C-section births rise rapidly to more than 20% worldwide, research finds

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They said it can be a life-saving intervention for women and newborns when complications occur, such as bleeding, foetal distress, hypertensive disease, and babies in abnormal position, but the surgery is not without risk for mother and child, and is associated with complications in future births.

Evidently, between the year 2000 and 2015, the rate of c-section births increased from 12 percent to 21 percent, with those in richer countries overusing it and those in poorer countries continue to have little access to a possibly life-saving procedure.

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.

However, the Series authors estimate that more than one in four countries in 2015 had lower levels (28 per cent), while most countries used C-section above the recommended level (63 per cent).

The study has already prompted responses from countries, with the Minister of Health of Brazil Gilberto Magalhães Occhi releasing a new country-wide strategy alongside the study to try and reduce the use of C-sections and ensure quality maternal health care.

Of the 6.2 million unnecessary C-sections performed annually, half were in Brazil and China.

Cesarean delivery, a surgical procedure in which a baby is born via incisions in the uterus and abdomen, now accounts for 21 percent of all births around the world, according to the new findings, compared to just 12 percent 18 years ago.

In North America, researchers found that C-sections are used in approximately 32 per cent of births, up from 24.3 per cent in 2000, with the United States at 32.9 per cent, and Canada at 26 per cent, up from 20.9 per cent in 2000.

Improvements have been slow across sub-Saharan Africa (around 2% per year), where C-section use has remained low, increasing from 3% to 4.1% of births in West and Central Africa, and from 4.6% to 6.2% in Eastern and Southern Africa.

"There is emerging evidence that babies born via C-section have different hormonal, physical, bacterial and medical exposures during birth, which can subtly alter their health".

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But in close to a quarter of nations surveyed, caesarean section use is significantly lower than average.

Researchers suggest that these disparities may be explained by persistent issues with shortages in healthcare facilities and staff in vulnerable and rural areas - a weakness they say needs to be addressed.

But experts also warn that the increase in C-sections needs to come alongside a greater awareness of the health risks that accompany the procedure.

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

"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".

The Lancet study, based on data collected by World Health Organization and UNICEF, does not explain this staggering increase in caesarean sections in some countries.

Dr Jane Sandall, professor of social science and women's health at King's College London and a study author, said there were a variety of reasons for women increasingly opting for surgery.

"Greater understanding of this is important to help inform decision making by families, physicians, and policy makers".

Prof Sandall says it is important to note that these are small but serious risks, but each of these risks increases with each time a woman undergoes the surgery.

"What is left unresolved are the tensions generated when women's agency in choosing a caesarean section go against medical directives to intervene against them", says a Lancet editorial published along with the series.

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