A recent analysis of worldwide Cesarean delivery rates found that the optimal cesarean delivery rate in relation to maternal and neonatal mortality was approximately 19 cesarean deliveries per 100 live births (national cesarean delivery rates of up to 19 per 100 live births were associated with lower maternal or neonatal mortality among WHO member states). The new analysis also found that higher cesarean delivery rates were not correlated with maternal or neonatal mortality at a country level.
The new analysis suggests that the optimal cesarean delivery rate is higher than the rate previously estimated by the World Health Organization (WHO): the WHO had previously recommended that population-level cesarean delivery rates should not exceed 10% to 15%, based on the observation that some countries with the lowest perinatal mortality rates had cesarean delivery rates that were less than 10 per 100 live births.
The authors who reported on the recent analysis stated that prior studies that had suggested that lower cesarean delivery rate thresholds were optimal for maternal and neonatal mortality were incomplete because those studies examined data from limited sets of countries (no study had cesarean delivery rate data for all 194 WHO member states) and the prior studies often examined outcomes in wealthier countries. Also, many of the prior studies had used data from varying years, without accounting for heterogeneity across years.
The new analysis used available data from 172 countries and included data estimated for a single year (2012). The new study also analyzed cesarean delivery rates for all WHO member states. However, the new study had certain limitations, including that cesarean delivery rate data were obtained from many different sources, cesarean delivery rates were not available for the year 2012 for 113 countries, cesarean delivery data were not available for 22 countries for any of the years studied (the rates were estimated using regression models), and most of the countries studied had cesarean delivery rate information from sources commonly used in policy decisions and research studies.
Cesarean Delivery Statistics
In developing countries, cesarean delivery rates in urban areas are up to three times higher than in rural districts. There are large absolute differences in cesarean delivery rates based on wealth within countries. In the United States, the variation in cesarean deliveries at the hospital level ranged from 7.1 to 69.9 per 100 lives births in 2009 (the contribution of patient factors to the large variation of cesarean deliveries in the United States was small, as evidenced by the wide variability of cesarean delivery in lower-risk pregnancies).
The authors who conducted the recent analysis concluded that their findings highlight a significant correlation between cesarean delivery rate and lower mortality that merits attention in the development of policy to strengthen surgical components of health systems. They note that cesarean delivery is lifesaving for obstructed labor and other emergency obstetrical conditions but also warn that as a surgical procedure, there are risks of complications and overuse that can be harmful to both mothers and neonates.
If you or a loved one suffered serious harm as a result of a cesarean 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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