C-section births surge to ‘alarming’ rates worldwide

Surgery in progress. /COURTESY

Surgery in progress. /COURTESY

"The growing use of c-sections for non-medical purposes could be introducing avoidable complications, and we advocate that c-section should only be used when it is medically required".

Low- and middle-income countries saw the greatest disparity the use of C-sections, where wealthy women were six times more likely to have one than the poorest of those populations.

In the 10 countries with the highest number of births in 2010-2015 period, there were large differences in caesarean section or C-section use between regions.

"In cases where complications occur, cesarean section births save lives, and we must promote women's access [to C-sections] in poor areas, but we should not abuse them". In 2000, 16 million babies were delivered by C-section, accounting for 12% of live births.

"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".

Dominican Republic had the highest proportion (58.1 per cent), followed by Brazil and Egypt (both 55.5 per cent), and Turkey (53.1 per cent).

In North America, researchers found that C-sections are used in approximately 32 per cent of births, up from 24.3 per cent in 2000, with the United States at 32.9 per cent, and Canada at 26 per cent, up from 20.9 per cent in 2000. C-section use has remained low in sub-Saharan Africa, however.

In places such as Brazil and China, numerous c-sections performed were in women with low-risk pregnancies, in women who previously had c-sections, and in women who were well-educated. The procedure is 1.6 times more likely to take place in a private institution rather than a public one, perhaps due to persistent shortages of staff and facilities in rural and vulnerable regions.

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The caesarean section, or C-section, is a surgical procedure that sees the baby delivered through a surgical incision in the mother's abdomen, rather than through the vaginal canal. "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".

"In cases where complications do occur, C-sections save lives", Temmerman said, "and we must increase accessibility in poorer regions, making C-sections universally available".

"The sharp increase in cesarean sections, mostly in affluent environments without medical reasons, is problematic because of the risks for mother and child associated with C-sections", says Marleen Temmermann from the Aga Khan University of Kenya and Ghent University, in Belgium.

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

"The medical profession on its own can not reverse this trend".

'Joint actions are urgently needed to stop unnecessary C-sections and enable women and families to be confident of receiving the most appropriate care for their circumstances'.

Mandy Forrester, head of quality and standards at the Royal College of Midwives, said it was important that women in the United Kingdom have access to all the available information on C-sections.

The authors suggested better education, more midwifery-led care and improved labour planning as ways of ensuring caesarean sections are performed only when medically necessary, as well as ensuring women properly understand the risks involved with the procedure. The situation has led gynecologists to question this "epidemic", as reported in a report published Friday in the British scientific journal The Lancet.

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