The World Health Organisation Has Called For a Reduction in C-Sections

Surgery in progress. /COURTESY

Surgery in progress. /COURTESY

The 33 per cent increase comes despite years of a natural birth campaign in many NHS hospitals, which still sees women occasionally denied the treatment at three-quarters of maternity units.

The study has already prompted responses from countries, with the Minister of Health of Brazil Gilberto Magalhães Occhi releasing a new country-wide strategy alongside the study to try and reduce the use of C-sections and ensure quality maternal health care.

C-sections may be marketed by clinics as the "easy" way to give birth, but they are not without risks. "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 Series lead Marleen Temmerman from Aga Khan University in Kenya and Ghent University.

Researchers reported a rate of more than 50% in the Dominican Republic, Brazil, Egypt and Turkey, though Brazil implemented a policy in 2015 to reduce the number of Caesarean sections performed by doctors.

The authors found that the global increases in C-section use are attributed both to more births taking place in health institutions (about two-thirds of the increase) and to greater frequency of intervention through C-section in health facilities (one-third of the increase).

While the series found 25 percent of countries underuse c-sections, 60 percent of countries were found to overuse it.

Authors pointed out that while the procedure is generally over-used in many middle- and high-income settings, women in low-income situations often lack necessarily access to what can be a life-saving procedure.

Over the past 15 years, this surgical intervention has nearly doubled surging from 12% to 21%, between 2000 and 2015, even exceeding 40% in some countries, as revealed in the recent study's report, issued today in the Lancet journal.

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The information was published by the Lancet in a series of three papers, covering the reasons for the rising use of caesareans around the world, the long-term health risks associated with C-sections, and possible interventions to lower procedure rates.

It is estimated that about 10 to 15 percent of births require c-section due to various complications such as hypertension, bleeding, fetal distress, problems with the placenta, problems with the umbilical cord, or when the baby is at an abnormal position.

The study found C-sections were overused in North America, Western Europe, Latin America, South Asia and the Caribbean and underused in parts the west and central Africa region.

Jane Sandall, professor of social science and women's health at King's College London and a study author, said that there were a variety of reasons women were increasingly opting for surgery.

"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".

China and Brazil have particularly high rates, with most c-sections being used in low-risk pregnancies and among women who have received the surgery before.

However, it notes a link with the level of income and education of women.

Some medical professionals also have strong financial incentives to push for surgery and are less likely to be sued after an elective c-section.

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