Medically Unnecessary C-Sections are on the Rise, Doctors Warn

A new study warns that the number of medically unnecessary c-sections is on the rise, raising the risk of serious health complications for new mothers and their children.

Researchers, publishing in the science journal The Lancet, report that the number of births by cesarean section has almost doubled, with 21 percent of all global births in 2015. In 2000, the number was only 12 percent. This data, pooled from 169 countries, is globally representative and shows a trend relevant to every part of the world.

C-sections appear to be favored in some parts of the world over others, however, and their frequency in some of the world’s poorest nations is alarming.

One of the countries with the highest rates of c-sections identified in this study is the Dominican Republic, where it accounts for around 58 percent of births. To give some sort of basis for how out of pace that is with actual health recommendations, the World Health Organisation notes  that the global consensus for acceptable c-section rates sits at around 10 to 15 percent. This figure is based on the clinical worth of c-sections, that is to say how many lives are saved based on this process of surgical intervention.

When c-sections account for up to 10 percent of births in a country, there tends to be decreased child mortality rate and improved health outcomes for mothers. Put simply, c-sections save lives. However, after that number reaches 10 to 15 percent of total births, there is no health benefit. As such, many c-sections are being carried out for no medical reason.

Why these Findings Matter

To understand why that is so concerning we may first need to understand what a c-section actually entails. The cesarean section procedure is typically used when delivering a baby the routine way has become unworkable, for example if the baby is in distress and must be delivered immediately, or if the baby has shifted in such a way as to make a vaginal birth difficult.

The procedure involves making incisions in a mother’s lower abdomen and then uterus, effectively creating an opening through which doctors can safely deliver the baby. Due to the nature of the procedure, c-sections are classed as major surgical interventions, and while their clinical worth as a means of saving a baby in distress is well evidenced, they carry some risks. These risks include bleeding, infection, blood clots, and perhaps most meaningful for nations who lack health infrastructure, increased risk of complications during future pregnancy and births.

C-sections can be a valuable clinical tool, and the study is quick to state that women who need a c-section should have access to it without delay. In areas of sub-Saharan Africa, for example, women who genuinely need c-sections appear to not be able to access them, the data found. However, the study raises questions about the multiple pressures doctors may face to provide c-sections, a trend that appears to be particularly noticeable in western countries like the United States where separate research confirms that one in every three births is a c-section.

“Pregnancy and labour are normal processes, which occur safely in most cases,” the lead author of the report, Doctor Marleen Temmerman of Ghent University in Belgium, told The Independent. “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. 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.”

How can we reduce c-section rates?

This is something that new guidance from the World Health Organisation is particularly interested in. It focuses on a number of key areas, including empowering women through education to know when c-sections are right for them and when there are other ways to manage pregnancy complications (in particular complications relating to prior birth trauma and anxiety) to avoid a c-section.

The World Health Organisation also advocates stricter guidelines on c-sections, for example audits on c-section rates in particular facilities and the use of a two-doctor system for signing off on c-sections.

These systems are specifically designed not to make access to c-sections harder for the women who need them but rather to safeguard women and children from the risks of medically unnecessary c-sections, which improves the health of both mother and child.

Related at Care2

Photo credit: Thinkstock.

62 comments

Carole R
Carole R7 days ago

You have to totally trust your doctors.

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Amparo Fabiana C

Thanks. It's the business pharma and malpractice legal cases.

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danii p
danii p9 days ago

tyfs

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danii p
danii p9 days ago

tyfs

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Leo C
Leo C10 days ago

Thank you for sharing!

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Leo C
Leo C11 days ago

Thank you for sharing!

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danii p
danii p12 days ago

Thanks for sharing.

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danii p
danii p12 days ago

Thanks for sharing.

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danii p
danii p12 days ago

Thanks for sharing.

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Emma L
Emma L12 days ago

Thank you for sharing

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