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    Sunday, April 23, 2006

    Caesarean Sections (HCMC) Part 3

    Alright, so I was wrong. I think. In my first post on caesarean sections in Vietnam, I said
    "Doctors force women to wait until late in gestation and to have c-sections so they can schedule in the birth and make more money."
    I still think this might be true in some cases, since so many people feel that way, but I do not think it is the ultimate reason.

    "So what is?" you ask. Glad you asked.

    After reading my post a couple nights ago, my wife looked at me and said very bluntly:

    "It's not the money, it's the government. It's the two-baby rule."

    You see, Vietnam cannot openly enforce the "suggestion" that couples should have no more than one or two children. If it did, it would be violating children's rights (according to my wife and Save the Children UK ... my view of rights is different and deserves another post). Such violations would keep Vietnam out of organizations like the World Trade Organization, which it desperately wants to enter, so Vietnam doesn't enforce the rules, per se. What my wife saw at SCUK was a government that enforced the rule on government employees (such as people who worked for the Committee on Population, Family, and children [CPFC]) by writing it in their contract. Otherwise, the government must revert to convincing the population through lots of propaganda.

    What is the best form of propaganda for birthing that the government has? It's cult of doctors. The government has successfully turned the profession of physician into a profession tantamount to godhood. There is a doctor's day. Only the smartest test takers can study medicine. At least 40% of all my English students want to be doctors because they are seen as morally above the people, the most intelligent, and very wealthy.

    The doctors at hospitals also happen to be under the pay of the government.

    So, the government has waged a very successful propaganda campaign against birthing. It has done this in a few ways:

    1. It tells women they will get fat. No woman wants to hear this. The doctors tell all newly expecting mothers that they must gain at least 15kg during the course of pregnancy. If you have travelled around Ho Chi Minh City lately, you've seen the prevalence of fat pregnant women. If you do not reach the requisite weight, they will use drugs to keep you from giving birth until you do (I have never heard of this actually happening, but its a threat I have heard uttered)

    2. In order to fight the fat, mothers should get a caesarean section. This surgery will make them less fat than giving birth vaginally. Never mind that the fat is already there from the previous 9 months, or the scar across the abdomen.

    3. Births, vaginally or via c-section, are painful. Obviously, no woman in her right mind would want to go through surgery more than once or twice.

    Now, this information doesn't explain why the doctors FORCE some women, like my friends, to have c-sections, but it does explain more realistically the probable leading driving force in pushing c-sections. Most hospital doctors make pittance from the hospital and get most of their money from private practice--but its the government that holds the key to promotions, prestige, and power. Also, I'm sure many believe what they practice. The doctors hear all through medical school about the wisdom and benefits of having only one or two children--and so they preach this to their patients.

    I know this happens with breastmilk vs. formula. Doctors reinforce the incorrect stereotype that formula is better than breastmilk by teaching it to their patients and promoting certain types for fees.

    The end result is a country of women who hear bad things about having more than two children (you'll be poor, it'll hurt, you'll be fat, etc.) and revere doctors giving birth in hospitals where doctors willingly push the doctrine either for personal gain or actual belief. The end result is a lot of c-sections and small families.

    Now, underneath this discussion on c-sections, has been the discussion about it's legality. Is it legal? Could someone sue? Here's what I found out from my lawyer here in Vietnam. This conversation is paraphrased, but quoted to the best of my knowledge (it only happened yesterday, but it won't be exactly word for word).

    The Bleeding Ear (TBE): "Are their lawsuits in Vietnam?"

    Lawyer: "Yes, of course! Lawsuits are very much protected underneath Vietnamese law."

    TBE: "If a doctor did something wrong, could he or she be sued?"

    Lawyer: "Most definitely."

    TBE: "...by a regular person? Do they have the money? How much does it cost?"

    Lawyer: "Yes, normal people can sue. Typically the lawyer will take 5% of the award. A couple days ago I closed a lawsuit worth over 2 billion VND, which gave me about 100 million VND. Lawyers will definitely take the cases."

    TBE: "But I don't see a lot of lawsuits in Vietnam like in America."

    Lawyer: "No, that's the difference--the culture. The Vietnamese culture hasn't embraced the concept of the lawsuit yet, so very few people do it or even think about it."
    So, ultimately, Vietnam has tort law, but the society doesn't use it to the excess (or probably over-excess in my opinion) that American society does. It also has successfully used propaganda to convince women of the benefits of few children and c-sections, so the quote by Le Anh Tuan, in my first post, seems to be more accurate now. He said:
    "..many mothers opt for a caesarian as a way of avoiding the average ten hours of labour pain caused by natural child birth.

    ...[and] some women prefer this unnatural method as they don’t want to lose their beauty after giving birth, while others want their children to be born on a chosen day.

    ...[and] it [is] very difficult for the hospital to deny any request for a caesarean. If they were to refuse the request and the mother was to have problems giving birth, the hospital could be sued."
    Still sounds like a pretty unethical thing to do, a trend that needs to be reversed for the benefit of Vietnamese family structure and the health of the women, and widespread. I am interested in comparing Vietnamese tort law to China (and it's one child system). Any takers?

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    1 comment:

    Thuy said...

    That is just crazy brainwashing HOG! C-section requires a longer recovery period. But you know, Vietnamese people have a lot of crazy superstitions too! I mean, a bank in Vietnam won't exchange my US dollars because it has a black spot on it! What crazy bollock.