One in five of all childbirths (about 25 per cent) across the world are through caesarean section, a trend that is going to increase over the coming decade with nearly a third of all births likely through C-Section by 2030.
Though a caesarean section can be essential and lifesaving surgery, it could put women and babies at unnecessary risk of short- and long-term health problems if performed without the need for a medical need. The World Health Organization cautioned this in its latest research work published recently.
WHO’s Department of Sexual and Reproductive Health and Research and the UN joint programme director Dr Ian Askew opined that unnecessary surgical procedures could be harmful, both for the mother and the baby.
C-Section is critical to save lives in situations where vaginal deliveries would pose risks. “So all health systems must ensure timely access for all women when needed,” he said and added that prolonged labour, obstructed labour, foetal distress or when the baby is presenting in an abnormal position necessitated C-Section. “ However, as with all surgeries, they can have risks. These include the potential for heavy bleeding or infection, slower recovery times after childbirth, delays in establishing breastfeeding and skin-to-skin contact, and increased likelihood of complications in future pregnancies,” he said.
The WHO said that caesarean section rates raised from around seven per cent in 1990 to 21 per cent. If the trend continues, the health organisation said that by 2030 the highest rates are likely to be in Eastern Asia (63%), Latin America and the Caribbean (54%), Western Asia (50%), Northern Africa (48%) Southern Europe (47%) and Australia and New Zealand (45%).
The WHO said that about eight per cent women in least developed countries gave birth by caesarean section. In Latin America and the Caribbean, the C-section rates stand high with almost 4 in 10 of all births through this procedure. The study shows that caesarean sections in Dominican Republic, Brazil, Cyprus, Egypt and Turkey outnumber normal deliveries.
WOMEN CENTERED CARE
The health organisation called for several drivers such as health sector policies and financing, perceptions and practices, cultural norms, rates of preterm births and quality of healthcare.
The WHO wants to focus on each woman’s unique needs in pregnancy and childbirth rather than recommending specific target rates. The mothers should get the opportunity to talk to healthcare providers and be part of the decision making on their birth. They should have adequate information about the risks and benefits of C-section.
Non-clinical actions that can reduce unnecessary use of caesarean sections:
- Educational interventions that engage women actively in planning for their birth.
- Relaxation programmes and psychosocial support
- Requirement for a second medical opinion for a caesarean section decision in settings where this is possible.
- For the sole purpose of reducing caesarean sections, some interventions have been piloted by some countries but require more rigorous research:
- A collaborative midwifery-obstetrician model of care, for which care is provided primarily by midwives, with 24-hour back-up from a dedicated obstetrician
- Financial strategies that equalize the fees charged for vaginal births and caesarean sections.