C-sec­tion births rise rapidly to more than 20% world­wide

Iran Daily - - Health -

Rates of ce­sarean sec­tion births al­most 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.

The re­search, pub­lished in The Lancet med­i­cal jour­nal, found that 60 per­cent of coun­tries overuse Csec­tions and 25 per­cent un­der-use them, sug­gest­ing that rec­om­men­da­tions for their use in cases of med­i­cal need are widely ig­nored, Reuters re­ported.

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.

Ex­perts es­ti­mate that be­tween 10 and 15 per­cent of births med­i­cally re­quire a C-sec­tion due to com­pli­ca­tions such as bleed­ing, fe­tal dis­tress, hy­per­ten­sion or a baby be­ing in an ab­nor­mal po­si­tion.

While the pro­ce­dure can save lives — of both moth­ers and new­borns — it can also cre­ate com­pli­ca­tions and side ef­fects, in­clud­ing higher risks for fu­ture births.

“The large in­creases in C-sec­tion use — mostly in richer set­tings for non-med­i­cal pur­poses — are con­cern­ing be­cause of the as­so­ci­ated risks for women and chil­dren,” said Mar­leen Tem­mer­man, an ex­pert from Aga Khan Uni­ver­sity in Kenya and Ghent Uni­ver­sity in Bel­gium who co-led the re­search.

She called on doc­tors, mid­wives and other health work­ers ‘to only in­ter­vene in this way when it is med­i­cally re­quired’.

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

It found that glob­ally, C-sec­tion use has in­creased by 3.7 per­cent a year be­tween 2000 and 2015 — ris­ing from 12 per­cent of live births in 2000, to 21 per­cent in 2015.

C-sec­tion con­tin­ues to be over used in North Amer­ica, Western Europe and Latin Amer­ica and the Car­ib­bean, where rates rose by around two per­cent a year be­tween 2000 and 2015 to 32 per­cent, al­most 27 per­cent and more than 44 per­cent re­spec­tively.

The pace of change var­ied widely be­tween re­gions, with rapid in­creases seen in South Asia and much slower rises in Africa.

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.

They said it was im­por­tant for women and health­care work­ers to un­der­stand the ‘small but se­ri­ous risks’ as­so­ci­ated with C-sec­tions, and en­sure they were used in cases med­i­cal need.

C-sec­tions have a more com­pli­cated re­cov­ery for the mother, they said, and lead to scar­ring of the womb, which is as­so­ci­ated with bleed­ing, ab­nor­mal pla­centa de­vel­op­ment, ec­topic preg­nancy, still­birth and preterm birth in sub­se­quent preg­nan­cies.

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


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