C-sections now at an 'alarming' level

Desiree Burns
October 13, 2018

Looking at trends in Brazil and China where there is high use of C-section, the researchers found that many were in low-risk pregnancies, in women who were well-educated, and in women who had previously had a C-section.

"It is crucial that women who need Caesarean sections are able to access this potentially life-saving procedure", the World Health Organization advises, adding that it is equally important that unnecessary procedures be avoided "so women and their babies are not put at risk".

Rates surged from about 16 million births (12 per cent) in 2000 to an estimated 29.7 million (21 per cent) in 2015, the BBC News report said quoting a report in the medical journal The Lancet said.

Rates of caesarean section births nearly doubled between 2000 and 2015 - from 12 to 21 percent worldwide - new research has found, with the life-saving surgery unavailable to many women in poor countries while often over-used in richer ones.

Africa, for example, still lags far behind other continents in C-section use, but experienced measurable increases during the study period.

Authors pointed out that while the procedure is generally over-used in many middle- and high-income settings, women in low-income situations often lack necessarily access to what can be a life-saving procedure.

Jane Sandall, professor of social science and women's health at King's College London and a study author, told AFP that there were a variety of reasons women were increasingly opting for surgery.

"Globally, drivers for the increasing rates vary between countries and include a lack of midwives to prevent and detect problems, loss of medical skills to confidently and competently attend a (potentially difficult) vaginal delivery, as well as medico-legal issues".

"Doctors are often tempted to organise C-sections to ease the flow of patients through a maternity clinic, and medical professionals are generally less vulnerable to legal action if they choose an operation over a natural birth".

She adds that financial incentives exist for both doctor and hospital with the certainty of planned day-time deliveries, especially in private practices.

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C-sections have a higher chance of maternal death and disability, as well as a more complicated recovery following the birth.

It also identified an emerging gap between wealthy and poorer regions within the same country. In West and Central Africa, the percentage of babies delivered by C-section rose from 3% to 4.1% between 2000 and 2015; in Eastern and Southern Africa, it jumped from 4.6% to 6.2%.

"In cases where complications do occur, C-sections save lives, and we must increase accessibility in poorer regions, making C-sections universally available, but we should not overuse them".

Risks associated with C-section, while rare, can be quite serious.

But experts also warn that the increase in C-sections needs to come alongside a greater awareness of the health risks that accompany the procedure.

The uptick in C-sections - and the persistent disparities in where they're performed - points to two connected trends, the authors write.

It has also become "fashionable" and considered "modern" or safer to have a C-section in some countries, the research said.

In a comment accompanying the study, Gerard Visser of the University Medical Centre in the Netherlands, called the rise in C-sections "alarming".

"The medical profession on its own can not reverse this trend", Prof. Until recently, the World Health Organisation (WHO) suggested that Caesarean section - or C-section - rates of more than 15 per cent were excessive.

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