Global increased cesarean section rates and public health implications: A call to action

Abstract

Over the years; global caesarian section (CS) rates have significantly increased from around 7% in 1990 to 21% today surpassing the ideal acceptable CS rate which is around 10%-15% according to the WHO. However, currently, not all CS are done for medical reasons with rapidly increasing rate of nonmedically indicated CS and the so-called "caesarian on maternal request." These trends are projected to continue increasing over this current decade where both unmet needs and overuse are expected to coexist with the projected global rate of 29% by 2030. CS reduces both maternal and neonatal morbidity and mortality significantly when it is done under proper indications while at the same time, it can be of harm to the mother and the child when performed contrary. The later exposes both the mother and the baby to a number of unnecessary short and long-term complications and increase the chances of developing different noncommunicable diseases and immune-related conditions among babies later in life. The implications of lowering SC rate will ultimately lower healthcare expenditures. This challenge can be addressed by several ways including provision of intensive public health education regarding public health implications of increased CS rate. Assisted vaginal delivery approaches like the use of vacuum and forceps and other methods should be considered and encouraged during delivery as long as their indications for implementation are met. Conducting frequent external review and audits to the health facilities and providing feedback regarding the rates of CS deliveries can help to keep in check the rising CS trends as well as identifying the settings with unmet surgical needs. Moreover, the public especially expectant mothers during clinic visits and clinicians should be educated and be informed on the WHO recommendations on nonclinical interventions towards reduction of unnecessary CS procedures.

Prevalence and Associated Factors of Cesarean Section Delivery in Nepal

“…The adjusted odds ratio underscores a substantial association between the place of delivery and the possibility of undertaking a CS. This nding aligns with global trends where private health facilities often witness higher rates of cesarean sections (42), which may be in uenced by the perceived convenience of scheduled deliveries (43), patient demands (43)(44)(45), and potential nancial considerations (28,38,40).…”

Prevalence of post‐caesarean section surgical site infections in Rwanda: A systematic review and meta‐analysis

“… 1 Global rates of caesarean sections (CSs) have risen dramatically over time, from about 7% in 1990 to 21% in 2023, above the WHO's recommended range of 10%–15%. 2 Depending on where a woman lives in the world, there are major differences in her access to caesarean sections. Only 5% of women in sub‐Saharan Africa gave birth via caesarean section, compared with 63% in Eastern Asia, 54% in Latin America and the Caribbean, 50% in Western Asia, 48% in Northern Africa, 47% in Southern Europe and 45% in Australia and New Zealand.…”

Yoğun Bakım Ünitesinde Ağrının Giderilmesinde Güncel Yaklaşımlar

“…Dünya geneline bakıldığında sezaryen oranlarının yıllar içerisinde artış gösterdiği görülmektedir. Küresel sezaryen oranları 1990 yılında yaklaşık %7 iken bugün %21 gibi bir oranla önemli ölçüde artış olduğu görülmüştür (Angolile, 2023). Ülkemizde de sezaryen oranındaki hızlı artış dikkat çekicidir.…”