According to a series of reports published in The Lancet, the number of babies born through caesarean section (C-section) nearly doubled between 2000 and 2015, jumping from 12 percent to 21 percent. Wide disparities have been found in the use of C-sections between rich and poor regions of the world.
The researchers have determined that 60 percent of countries are overusing C-sections, while 25 percent of countries are underusing the life-saving procedure, particularly in low-income regions where it is still unavailable.
The study authors are urging both healthcare professionals and the public to only intervene with a C-section when it is medically required.
C-section is a procedure that is used for women and newborns when life-threatening complications arise such as bleeding, fetal distress, hypertensive disease, and when babies have moved into an abnormal position. The surgery, however, comes along with its own risks and can cause problems in future births.
An estimated 10-15 percent of all births require a C-section due to complications, which indicates that average C-section use should fall within this range. However, the research revealed that 28 percent of countries had usage levels below the estimated need and 63 percent had usage levels that fell above this range. In addition, C-section use was found to exceed 40 percent in at least 15 countries.
“Pregnancy and labor are normal processes, which occur safely in most cases. 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. C-sections can create complications and side effects for mothers and babies, and we call on healthcare professionals, hospitals, funders, women and families to only intervene in this way when it is medically required,” said Dr. Temmerman.
“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.”
According to the researchers, there are no benefits of C-section in cases without a medical indication. Furthermore, the procedure can cause harm and even death to women and children, especially when there are not sufficient facilities, skills, and health care available.
The risk of maternal death and disability is higher after C-section compared to vaginal birth. These procedures make recovery more complicated for the mother and also lead to scarring of the womb, which is associated with major risks in subsequent pregnancies including ectopic pregnancy, stillbirth, and preterm birth.
The study authors said that while these risks are small they are also very serious, and each of these risks increases as a woman has more C-sections.
“Given the increasing use of C-section, particularly cases that are not medically required, there is a crucial need to understand the health effects on women and children,” explained Professor Jane Sandall of King’s College London. “Greater understanding of this is important to help inform decision making by families, physicians, and policy makers. C-section is a type of major surgery, which carries risks that require careful consideration.”
“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.”
The research was presented at the International Federation of Gynecology and Obstetrics (FIGO) World Congress in Brazil.