Trends and projections of caesarean section rates: global and regional estimates

Abstract

BackgroundThe caesarean section (CS) rate continues to increase across high-income, middle-income and low-income countries. We present current global and regional CS rates, trends since 1990 and projections for 2030.MethodsWe obtained nationally representative data on the CS rate from countries worldwide from 1990 to 2018. We used routine health information systems reports and population-based household surveys. Using the latest available data, we calculated current regional and subregional weighted averages. We estimated trends by a piecewise analysis of CS rates at the national, regional and global levels from 1990 to 2018. We projected the CS rate and the number of CS expected in 2030 using autoregressive integrated moving-average models.ResultsLatest available data (2010–2018) from 154 countries covering 94.5% of world live births shows that 21.1% of women gave birth by caesarean worldwide, averages ranging from 5% in sub-Saharan Africa to 42.8% in Latin America and the Caribbean. CS has risen in all regions since 1990. Subregions with the greatest increases were Eastern Asia, Western Asia and Northern Africa (44.9, 34.7 and 31.5 percentage point increase, respectively) while sub-Saharan Africa and Northern America (3.6 and 9.5 percentage point increase, respectively) had the lowest rise. Projections showed that by 2030, 28.5% of women worldwide will give birth by CS (38 million caesareans of which 33.5 million in LMIC annually) ranging from 7.1% in sub-Saharan Africa to 63.4% in Eastern Asia .ConclusionThe use of CS has steadily increased worldwide and will continue increasing over the current decade where both unmet need and overuse are expected to coexist. In the absence of global effective interventions to revert the trend, Southern Asia and sub-Saharan Africa will face a complex scenario with morbidity and mortality associated with the unmet need, the unsafe provision of CS and with the concomitant overuse of the surgical procedure which drains resources and adds avoidable morbidity and mortality. If the Sustainable Development Goals are to be achieved, comprehensively addressing the CS issue is a global priority.

Factors Associated with Successful Vaginal Birth After a Primary Cesarean Section in Women with an Optimal Inter-Delivery Interval

“…The rates of cesarean sections (CS) have increased worldwide and are projected to continue to increase, with countries in sub-Saharan Africa experiencing the lowest rates. 1 In the World Health Organization's most recent statement on CS, they advised that no region should have a CS higher than 10% and that CS should only be conducted when medically necessary, as CS can result in significant and permanent complications. 2 Although the CS rate in the Democratic Republic of Congo (DRC) is within the recommended CS rate, women in developing countries experience a higher rate of complications due to CS compared to women in developed countries.…”

Women's experiences of VBAC in Cyprus: a qualitative study

“…The interviews took place at the participants’ preferred place, were recorded by the researcher and lasted on average about 50 minutes. The interview questions were developed by the authors (C.K., E.H.) on the basis of the relevant literature [ 1 , 7 – 9 , 14 ] and consisted of four main open-ended questions and clarifying questions about VBAC experience (Table 1 ). The interview approach was semi-structured in order to avoid limitations and biases towards specific themes and to open ‘gate’ to themes that the women wished to discuss during the interview.…”

“…In the 21 st century there has been a global concern over the increase in the number of caesarean sections (CSs) as these have been associated with an increased perinatal mortality and morbidity [ 1 ]. The observed increase constitutes an important public health issue, with potential negative consequences on the health of both the mother and the newborn [ 2 ].…”

“…The observed increase constitutes an important public health issue, with potential negative consequences on the health of both the mother and the newborn [ 2 ]. While WHO recommends the ideal rate of CSs to be between 10-15% of all births [ 3 ], the CS rate has been increasing worldwide, with some countries exceeding 40% [ 1 ]. For example, the CS rate reached 58.1% in Dominican Republic, 55.5% in Brazil, 55.5% in Egypt and 53.1% in Turkey in 2015 [ 4 ].…”

Determinants of Successful Vaginal Birth After Caesarean Section at Public Hospitals in Ambo Town, Oromia Region, Central Ethiopia: A Case-Control Study

“…Worldwide, the CS rate is projected to be 28.5% by 2030. 1,2 Ethiopia's 2019 demographic and health survey showed that only 48% of births were in a health facility. 3 The overall prevalence of caesarean section in Ethiopia among those who gave birth at the health institutions was 29.55%, ranging from 11.03% to 63.75%.…”