Caesarean births at epidemic levels in some nations: Docs

Surgery in progress. /COURTESY

Surgery in progress. /COURTESY

C-sections can save the lives of women and babies when there are birth complications such as fetal distress, or abnormal positioning.

Worldwide Caesarean section use has almost doubled in two decades and has reached "epidemic" proportions in some countries, doctors warned Friday, highlighting a huge gap in childbirth care between rich and poor mothers.

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.

The authors suggested better education, more midwifery-led care and improved labour planning as ways of ensuring C-sections are only performed when medically necessary, as well as ensuring women properly understand the risks involved with the procedure.

While the USA saw more than a quarter of all births performed by C-section, some states used the procedure more than twice as often as others.

"In cases where complications occur, cesareans save lives, and we need to promote women's access [to this intervention] in poor areas, but we should not abuse it".

A new study has found that the number of births through caesarean section has nearly doubled globally since 2000.

Common reasons why women request C-sections include past negative experiences of vaginal birth, fear of labor pain or of the effects of labor such as pelvic floor damage, incontinence and reduced sexual function.

The number of C-section births around the world has almost doubled since 2000, and only a fraction of those surgical procedures are medically necessary, according to a series of three papers published today by an global coalition of researchers from the World Health Organization, Yale University, King's College London and elsewhere.

Of the 169 countries included in the study 15 of them, including Mexico, Brazil, and Turkey, have C-section use that exceeds 40 per cent of births, with the Dominican Republic having the highest figure worldwide with 58.1 per cent of births.

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Improvements have been slow across sub-Saharan Africa (around 2% per year), where C-section use has remained low, increasing from 3% to 4.1% of births in West and Central Africa, and from 4.6% to 6.2% in Eastern and Southern Africa.

But in close to a quarter of nations surveyed, caesarean section use is significantly lower than average.

The Lancet researchers point to several possible reasons for the rise: Younger doctors who perform C-sections may lose confidence in completing vaginal deliveries, driving up the surgery rate over time.

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.

"C-section is a type of major surgery, which carries risks that require careful consideration".

But the procedure can lead to scarring of the womb, which heightens the risk of complications during future births, such as from bleeding, abnormal development of the placenta, ectopic pregnancy, stillbirth and preterm birth.

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

Emeritus Professor Gerard Visser, of University Medical Centre Utrecht in the Netherlands, and chairman of FIGO's Committee for Safe Motherhood and Newborn Health, said: "Worldwide there is an alarming increase in caesarean section rates. Joint actions with governmental bodies, the health care insurance industry, and women's groups are urgently needed to stop unnecessary C-sections and enable women and families to be confident of receiving the most appropriate obstetric care for their individual circumstances".

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

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