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

Britain is among the highest users in Western Europe

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.

A special series of three papers published in The Lancet reveal the alarming rate of c-section births worldwide, and focuses on the optimization of c-section use. The South Asia region has seen the most rapid increase in use (6.1% per year), with C-section being underused in 2000 but being overused by 2015 (increasing from 7.2% of births via C-section to 18.1%). That translates to 16 million of the 132 million live births in 2000 and 30 million of the 141 million live births in 2015.

However, it is estimated that between 10% and 15% of all the cesarean section births are necessary for medical reasons.

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).

The nation with the highest rate for using the surgery to assist childbirth is the Dominican Republic with 58.1%.

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.

"More research is needed to understand the high frequency of C-section use and its determinants in some countries, and the very low use of C-section in other countries, to provide a more solid basis for interventions towards an optimal frequency of C-section use for mothers and children", the authors write.

In the article, the World Congress of Gynecology and Obstetrics in Brazil puts forward several hypotheses as to the reasons for this "epidemic", including a decline in the competence of the medical profession to accompany a potentially hard childbirth by natural means, the comfort of scheduling day births, and more attractive rates for doctors and clinics in case of caesarean section.

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What are the risks associated with c-section births?

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 reproduction of the story/photograph in any form will be liable for legal action.

She adds that financial incentives exist for both doctor and hospital with the certainty of planned day-time deliveries, especially in private practices.

The study warned that in many settings, young doctors were becoming "experts" in caesarean births while losing confidence in their abilities when it comes to natural births. But there are wide interstate disparities, with 49% of live births in Andhra Pradesh taking place through C-section, compared to just 7% in Nagaland. "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".

In the USA, the C-section rate is even higher than the global average, making up 25 percent of births.

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 procedure scars the womb, which can lead to bleeding, ectopic pregnancies (where the embryo is stuck in the ovaries), as well as still- and premature future births. "In Brazil, for example, the free public healthcare system is of poorer quality and pregnant mothers who can't afford private healthcare might be offered the procedure to help clear patients more quickly through the system".

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