C-section births almost double to more than 20 percent worldwide

By Pascale Davies with Reuters
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The rates of caesarean section births almost doubled between 2000 and 2015 – from 12 to 21 percent worldwide - new research has found.


The number of women having cesarean births has almost doubled between 2000 and 2015 – from 12 to 21 percent worldwide, according to new research published in The Lancet medical journal on Thursday.

It reported that the surgery was in some cases over-used in richer western countries, but unavailable to many women in poor nations.

In at least 15 countries, more than 40 percent of all babies born are delivered by C-section. The highest rate, of 58.1 percent, was in the Dominican Republic.

Jane Sandall, the lead author of the report told Euronews: "In some cases the trend is system-driven. In Brazil, for example, the free public healthcare system is of poorer quality and pregnant mothers who can't afford private healthcare might be offered the procedure to help clear patients more quickly through the system."

Why do mothers use C-sections?

Experts estimate the life-saving operation is medically required in 10 and 15 percent of births, due to complications such as a baby being in an abnormal position, bleeding, foetal distress, or hypertension.

Women can often request C-sections due to past negative experiences of birth, fear of labor pain, or of the effects of labor such as pelvic floor damage, incontinence and reduced sexual function.

However, the surgery can also create complications and side effects, including higher risks for future births and scarring of the womb.

Sandall also said there is emerging evidence that babies born via C-section have different hormonal, physical, bacterial and medical exposures during birth, which can subtly alter their health.

Adding that while the long-term risks of this are not well-researched, the short-term effects include changes in immune development which can increase the risk of allergies and asthma and alter the bacteria in the gut.

What can be done to prevent the misuse of C-sections?

"Pregnant mothers must have access to professional and informed advice in order to make a decision," said Sandall.

She said that conjecture that blames mothers for the high caesarean section rate, either because of their poor health (eg, obesity, hypertension) or because they are demanding the medically unnecessary surgery due to fear or disinterest in labour, ignores the wider systems issues that drive the growing reliance on C-sections such as lack of midwives.

She added that the focus should be on countries where the issue is of bigger concern by providing them with more staff.

"We need to start working with insurance companies in these countries to help with the provision of services and staff, as well as dealing with local and national governments to invest in healthcare," she said.

The research published in The Lancet tracked trends in C-section use globally and in nine regions based on data from 169 countries from the World Health Organization and UNICEF databases.

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