rising rates of c-sections globally

Introduction

The global rise in Caesarean section (C-section) rates has become a significant public health concern. This trend is observed across high-income, middle-income, and low-income countries, with varying rates and contributing factors. Understanding the reasons behind this increase is crucial for developing strategies to optimize the use of C-sections and address associated health risks.

Key Insights

Global and Regional Trends:
- C-section rates have increased globally from 6.7% in 1990 to 19.1% in 2014, with the highest rates in Latin America and the Caribbean (40.5%) and the lowest in Africa (7.3%).
- By 2018, the global C-section rate reached 21.1%, with projections indicating it could rise to 28.5% by 2030.
Socioeconomic and Geographic Disparities:
- Higher C-section rates are associated with higher socioeconomic status, urban living, and higher education levels. This trend is evident in countries like Pakistan, Bangladesh, and Indonesia .
- In Pakistan, C-section rates increased from 2.7% in 1990 to 15.8% in 2013, with significant disparities between urban (25.6%) and rural (11.5%) areas.
- In Bangladesh, C-section rates rose from 3.5% in 2004 to 23% in 2014, with higher rates among women of advanced maternal age, urban areas, and higher socioeconomic status.
Women's Autonomy and Demand:
- Increased women's autonomy to choose C-sections, even when not medically necessary, has contributed to higher rates. For example, a law in São Paulo, Brazil, led to a 3% increase in overall C-section rates .
- Women's demand for C-sections to avoid labor pain and for convenience also plays a role in rising rates.
Healthcare System Factors:
- The availability and type of healthcare services influence C-section rates. In Indonesia, the rate of C-sections by private services increased more than by public services over time.
- In South Africa, high C-section rates in private practices (60.4%) reflect global trends and are influenced by factors such as previous C-sections and maternal requests.
Physician-Related Factors:
- Physicians' professional experience, time-convenience, financial incentives, and fear of litigation contribute to the increase in C-section rates.
Biological and Environmental Factors:
- Changes in maternal and fetal body sizes due to improved living conditions and nutrition have led to increased risks of obstructed labor, contributing to higher C-section rates.

Conclusion

The global rise in C-section rates is driven by a complex interplay of socioeconomic, geographic, healthcare system, and individual factors. Higher socioeconomic status, urban living, increased women's autonomy, and physician-related factors are significant contributors. Additionally, biological changes due to improved living conditions have also played a role. Addressing these multifaceted issues requires comprehensive strategies to optimize C-section use and ensure maternal and fetal health.

Rising rates of c-sections globally

Summary

Introduction

Key Insights

Conclusion

Sources and full results

The Increasing Trend in Caesarean Section Rates: Global, Regional and National Estimates: 1990-2014

Caesarean section rates worldwide have increased to unprecedented levels, with the global average rate increasing 12.4% from 6.7% to 19.1% between 1990 and 2014, with Latin America and the Caribbean having the highest rates.

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

The caesarean section rate has steadily increased worldwide, with 28.5% of women giving birth by 2030, highlighting the need for global effective interventions to address unmet need and overuse.

The effect of increasing Women's autonomy on primary and repeated caesarean sections in Brazil

Increasing women's autonomy to choose caesarean sections in Brazil led to a 3% increase in overall C-section rates, driven by a 5% increase in primary C-sections.

The effect of increasing Women's autonomy on primary and repeated caesarean sections in Brazil.

Increasing women's autonomy in choosing caesarean sections in Brazil led to a 3% increase in overall C-section rates, driven by a 5% increase in primary C-sections.

Rising trends and inequalities in cesarean section rates in Pakistan: Evidence from Pakistan Demographic and Health Surveys, 1990-2013

C-section rates in Pakistan increased from 1990-2013, with higher rates in rich, highly educated, and urban women, and underuse in poor and rural areas.

Socio-demographic predictors and average annual rates of caesarean section in Bangladesh between 2004 and 2014

Caesarean section rates in Bangladesh increased from 2004 to 2014, with higher rates in women of advanced maternal age, urban areas, and relatively high socio-economic status.

Socioeconomic, geographic and health system factors associated with rising C-section rate in Indonesia: a cross-sectional study using the Indonesian demographic and health surveys from 1998 to 2017

The C-section rate in Indonesia has steadily increased from 1998 to 2017, with women's socioeconomic status and health system factors being key determinants of the increase.

Can we have many C-sections

C-section rates are increasing worldwide due to factors like physician experience, time-convenience, financial incentives, and women's demand for convenience and involvement in decision-making.

Rising Caesarean section rates: an audit of Caesarean sections in a specialist private practice.

The high caesarean section rate in private practice in KwaZulu-Natal is a window into increased rates worldwide, and is higher than the ideal rate of 10.15% suggested by the WHO for low-risk obstetric populations.

Secular changes in body height predict global rates of caesarean section

A third of global variance in caesarean-section rates can be explained by trends in adult body height from the 1970s to the 1990s, due to improved living conditions leading to larger fetuses and increased labor difficulty.

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