Caesarean section (original) (raw)
Related papers
Short-term and long-term effects of caesarean section on the health of women and children
Lancet (London, England), 2018
A caesarean section (CS) can be a life-saving intervention when medically indicated, but this procedure can also lead to short-term and long-term health effects for women and children. Given the increasing use of CS, particularly without medical indication, an increased understanding of its health effects on women and children has become crucial, which we discuss in this Series paper. The prevalence of maternal mortality and maternal morbidity is higher after CS than after vaginal birth. CS is associated with an increased risk of uterine rupture, abnormal placentation, ectopic pregnancy, stillbirth, and preterm birth, and these risks increase in a dose-response manner. There is emerging evidence that babies born by CS have different hormonal, physical, bacterial, and medical exposures, and that these exposures can subtly alter neonatal physiology. Short-term risks of CS include altered immune development, an increased likelihood of allergy, atopy, and asthma, and reduced intestinal ...
The global epidemiology of Caesarean Sections: major increases and wide disparities
2018
This Lancet Series paper, one of three on the high rate of Caesarean Section (CS), describes the global, regional and selected country levels, trends, determinants and inequalities in CS. Based on data from 169 countries representing 98.4% of the world’s births, we estimate that 21.1% (95% uncertainty range 19.9-22.4%) or 29.7 million births occurred through CS in 2015, representing almost a doubling since 2000 (12.1%; 10.9-13.3%). The differences in CS rates between regions in 2015 were tenfold, with a high of 44.3% (41.3-47.4%) in the Latin America and the Caribbean region and a low of 4.1% (3.6-4.6%) in the West and Central African region. The global and regional increases were driven both by increasing coverage of births by health facilities (66.5% of the global increase) and higher CS rates within health facilities (33.5%), with considerable variation between regions. Based on the most recent data, population-based CS rates exceeded 15% of births in 63% of 169 countries, while ...
Caesarean section: an epidemic
International Journal Of Community Medicine And Public Health, 2018
Worldwide steady increase in caesarean section (CS) rate during the last decades has been the cause of alarm and needs an in depth study. Caesarean section is major surgery and increases the likelihood of many short and longer-term adverse effects in mothers and babies. The caesarean epidemic is a reason for immediate concern and deserves serious international attention. There are to be needs to make policy on caesarean section for reversing this trend that can be truly called as…
The health implications of birth by Caesarean section
Biological Reviews, 2012
Since the first mention of fetal programming of adult health and disease, a plethora of programming events in early life has been suggested. These have included intrauterine and postnatal events, but limited attention has been given to the potential contribution of the birth process to normal physiology and long-term health. Over the last 30 years a growing number of studies have demonstrated that babies born at term by vaginal delivery (VD) have significantly different physiology at birth to those born by Caesarean section (CS), particularly when there has been no exposure to labour, i.e. pre-labour CS (PLCS). This literature is reviewed here and the processes involved in VD that might programme post-natal development are discussed. Some of the effects of CS are short term, but longer term problems are also apparent. We suggest that VD initiates important physiological trajectories and the absence of this stimulus in CS has implications for adult health. There are a number of factors that might plausibly contribute to this programming, one of which is the hormonal surge or ''stress response'' of VD. Given the increasing incidence of elective PLCS, an understanding of the effects of VD on normal development is crucial.
Health Consequences of the Increasing Caesarean Section Rates
Epidemiology, 2007
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Rates of caesarean section: analysis of global, regional and national estimates
Paediatric and Perinatal Epidemiology, 2007
The attached paper was published in 2007 by WHO staff members (and me as a retired staff member) and clearly demonstrates with good, hard data that the WHO recommendations of 1985, saying that C section should not be below 10% or over 15%, are still absolutely valid and not "out-of-date". This new WHO study found that as a country's C section rate goes above 15%, the maternal mortality rises-ie unnecessary C section kills women. The past 20 years in the US, the maternal mortality rate keeps rising and rising while the rate of C section continues to rise. It can now be reliably calculated that C section is the number one cause of maternal mortality in the U.S.-at least 45% of all maternal death is associated with a C section. "
The harmful consequences of prelabour caesarean section on the baby
Obstetrics, Gynaecology & Reproductive Medicine, 2012
Interest in rising caesarean section (CS) rates, especially 'non-medical' planned prelabour CS (PLCS), has not usually focused on the potential detrimental effects on babies, especially as long-term health is harder to study. Shortening pregnancy and avoiding labour may affect fetal maturity. Babies who do not experience labour have significantly increased respiratory and other morbidities which may have profound effects on development, determining immediate and potentially lifelong disease. As labour is usually beneficial, this must be factored into individual decisions. Consideration should be given to awaiting or inducing labour even in women with a high chance of CS or who are requesting this operation. Mothers must be fully informed of all the evidence before they can give valid consent and make decisions on their baby's behalf. Although all modes of delivery carry potential risk of neonatal morbidity or mortality, avoiding labour may cause more long-term harm than good for children overall.
The Increasing Trend in Caesarean Section Rates: Global, Regional and National Estimates: 1990-2014
PloS one, 2016
Caesarean section (CS) rates continue to evoke worldwide concern because of their steady increase, lack of consensus on the appropriate CS rate and the associated additional short- and long-term risks and costs. We present the latest CS rates and trends over the last 24 years. We collected nationally-representative data on CS rates between 1990 to 2014 and calculated regional and subregional weighted averages. We conducted a longitudinal analysis calculating differences in CS rates as absolute change and as the average annual rate of increase (AARI). According to the latest data from 150 countries, currently 18.6% of all births occur by CS, ranging from 6% to 27.2% in the least and most developed regions, respectively. Latin America and the Caribbean region has the highest CS rates (40.5%), followed by Northern America (32.3%), Oceania (31.1%), Europe (25%), Asia (19.2%) and Africa (7.3%). Based on the data from 121 countries, the trend analysis showed that between 1990 and 2014, th...
Bmj, 2007
To assess the risks and benefits associated with caesarean delivery compared with vaginal delivery. Prospective cohort study within the 2005 WHO global survey on maternal and perinatal health. 410 health facilities in 24 areas in eight randomly selected Latin American countries; 123 were randomly selected and 120 participated and provided data 106,546 deliveries reported during the three month study period, with data available for 97,095 (91% coverage). Maternal, fetal, and neonatal morbidity and mortality associated with intrapartum or elective caesarean delivery, adjusted for clinical, demographic, pregnancy, and institutional characteristics. Women undergoing caesarean delivery had an increased risk of severe maternal morbidity compared with women undergoing vaginal delivery (odds ratio 2.0 (95% confidence interval 1.6 to 2.5) for intrapartum caesarean and 2.3 (1.7 to 3.1) for elective caesarean). The risk of antibiotic treatment after delivery for women having either type of cae...