"Greece continues to rank among the highest in the world in terms of cesarean section rates, as 67% of births, that is, about seven out of ten children, are delivered by cesarean section, whereas in most European countries the corresponding rates range between 15% and 30%. In fact, in some provincial hospitals, data from 2023 show rates reaching as high as 84%.” The data were presented to FM Agency and on Tania Mantouvalou’s show “104.9 Health Secrets” by the president of the Greek Observatory on Midwifery Violence, a Ph.D. candidate at the National and Kapodistrian University of Athens School of Medicine, and vice president of the Disciplinary Council of the Patras Midwives Association, Konstantina Nousia. Citing scientific studies, she stated that children born via cesarean section have an increased risk of developing allergies and asthma. According to Ms. Nousia, the Greek Observatory on Obstetric Violence is the ninth such observatory worldwide and a member of the International Federation InterOVO. “It was created with the aim of documenting and highlighting incidents of obstetric violence in maternity care settings, to collect women’s testimonies, and to promote changes in practices during pregnancy, childbirth, and the postpartum period.”

Unnecessary cesarean sections are one of the most common forms of obstetric violence

She argued that unnecessary cesarean sections are one of the most common forms of obstetric violence documented by the Observatory, while explaining that, when a cesarean section is not medically necessary, it is associated with a longer recovery time for the mother. “Obstetric violence can be verbal, psychological, or physical and manifests itself through practices such as performing medical procedures without informed consent, failing to provide adequate information to the pregnant woman, repeated vaginal examinations without medical indication, as well as the Christeller maneuver—that is, applying intense pressure to the laboring woman’s abdomen during the fetus’s descent. According to international guidelines, during a normal delivery, cervical dilation should be checked approximately every four hours, while in practice in Greece, these examinations are often performed much more frequently. The Christeller maneuver has been abandoned in many countries, as it is considered dangerous for both the mother and the fetus.” The president of the Greek Observatory on Obstetric Violence revealed that she has experienced all forms of obstetric violence during her own childbirths, clarifying, however, that she does not wish to highlight her personal experience, but rather to draw attention to the phenomenon itself. As a prime example of psychological violence, she cited the pressure placed on expectant mothers that their child is at risk if they do not undergo an immediate cesarean section, even when, as she argued, there is no actual medical indication. “Your baby will die if we don’t do a C-section now,” they told me. Of course, I didn’t have a C-section, and my baby was fine. Because I was a midwife and I could see that his heart rate was very strong. I felt a strength inside me that I could do it. And all of that helped me stay in the delivery room instead of being taken to the operating room. But if I hadn’t been a midwife, they would have 100% used this form of psychological coercion to force me into an unnecessary surgery.”

Natural childbirth contributes to better development of the newborn’s immune system

Referring to the causes of the high cesarean section rates in the country, Ms. Nousia noted that Greece continues to operate under a strongly physician-centered model, in contrast to other European systems, where midwives play a leading role in the management of normal pregnancies and normal deliveries. The Observatory’s president further argued that normal childbirth is associated with a faster recovery for the mother and promotes the transfer of the microbiome to the newborn, a fact which, she said, contributes to better development of the newborn’s immune system. In closing, she urged pregnant women to educate themselves thoroughly before giving birth, to create a birth plan, to seek informed consent for every medical procedure, and to be aware that, under the right conditions, even after a cesarean section, a vaginal birth may be possible in a subsequent pregnancy.

“Obstetric violence also affects demographics”

Ms. Nousia also emphasized the long-term psychological consequences that a negative childbirth experience can have. “Many women who have experienced obstetric violence develop secondary tokophobia—that is, an intense fear of becoming pregnant again and giving birth following a traumatic childbirth experience. The Observatory has documented testimonies from women who state that they do not wish to have a second child because they have been traumatized by what they experienced during their first childbirth.” In closing, the Observatory’s president argued that obstetric violence not only affects the mother’s physical and mental health but can also have broader social implications, noting that in a country facing a severe demographic crisis, the fear of another pregnancy following a traumatic childbirth experience is yet another factor that may deter some women from having more children.

Source: APE-MPE