Published: Sun, October 14, 2018
Medicine | By Brett Sutton

Births by C-secs doubled between 2000 & 2015: Lancet

Births by C-secs doubled between 2000 & 2015: Lancet

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

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, researchers said.

In low and medium-income countries, C-sections were nearly five times more frequent in births among the richest quintile versus the poorest quintile.

Researchers said 60 per cent of countries were overusing the procedure and 25 per cent underusing it, suggesting wide disparities in how the clinical recommendations are being followed.

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.

However, a surge in C-section births is also on the rise across North America (32%) and Western Europe (27%).

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 large increases in C-section use - mostly in richer settings for nonmedical purposes - are concerning because of the associated risks for women and children", said Dr. Marleen Temmerman, lead author of three studies published October 11 in The Lancet.

In at least 15 countries C-section use exceeds 40 per cent, researchers said.

More than half of all births are carried out with C-section in Brazil, Egypt and Turkey, while in parts the west and central Africa region the procedure was used in only 4.1 percent of births.

In France, the rate of caesarean section (20.4% in 2016) remains stable since 2010, "which suggests a general attitude tending to limit the achievement of this intervention", notes the latest perinatal survey published by the Ministry of Health.

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.

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.

Some of the possible risks associated with c-sections may include bleeding, blood clots, surgical injuries to the mother's organs, infection, injury to the child, increased risks in future pregnancies, adverse reactions to medications, and breathing problems for the child especially when born before 39 weeks of pregnancy.

"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, ' said Sandall.

"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".

According to a study published today in the Lancet journal, it would be easier for wealthy women to give birth via cesarean sections. "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". However, the trends reveal that more and more childbirths are being done via c-section, regardless of whether it is necessary or not.

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