In Kenya, the increase in elective cesarean births, also called C-sections, mirrors a trend in the West, and is happening despite warnings from medical experts who say it should remain a last resort.
C-section delivery -- in which a doctor makes an incision in the lower abdomen as well as the uterus to deliver the baby -- is becoming more common within Kenya's urban population, especially among the well-to-do.
The women who opt for elective C-section deliveries said natural birth deliveries come with complications, such as long hours in labor and the physical pain of pushing as well as other changes in their bodies.
Personal decision
Jane Mukami, communications officer with a nongovernmental organization in Nairobi, said, based on her personal research and discussions with friends, she opted for an elective C-section.
“This being my first baby, I was really afraid of giving birth naturally because of the pain during labor, so I opted to just have a C-section done," Mukami said.
"My peers also were telling me how painful it is and some even fainted ... so I was really scared," she added.
Dr. Peter Murimi, a gynecologist at Nyeri Aga Khan Hospital, said the elective C-section trend is growing at what he described as an "alarming" rate among young women and is steered by bad advice and misconceptions.
“There is a new trend emerging, especially among young women, whereby most of them ... by the time they are completing their nine months, most are opting to have cesarian-section delivery rather than go the natural process because they are fearing the pain," Murimi said.
"Some are saying that when you have a natural birth you may have damage in the birth canal," he said, downplaying the issue.
Proper planning
But Mukami argued Kenya’s health institutions are well-equipped to handle surgeries, and that with proper planning, any woman can pull off a safe delivery via C-section.
“In Kenya, currently we have very good hospitals and and very professional doctors. So for example, Nairobi Hospital is one of the best. So as long as you have planned well for your baby, by that I mean you have good money and you have chosen a nice hospital where they have good doctors, you do not have to worry about anything. You will just feel safe," she said.
Murimi, who said about half of women who undergo elective C-sections suffer adhesions, advised that a natural birth is safer than a C-section.
“I always tell any woman who is capable of giving birth naturally to use that method, and if it’s going to be a cesarean section, let it be due to an induction, do not just do that out of a preference. ... A cesarean section should be an intervention, it should not be the first option," he said.
According to the World Health Organization, Kenya had a C-section rate of 4 percent in 2013. In the U.S., the C-section rate was 32.7 percent, while Brazil tops the list with 52 percent. WHO considers the "ideal rate" for C-sections to be between 10 and 15 percent.