Saturday, 17 November, 2018

Number of babies born through C-section double globally since 2000

Britain is among the highest users in Western Europe Britain is among the highest users in Western Europe Credit Telegraph
Samantha Long | 14 October, 2018, 22:37

It says there is an over-reliance on Caesarean section procedures - when surgery is used to help with a hard birth - in more than half of the world's nations.

Fifteen nations, including Mexico and Cuba, had C-section rates that topped 40 percent.

While c-sections can undoubtedly be a life-saving procedure, a new series of three papers reveals the surgery is being dangerously overused in middle- and high-income countries.

The study says that there is also emerging evidence that a C-section birth can subtly affect the health of a child, affecting their hormonal, physical and bacterial exposures during birth, which may increase the risk of allergies and asthma later in life.

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 worldwide coalition of researchers from the World Health Organization, Yale University, King's College London and elsewhere.

In 15 countries, more than 40% of births are by C-sections.

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).

It is estimated that 10-15 per cent of births medically require surgery due to complications such as bleeding, foetal distress, hypertensive disease. In China, C-section rates diverged from 4 per cent to 62 per cent in India the range was 7-49 per cent. In addition, say the researchers, fear of labor may be fueling patients' requests for C-sections.

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These include 'a lack of midwives to prevent and detect problems, loss of medical skills to confidently and competently attend a vaginal delivery, as well as medico-legal issues'.

"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.

Globally, C-section use has increased by 3.7% each year between 2000-2015 - rising from 12% of live births (16 million of 131.9 million) in 2000, to 21% of live births (29.7 million of 140.6 million) in 2015.

They said it is important to note there are small but serious risks with C-sections, and that each of these risks increases the more times a woman has the procedure.

Researchers, who used World Health Organisation (WHO) and Unicef data from 169 countries, also found significant disparities within low and middle-income countries, where the wealthiest women were six times more likely to have a C-section compared with the poorest women.

While often lifesaving, C-sections aren't without risks, cautions the Lancet report. Further, WHO also created recommendations for reducing unnecessary c-sections.

The authors are recommending more education about childbirth for expectant parents and revised surgical guidelines for health-care professionals to help reverse the trend. "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".

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