Worldwide, the proportion of babies delivered by caesarean section (C-section) has nearly doubled in the past decade and a half, and a worrying number of these procedures were performed unnecessarily, according to new research published in The Lancet. At the same time, the international team behind the paper found that many low-income nations and regions still lack adequate access to the surgery, which is often necessary to save the life of the child and the mother when pregnancy complications arise.
“Pregnancy and labour 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,” lead author Dr Marleen Temmerman said in a statement. “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.”
Using healthcare data from 169 countries that account for over 98 percent of the world’s births, Dr Temmerman and her colleagues calculated that, overall, C-sections were performed in approximately 21 percent of births (29.7 million) in 2015, compared to about 12 percent (16 million) in 2000. Past medical studies have suggested that 10 to 15 percent of deliveries require a C-section, yet 63 percent of countries showed C-section rates well above this threshold. The majority of these procedures were found to be performed for low-risk deliveries and for women who had previously had C-sections (which can make a subsequent vaginal delivery dangerous).
Alarmingly, there were at least 15 nations in which 40 or more percent of babies were born via C-section. The top spot went to the Dominican Republic (58 percent), followed by Brazil and Egypt (both 55.5 percent).