Starvation in the midst of plenty… of caesarean deliveries

Abstract

The capacity to perform caesarean delivery (CD) at facilities in low- and middle-income countries including South Africa is now a well-documented global public health concern.¹ Where public sector district-level facilities struggle to provide reliable access to safe CD, patients are referred (or self-referred) to busy urban and peri-urban regional and central hospitals. Here, the tension of balancing heavy elective caesarean and emergency caesarean caseloads is acutely felt. As the caesarean rate in South Africa progressively rises,² there is the growing need for elective repeat CD that compounds the service pressure.