A C-Section Should Not Be a Privilege: Expanding Access to Life-Saving Maternal Care

Erin Barringer, Partner at Dalberg, and Erastus Maina, Project Manager at Dalberg, explain why every mother should have access to safe surgical care if labor becomes complicated.

Read the full article on Next Billion.


Mothers often experience a mix of excitement and apprehension as they prepare for the birth of their child. Months of planning culminates in an experience that remains unpredictable. When complications arise, often the safest way to protect the mother’s and baby’s lives is an emergency C-section.

C-sections are major surgeries and there are risks involved – and in the U.S., there is growing awareness that they are even riskier for black mothers. Fortunately, though, it is very rare that a mother in the U.S. will not be able to access a C-section in an emergency situation. Sadly, this is not the case for women everywhere.

Many women in low- and middle-income countries cannot access life-saving C-sections when they desperately need them. Even if they have the surgery, post-op complications and infections are much higher in developing countries than elsewhere in the world.

Local Partnerships for Local Problems

Across sub-Saharan Africa, only 7.3 percent of babies are born by C-section. And the rates become more shocking when you look at individual countries – the caesarean rate in Nigeria is 2 percent, in Liberia it is 3.5 percent and Zimbabwe it is 6 percent. Now take a look at the maternal mortality rates (MMR) of these countries: for every 100,000 live births, 814 women die in Nigeria, 725 die in Liberia, and 443 die in Zimbabwe. (For comparison, the U.S. has the highest MMR in the developed world at 26.4). It is clear, C-sections are essential to saving mothers’ lives.

Improving access to safe C-sections in low- and middle-income countries is not easy. A hospital could have the most qualified surgeon ready to provide a C-section, but without an anesthesia provider, running water, medical oxygen, sterilized equipment or lighting, the surgery can’t go ahead. The entire surgical system, the people, supplies and infrastructure, must come together to deliver safe C-sections.

Safe Surgery 2020, a partnership funded by GE Foundation, brings together innovations, global expertise and local experience to make surgical care safe and accessible for all. The initiative develops the technical and soft skills of surgical teams working in remote parts of Ethiopia and Tanzania, while overcoming infrastructure barriers by identifying and scaling innovations.

By adopting a unique approach to partnering with ministries of health and local organizations, such as universities, professional associations and NGOs, Safe Surgery 2020 strengthens surgical systems in both the short and long term. From supporting national policy development and implementation around surgical care to providing significant coaching and technical support to local partners, the initiative empowers local actors to continue building surgical capacity independently long into the future.

The combination of a holistic program and local leadership has dramatically improved access to C-sections, and surgical care more broadly, in Ethiopia and Tanzania.

 Read the full article on Next Billion.

Ashley Eberhart