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The number of women delivering by caesarean section has nearly doubled worldwide since 2000, reaching about 21 percent, according to new studies.
This is significantly higher than the 10% to 15% considered medically necessary, researchers said.
When complications develop, caesareans can save the lives of mothers and their babies. But the operation is not without risk and has been linked to difficulties for future births.
"The sharp increase in the use of caesareans – mainly in richer environments for non-medical purposes – is of concern because of the associated risks for women and children," said Dr. Marleen Temmerman, lead author of three studies published on October 11 The lancet.
Temmerman is professor of obstetrics and gynecology at the Aga Khan University in Nairobi, Kenya.
According to the study, caesareans worldwide increased by almost 4% per year between 2000 and 2015. This represents 16 million of the 132 million live births in 2000 and 30 million of the 141 million live births in 2015.
The fastest increase (6%) occurred in South Asia, where researchers reported that cesarean deliveries were underutilized in 2000 but overused 15 years later.
Caesareans were also overused in the United States, Canada, Western Europe, Latin America and the Caribbean, where rates increased by about 2% per year over the period 2000 to 2015.
In North America alone, births of caesareans rose from about 24% to 32% during this period, the study found.
Fifteen countries, including Mexico and Cuba, had caesarean section rates of over 40%.
Some women choose an unscheduled caesarean delivery because it allows them to avoid the pain and uncertain timing of natural work. Caesarean section is medically necessary when complications occur, such as bleeding, high blood pressure, or the baby is in an abnormal position in the womb, putting his mother or child at risk.
But the researchers found that the procedure was inaccessible to many women in low-income countries and overused in many middle- and high-income countries.
The study found that six out of ten countries do too much caesarean section and that a quarter actually do too little. In addition, there are big differences between the rich and the poor, the public and private sectors and between regions.
"In cases of complications, cesareans save lives and we need to improve accessibility in the poorest regions, making cesareans universally available, but we should not abuse them," Temmerman said in a statement. Press.
For the three studies, researchers used data from 169 countries from the World Health Organization's databases and from UNICEF. One study dealt with disparities around the world.
A second examined the harmful effects of overuse and underutilization of cesarean deliveries, and the third examined ways to limit unnecessary losses.
The publication of the three studies coincided with their presentation at a meeting of the International Federation of Gynecology and Obstetrics, which began Sunday in Rio de Janeiro, Brazil.
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