The World Health Organisation says that CS should be done only as a life-saving measure when there is a risk of foetal or maternal death. The global organisation believes, “There should be no justification for any region in the world to have CS rates higher than 10 to 15 per cent.” In Nigeria, some states like Kebbi have a CS rate of 20.3 per cent.

A professor and former WHO consultant, Dr. Sundari Raveendran, said subjecting women to CS when not medically necessary is a violation of women’s rights.

“There are good reasons to be concerned about the spate of unnecessary C-sections carried out in a casual manner. Consent has been taken from women, and doctors are not giving full and complete information about the possible side effects of abdominal surgery,” she said.

A surgeon with the Lagos State University Teaching Hospital, Dr. Olugbenga Saliu Oseni, explained that CS, as an interventional delivery process, should only be explored when it is the only option left to save the lives of mother and baby.

“The best thing to happen to a woman is to have a normal delivery but when this is not available, the preferred option should be CS.

“There are many reasons why a doctor may prescribe CS and some occur in critical situations. But it will be crazy for any doctor to elect to do CS because he wants to make more money; that means that person is not an expert,” he said.

While before now CS in most public hospitals across the country was between N60,000 and N75,000, the fee has since been jacked up to around 150,000 and N200,000 in many of the places today. In private hospitals, it hovers between N300,000 and N1m.

A gynaecologist, Dr. Samuel Adebayo, fingers the high cost of medical equipment and other necessary infrastructure like regular electricity supply as part of the reasons why some hospitals charge exorbitant fees for CS. He said about 90 per cent of the medical supplies needed for the procedure is imported.

“Most of the supplies we use are not produced in Nigeria; not even the surgical blade that is used to severe the umbilical from the mother. The anaesthetic pack alone goes for N35,000 in some areas, though it used to be N15,000. Even ordinary Paracetamol injection is imported. That is why you see that even teaching hospitals have to increase their price.

“Again, absence of regular electricity supply is another challenge because we must sterilise all the surgical instruments we use and we must also ensure that we are on generator when doing the operation because you cannot afford to experience power failure during a Caesarian delivery. It is a multi-sector problem which government must address,” he said.

While in many parts of Europe and the United States of America the cost of CS is largely covered under the national health insurance, in Nigeria, women on the verge of delivery and their families are made to cough out huge sums from their pockets without largely any form of support from government. As a result of this, many nursing mothers are held back in the hospital for several days after delivering and sometimes weeks until their husbands or relations can clear the bogus bills.

President, Nigeria Medical Association, Dr. Kayode Obembe, said there must be certain indicators in place for a CS to take place. He said carrying out such surgeries when these indicators are absent is not only unethical but also a violation of the rights of a patient.

“Caesarean Section in the real sense of it is a life saving measure but there must be some clear cut indicators for performing such. If there is any situation now where anybody performs Caesarean Section and there are no indications for it, the patients or their relations are quite free to report to the Medical and Dental Council of Nigeria and professionals in that field would be asked to go and reappraise the procedure. Nobody should be tricked into delivering at any hospital against their wish,” he said.

Public Relations Officer of the Medical and Dental Council of Nigeria, Mr. Henry Okwuokenye, told PUNCH that there is a tribunal and investigating panel in place that looks into any such matter and hands down appropriate sanction if complaints get to them.

He said the MDCN cannot do much on the matter except victims of such fraudulent practice take the courage to report their experiences to the organisation as they cannot be everywhere at the same time.

“The MDCN is not in hospitals everywhere, so we may not know some of these things except people give us information and make reports. We have an investigating panel and tribunal that look into matters like this and try erring doctors. As soon as we get such reports, erring doctors would be tried and dealt with.

“We need people to come out and make reports for us to set examples of these doctors. If we get only one of these fraudulent doctors and make him or her scapegoat, the others will behave properly,” he said.

Constitutional lawyer, Mr. Jiti Ogunye, posits that if truly some doctors now deliberately lure pregnant women into electing for needless CS just for pecuniary motives, they have both violated the patients’ rights and breached a fundamental part of the law.

“Subjecting a pregnant and expectant mother on the verge of delivery to a fraudulent and needless caesarian operation, based on misleading and fraudulent representation that she could not self-deliver her baby unless subjected to an assisted delivery procedure, in order to compel the woman and her husband to pay huge sums of money to a medical practitioner, maternity home, clinic or hospital, is not only cruel in the extreme but also unlawful and illegal. It is a gross act of professional misconduct, a civil wrong and a criminal act.

“It is against the physician oath because it is a surgical operation which ought to be embarked upon only to save the lives of the mother and child. It is not a cosmetic surgery. Thus, under Section 16 of the Medical and Dental Practitioners Act, Cap M8, Vol 8, Laws of the Federation, 2004, such a medical practitioner, clinic or hospital is liable to be sanctioned for infamous conduct or professional misconduct.

“Such act also constitutes a civil wrong. It is tantamount to a violation of the integrity of the body of the woman. It is a tort, an act of battery that is actionable under the law of negligence, the categories of which, in law, are never closed,” he said.

A sociologist, Lanre Adewuyi, told PUNCH that this sad trend of needless extortion and unethical practice will continue to soar in Nigeria because of the seeming goldmine doctors and private hospitals appear to have found in CS.

According to him, the poor regulation of the industry and the weak laws guiding the practice in Nigeria is another dimension to the problem.

“Many of these beautiful hospitals and smartly-dressed gynaecologists are more interested in financial gains than saving lives. A caesarean delivery costs an average of N200,000 in many of these private hospitals. By the time they add other related charges, you could be paying as much as N350,000. This is a lot of money for the hospitals and that is why they would continue to trick pregnant women into opting for CS.

In a country plagued by scores of social problems top among them infrastructural shortfalls, many hospitals across Nigeria – government and private – have had to provide basic needs like clean portable water, security and even motorable roads on their own. This is aside spending huge amounts providing their own electricity supply and equipping the facilities to acceptable standards.

Adewuyi explains that until government lives up to its side of the social contract by providing basic infrastructure in the country, those who do so on their own would continue to dictate the tune to the larger majority – in this case helpless pregnant women like Mrs. Adekunle and Otumagba whose hard-earned money is daily slithered away from their grip.

This doctors are all the same all over the world.