According to a study by The Lancet, the number of births by cesarean section is on the rise, climbing from about 16 million (12.1% of all births) in 2000 to 29.7 million (21.1% of all births) in 2015.
The study’s first author, Dr. Ties Boerma, told CNN, “We knew that globally, C-section rates were increasing for quite some time now, but that now more than one in five babies are delivered by C-section is striking.”
Dr. Ana Pilar Betran, medical officer at WHO Department of Reproductive Health and Research said, “It is crucial that women who need caesarean sections are able to access this potentially life-saving procedure, but equally unnecessary procedures should be avoided, so that the lives and well-being of women and their babies are not put at risk.”
According to CBS News, for the three studies, researchers used data from 169 countries in World Health Organization and UNICEF databases. One study dealt with disparities around the world. A second looked at the harms of overuse and underuse of cesarean delivery, and the third at ways to curb unnecessary ones.
The World Health Organization released new guidelines on non-clinical interventions to reduce unnecessary caesarean sections and the key recommendations include:
- Educational interventions for women and families to support meaningful dialogue with providers and informed decision-making on mode of delivery (i.e. providing childbirth training workshops for mothers and couples, relaxation training programmes led by nurses, psychosocial couple-based prevention programmes, psychoeducation for women with fear of pain or anxiety).
- Use of clinical guidelines, audits of caesarean sections, and timely feedback to health professionals about caesarean section practices.
- Requirement for second opinion for caesarean section indication at point of care in settings with adequate resources.
- Some interventions aimed at health organizations are recommended only under rigorous research such as collaborative midwifery-obstetrician model of care (i.e. a model of staffing based on care provided primarily by midwives, with 24-hour back-up from an obstetrician who provides in-house labour and delivery coverage without other competing clinical duties) or financial strategies (i.e. insurance reforms equalizing physician fees for vaginal births and caesarean sections).