Pregnancy blog, 12/10/2018
Recent analysis shows that 21% of births globally are c-section births. Although The World Health Organisation states that “Every effort should be made to provide caesarean sections to women in need, rather than striving to achieve a specific rate”, it is thought that c-sections are medically required in only 10-15% of births.
Why would a c-section be “medically required”?
C-sections can be a life-saving intervention for women and babies when complications occur, including:
- if baby is distressed
- hypertension diseases such as pre-eclampsia
- babies in an abnormal position, for example breech.
However, it is still major abdominal surgery which carries risks for mum and baby and can cause complications in future pregnancies.
C-section rate almost doubled between 2000-2015
According to a series of 3 papers published in The Lancet, the number of babies born by c-section rose from 12% in 2000 to 21% in 2015 across the globe. With the UK rate rising from 20% of births in 2000 to 26% in 2015.
Data also showed that c-sections are still not an option in many low-income countries, even where it would be safer to do so, and is potentially ‘overused’ in in higher-income areas.
Countries where the c-section rate exceeds 40%:
C-section use (%)
Year data point
Venezuela (Bolivarian Republic of)
Iran (Islamic Republic of)
“It is widely documented that maternity services around the world differ dramatically. It depends on many different socio-economic factors, as shown clearly in the Lancet series. In an ideal world, women should be able to receive the same levels of maternity care regardless of where they are in the world. It should be about getting the balance right.” Jo, Tommy’s midwife
Brazil and China have a particularly high use of c-sections, and the series authors found that most were low-risk pregnancies or where the woman had a previous a c-section.
Benefits and risks of having a c-section
“Given the increasing use of C-section, particularly cases that are not medically required, there is a crucial need to understand the health effects on women and children. 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. 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.” Professor Jane Sandall, King’s College London
Find out more about the benefits and risks of having a c-section.
Reasons why women are asking for a c-section:
- past negative experiences of vaginal birth
- fear of labour
- fear of the possible physical side effects of labour, such as pelvic floor damage, urinary incontinence, reduced quality of sexual feeling.
Although these reasons are not deemed “medically required” they are real concerns for women based on past experience, the varying information available and the portrayal of birth in the media.
As such, the Lancet Series authors have called for more research into the effectiveness of certain support options for expectant mums, such as relaxation training, childbirth training workshops, educational lectures and brochures, and face-to-face meetings with health professionals to encourage supportive relationships.
“The decision to have a c section should be an informed one and on a case by case basis. Women should be given the opportunity to be fully informed of the benefits and risks of having a c section, then they can give their full informed consent and can ask questions as and when they need to.” Jo, Tommy’s midwife
Information about c-sections
More information about the Lancet Series
The research was conducted by teams from:
- University of Manitoba
- London School of Hygiene & Tropical Medicine
- Federal University of Pelotas
- Catholic University of Pelotas
- World Health Organization
- Sichuan University
- Ministry of Health
- Aga Khan University
- Ghent University
- University of Central Lancashire
- São Paulo Federal University
- Shanghai Jiao Tong University
- Uganda Martyrs University
- St Francis Hospital Nsambya
- King’s College London
- University of Papua New Guinea
- Port Moresby General Hospital
- International Federation of Gynecology and Obstetrics (FIGO)
- Burnet Institute
- Yale University.
You can read more about it on the Lancet website.Hide details
Now I'm in the third trimester I have to remind myself to be more cautious. This is frustrating as lockdown is easing at the time I need to be extra careful!
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