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HEALTH: Asia’s designer babies: but at what price?

HONG KONG: We all want to give our children the best possible start in life — but the question is how far would you go?

Genetic determination? Vetted sperm donors? What about going under the knife to ensure that your child is born on the most auspicious day of the year?

Every year tens of thousands of women in Asia eschew natural birth and opt for surgery, earning the region the moniker of ‘caesarean capital of the world’.

But while caesarean sections are not the high-risk, emergency-only operations they once were, medical experts are concerned that needless surgery is putting women’s health at risk.

Fortune-tellers across Asia do a roaring trade in determining the best day for a marriage, birth, business or property deal.

“Many women come to me because they want to know a good day to have a baby. They want to give their child a head start in life,” says astrologer Yeung Ki-yue.

Sitting down with the parents, Mr Yeung consults the Chinese Almanac — a voluminous book full of astrological charts and pictures — to work out a birth day and time for the child that would set it on a path for great things.

“Some days are good, some not so good. It depends on when the parents were born,” says the Hong Kong-based fortune-teller.

“With the birth day and time many things I can calculate into the future,” he tells AFP.

There are thousands of fortune-tellers like Mr Yeung across Asia. Many ply their trade from street corners with just a laminated chart in front of them while others hold court in backstreet rooms stuffed with charts and thick with incense.

Some savvy fortune-tellers have even turned to the net to allow parents to calculate for themselves which days would be luckiest for their child to be born.

Using a complex numerical system based on the Chinese calendar’s 60-year cycle and the five elements — wind, water, fire, wood and earth — some even claim to be able to determine what sex the child will be in any given month.

Mambo Man, vice-president of the Hong Kong Midwives Association, says she has seen a growing trend towards caesareans during her 30 years as a midwife here but that “very few expatriates” opt for surgery.

The private Sanatorium hospital where Ms Man works, and much favoured by Hong Kong’s society scene, is said to deliver more babies by caesarean than natural birth.

“It’s a Chinese tradition that women like to ask a fortune-teller when is a good day and time to give birth,” says Ms Man.

But Mr Yeung says that mums are wasting their time and that a child cannot escape the destiny that nature has intended.

“Just like surgery to change the face — the nature of the face is still there,” he says.

This argument is apparently lost on South Korea where a flood of babies were delivered by caesarean on the eve of the Year of the Horse, which started on February 12 this year.

According to the Chinese Zodiac, also followed in South Korea, a girl born in the Year of the Horse, which comes every 12 years, is fated to be strong willed and short tempered.

According to the ministry of health, South Korea now has the highest rate of caesarean sections in the world with nearly half of all pregnant women opting for an operation. It cites, among other things, superstition, and a belief that caesareans are safer, pain free and more convenient.

The World Health Organisation (WHO) estimates that 15 percent of babies should need to be born by caesarean either due to the baby lying horizontal across the mother’s womb, or foetal distress.

These figures have been superseded in most countries in Asia, but also in the United States and Britain where caesarean mums have been dubbed “too posh to push”.

But GPs are concerned that more women are making decisions to have a major operation without knowing the risks involved and egged on by doctors looking to cash in on the business of birth.

It certainly is a lucrative business. In Hong Kong an obstetrician can earn up to US$10,250 for one caesarean. Most charge, more than double the rate for a natural birth.

“For an obstetrician, a c-section is certainly easier, it doesn’t mess up your schedule and is financially lucrative,” says one obstetrician in the region.

“Obstetricians should be supporting a woman’s right to choose based on what is best for the woman, but that’s compromised by their vested influence in her choosing a c-section,” the GP said, wishing to remain anonymous for fear of being struck off the medical council.

And while the immediate dangers of a caesarean have been greatly reduced with the advances in medical technology, there is still concern that the operation is putting the future health of the mother at risk. A study in Taiwan in 2000 showed that doctors rushing to stitch a woman after a caesarean were leaving a mass of scar tissue.

This had led to five ectopic pregnancies — where the eggs had been trapped in the tissue and the foetus developed outside the uterus — a potentially fatal diagnosis for both mother and child. Taiwan has since made efforts to reduce its 35 percent rate of caesarean births.

Another study in Britain found that women who had had a caesarean found it more difficult to conceive later on.

“Neither the medical profession nor women themselves realise the extent of the long-term problems caesarean sections can cause,” Prof James Walker of Britain’s Royal College Of Gynaecology said last month. —AFP

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