number of children a woman has.
Outcomes such as these have led to many countries engaging in an effort to decrease the number of caesarean sections they perform. At first glance, it may seem that Turkey is one of these countries, but it is not what it may seem.
Caesarean sections are popular among women in Turkey and many women would prefer the procedure, but caesarean sections were banned in 2014 unless the health of the mother or the child requires it. Essentially, elective caesarean sections are prohibited. On the surface, it seems that the rationale for this legislation is to optimize women and child health. But rather than improve women and child health, President Erdogan is concerned with his country’s high caesarean section rate because high caesarean sections may decrease the birth rate, which might hinder Turkey’s future economy.
President Erdogan said “We are very sensitive about children Turkey. I love children. In my country I want at least three children for each family. Because I know that we need a young and dynamic population…I declare openly that I am a prime minister who is against delivery by caesarean section.”
Assuming this law is implemented, caesarean sections would decrease in incidence, and consequently, the birth rate would increase. President Erdogan would have his “young and dynamic population.” But the we should consider what the effect on women will be. How will being denied the right to make their own choices about their care affect the kind of mothers and citizens they become? How will that affect the economic future of Turkey? These are the kind of questions that the book sparks.
For full research on the situation in Turkey and other insights on maternal health, keep an eye out for the book “Abortion Pills, Test Tube Babies, and Sex Toys: Emerging Sexual and Reproductive Technologies in the Middle East and North Africa” scheduled for publishing this December.
American Pregnancy Association. “Placenta Previa.” APA. Aug. 2015. Web. 29 Sept. 2016.
Boutsikou,T. and A. Malamitsi-Puchner. 2011.“Caesarian Section:Impact on Mother and Child.”Acta Paediatrica 100: 1518-22.
Foster, A. and Wynn L. Abortion Pills, “Test Tube Babies, and Sex Toys: Emerging Sexual and Reproductive Technologies in the Middle East and North Africa.” Nashville: Vanderbilt University Press, 2016.
Khazan, Olga. “Why Most Brazilian Women Get C-Sections.” The Atlantic. Atlantic Media Company, 14 Apr. 2014. Web. 22 Sept. 2016.
VBAC.com. “What Is a Uterine Rupture and How Often Does it Occur?”VBAC.com. 23 Feb. 2016. Web. 29 Sept. 2016.
World Health Organization, HRP. “WHO Statement on Caesarean Section Rates.” World Health Organization. World Health Organization, Apr. 2015. Web. 22 Sept. 2016.
World Health Organization. “Caesarian Sections Should Only Be Performed When Medically Necessary.” News Release, 10 Apr. Web. 2015.