Caesarean study reveals potential harm of rising trend

UNICEF/Noorani

More lives could be saved in poorer countries through better access to caesarean section, the World Health Organization (WHO) said Friday.

At the same time, the UN health agency also cautioned against unnecessary caesareans in richer countries, since it can increase the risk of complications for women and their babies.

Doctors and hospitals often promote the operation as it "makes their lives easier", said WHO's Dr Marleen Temmerman, who insisted that mothers should be told about the risks associated with the procedure.

Daniel Johnson has more.

New data released by the World Health Organization shows that when caesarean rates rise to 10 per cent of women, the number of maternal and newborn deaths drops.

But go above this level and there's no benefit, according to WHO's Dr Marleen Temmerman, who warned against "an epidemic of caesarean section" in middle-income and rich countries.

The findings are particularly important for developing countries where complications such as prolonged labour, birth asphyxia and stillbirths could be avoided, Dr Temmerman said.

"Out there in reality, we are still dealing with a number of countries or regions where women have no, or almost no, access to safe delivery care, and no access to caesarean section, and in those countries we see women dying because of not having access."

In Brazil, some 45 per cent of women now opt for the procedure, WHO said.

In Europe, the level has risen from 15 to 22 per cent in the last 20 years.

Caesareans have become increasingly popular in the last 45 years as medical advances have made the procedure safer.

It's also made gynaecologists' lives easier, Dr Temmerman said, as they can perform two caesarians in the morning and not have to worry about emergencies or working late.

The arrangement suited hospitals too, the WHO expert said.

She added that mothers-to-be also pushed for the procedure, especially in countries where it wasn't done for "women of stature" to give birth naturally.

"Caesarean is a safe operation and we are very happy, but it also has a lot of consequences on health; you have a higher risk of bleeding because the placenta will in a number of women give problems with bleeding in the scar of the caesarean section of the last pregnancy, so you have a harmful complication – serious ones – for the women and for the baby. And even in developed countries if you see maternal mortality it is linked, not the only reasons, but it is linked to increased caesarean rates."

Dr Temmerman called for hospitals and doctors to tell women about the pros and cons of the procedure, which should be available where there was a good medical reason for it.

Daniel Johnson, United Nations

Duration: 2'15"

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