Sky-high Caesarian Section Rates in the World

Caesarean section is one of the most common surgeries in the world, with rates continuing to rise, particularly in high- and middle-income countries. Although it can save lives, caesarean section is often performed without medical need, putting women and their babies at-risk of short- and long-term health problems. A statement from the World Health Organization (WHO) underscores the importance of focusing on the needs of the patient, on a case by case basis, and discourages the practice of aiming for “target rates.”Caesarean section may be necessary when vaginal delivery might pose a risk to the mother or baby – for example due to prolonged labour, foetal distress, or because the baby is stuck in an abnormal position. However, caesarean sections can cause significant complications, disability or death, particularly in settings that lack the facilities to conduct safe surgeries or treat potential complications.

Ideal rate for caesarean sections

Since 1985, the international healthcare community has considered the “ideal rate” for caesarean sections to be between 10% and 15%. New studies reveal that when caesarean section rates rise towards 10% across a population, the number of maternal and newborn deaths decreases. But when the rate goes above 10%, there is no evidence that mortality rates improve. There are wide variations in Caesarean section rates across the world, indicating a lack of consensus about the best way of delivering babies.

In countries where cesarean deliveries are currently below 15 percent, there is an improvement in infant, neonatal and maternal mortality and low birth rate with increases in the cesarean rate. In countries where cesarean deliveries are greater than 15 percent, the increasing rates are not associated with these health improvements and can be associated with harm. In middle and higher income countries, substantial decreases in health risks and costs can be achieved through reduction of unnecessary cesarean deliveries.

Countries with the highest CS Rates in each Region:
1). Brazil (55.6%) and Dominican Republic (56.4%) in Latin America and the Caribbean
2). Egypt (51.8%) in Africa,
3). Iran and Turkey in Asia (47.9% and 47.5%, respectively),
4). Italy (38.1%) in Europe, 
5). United States (32.8%) in Northern America,
6). New Zealand (33.4%) in Oceania. 

In Egypt, according to the latest data, more than half of all women give birth by CS without much difference between urban and rural areas. In China, choosing the date of the baby’s delivery on the basis of luck and fate for the future of the baby by some people is one of the explanations for scheduling a CS. On the other hand, several European countries have managed to control their CS rates over time. It is noteworthy that Finland has one of the lowest increases not only in Europe but among all countries included in this analysis.Japan (19.8 per cent) among the lowest in Asia.

Around one in four births in the UK is by c/s, while in Cyrus the figure is 52% and in Sweden 17%. The United States has a very high rate of cesarean delivery, one in three births happen by c/s, or 1.3 million babies born via surgery (32.8%). A study in France found more cesarean sections were performed in for-profit hospitals than in public hospitals, which treat more complicated pregnancies, suggesting that financial incentives may also play a role in explaining excess cesarean deliveries.

Betrán, A. P, Ye, J., Moller, A-B., Zhang, J., Gülmezoglu, A. M., & Torloni, M. R. (2016). The increasing Trend in Caesarean Section Rates: Global, Regional and National Estimates: 1990-2014. PLoS ONE,11(2):e0148343. doi:10.1371/journal.pone.0148343. http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0148343

Health at a Glance:  OECD INDICATORS. (2013). Retrieved from website:http://www.oecd.org/els/health-systems/Health-at-a-Glance-2013.pdf