A study published in the medical journal The Lancet on October 13, 2018 found that Cesarean section deliveries (“CS”) nearly doubled worldwide from 2000 to 2015, based on data from 169 countries that include 98.4% of the world’s births. The study estimated that 29.7 million births occurred through CS in 2015, compared to 16.0 births through CS in 2000.
The study found a high of CS (44.3%) in the Latin America and Caribbean region, and a low of CS (4.1%) in the west and central Africa region. In low-income and middle-income countries, births in households in the wealthiest quintile had almost five times more frequent CS use than those in the poorest quintile. Within large-population countries, CS use between regions and provinces often differed by a factor of at least five.
The global increase in CS use between 2000 and 2015 was driven by increases in the proportion of births occurring in health institutions (accounting for 66.5% of the increase) and an increase in CS use within health institutions (accounting for 33.5% of the increase). CS was used in more than 15% of births in 106 (63%) of the 169 countries assessed, whereas in 48 (28%) countries, CS was used in less than 10% of births. The proportion of births by CS was significantly higher in countries with higher levels of socioeconomic development, higher net female enrollment in secondary education, higher levels of urbanization, greater density of physicians, and lower fertility.
In North America, 32.0% of the live births were by CS in 2015, compared to 24.3% in 2000. The study stated that CS use has increased during the past 30 years to a frequency in excess of the proportion of 10–15% of births that is thought to be optimal, and that the increase in use has been driven by major increases in non-medically indicated CS in many middle-income and high-income countries.
The study’s key messages were:
– CS can save women’s and infants’ lives and should be universally accessible. However, the large increase in CS use, often for non-medical indications, is of concern given the risks for both women and children.
– CS use is increasing in all regions and, in 2015, more than one in five live births were by CS. In most countries, CS use has reached a frequency well above what is expected on the basis of obstetric indications. Within-country CS use is often particularly high among wealthier women and in private facilities.
– By contrast, inadequate access to CS is still a major issue in most low-income and several middle-income countries, especially in sub-Saharan Africa and among the poorest women. The low use of CS implies that women and babies are at much higher risks of dying because they cannot access lifesaving surgery during childbirth.
– Optimization of CS use is needed, underpinned by a better understanding of demand and supply factors that drive the overuse of CS and by greater efforts to ensure universal access to CS for all women.
If you or a loved one suffered serious harm as a result of a cesarean section delivery (or the failure to timely and properly perform a cesarean delivery) in the United States, you should promptly find a birth injury lawyer in your U.S. state who may investigate your birth injury claim for you and represent you and your child in a birth injury case, if appropriate.
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