Natural Birth a Challenge

The number of labor-delivery-recovery (LDR) rooms where women can stay for two hours after delivery, will be increased to 1,800 in more than 300 state-run hospitals across the country before the end of the government’s tenure in mid- 2017, said Farah Babaee, head of the Midwifery Office at the Health Ministry.

 “Since implementation of the 2014 Health Reform Plan, 848 LDR rooms were established in many state-run hospitals (which number around 550)  to encourage natural births by providing a pleasant and conducive environment for pregnant women,” similar to private wards, she said on the sidelines of a meeting of midwifery development working group, held Monday at the University of Medical Sciences in Kashan, Isfahan Province. 

Pointing to the high rates of c-section, she said, “The fear of labor pain during delivery, and the nosy, non-private and stressful environment in natural birth wards in state-run hospitals, is the main reason for choosing caesarean delivery over natural births.” 

Natural childbirth training centers for pregnant women have also been established in almost all universities of medical sciences. Ten more will be added by the end of the current Iranian year in March. 

The main goal of the training centers is to encourage mothers to give birth to their babies normally with the least pain.  “We have plans to add a bathtub to every LDR room so women can also take advantage of water treatment services,” Babaee added.  

While global statistics says the ideal rate for c-section is between 10% and 15%, the figure is 50% in Iran, the second highest in the world after Brazil. Before implementation of the health plan it was 56%. Health officials want to reduce the number of c-section births to 35%. 

  More Midwives Needed

As per data released by the Iranian Association of Midwifery, there are 36,000 midwives in the country.

During the current fiscal, 2,000 midwives were recruited for labor wards in state-run hospitals. This number is grossly inadequate and 2000 more midwives are needed.

Annually, around 1.5 million births are registered in the country. In 2013, infant mortality was 15 per 1000 births. The figure decreased to 13.8 in 2015. 

Natural delivery is free in all state-run hospitals since May 2014. However, women who opt for natural birth in private hospitals should pay higher tariffs, depending on the facilities the hospitals offer. 

A woman, who gave birth by normal delivery recently at the private Sarem Women’s Hospital in Tehran, told the Financial Tribune that she paid $1,400 (55 million rials) for her delivery and a one-day stay in a private room with her husband. The hospital offers postpartum care and baby care kits to new moms. 

However, some hospitals refuse to do natural deliveries and offer only c-births.

Part of the reason private hospitals promote c-section is financial and their charges are very high for the surgery compared to a normal birth which is also seen as time-consuming and does not generate earnings.  It has been reported that most, and possibly all, state hospitals are in the red due to the low tariffs and the systemic rising demand for medical care. 

Additionally, the demand for caesarean births is widespread and in some cases it is a difficult task to find a doctor who will deliver babies naturally. Reports say that Iranian doctors are experts in c-section delivery having performed so many, and therefore see it as a safer alternative.