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The Debate Over Rising Rates of Cesarean Delivery
On the Rise
According to the World Health Organization (WHO), rates of cesarean deliveries (C-section) have been rising in many countries, including the US, Canada, England, France, Germany, Italy, and Ireland. Now, countries like Brazil, India, and China are also seeing an increase in rates.
While the WHO recommends rates below 15%, C-sections account for over 30% of deliveries in the US. It is estimated that 1 in 3 mothers has a C-section.
Why is the rate rising? Reasons for C-sections range from life-threatening emergencies to simple convenience to threats of malpractice. Doctors agree that, when indicated because of complications involving either mother or baby, C-sections can save lives. And in the face of those who may demand the procedure and threaten malpractice suits if a vaginal birth goes wrong, the surgery may also save them time with their lawyers. Still, the major abdominal surgery has risks, including rare cases of death, infection, excessive bleeding, reactions to medications, and injury to the baby. Many doctors and professional organizations worry that rising cesarean rates indicate too much of a good thing.
The American Congress of Obstetricians and Gynecologists (ACOG) advises that doctors and patients carefully weigh the benefits and risks associated with both cesarean and vaginal deliveries on a case-by-case basis. The earlier pregnant women begin conversations with their doctors about their delivery options, the better.
ACOG advises women to speak frankly with their doctors and ask plenty of questions, such as:
- What is your rate of cesarean versus vaginal deliveries?
- Under what circumstances is a C-section necessary?
- How is the hospital/birth center where I will give birth prepared for emergencies?
- What if I want to schedule a C-section before I go into labor?
- What if I do not want a C-section as part of my birth plan?
Even if you had a C-section in the past that does not necessarily mean that you will have to have another C-section. In some cases, a vaginal birth after cesarean delivery (VBAC) can be a safe choice. By talking with your doctor, you can learn more about delivery options and make a birth plan that is right for you and your baby.
The American Congress of Obstetricians and Gynecologists
The Society of Obstetricians and Gynaecologists of Canada
Women's Health Matters
American College of Obstetricians and Gynecologists. ACOG committee opinion no. 559: cesarean delivery on maternal request. Obstet Gynecol. 2013;121(4):904-907.
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Cesarean section. Childbirth Connection website. Available at: http://www.childbirthconnection.org/article.asp?ck=10456. Updated October 1, 2015. Accessed February 25, 2016.
Cesarean section. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated February 23, 2016. Accessed February 25, 2016.
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Sufang G. Padmadas S, Fengmin Z, Brown J, Stones R. Delivery settings and caesarean section rates in China. World Health Organization website. Available at: http://www.who.int/bulletin/volumes/85/10/06-035808/en. Accessed February 25, 2016.
Trial of laber after cesarean section (TOLAC). EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated November 3, 2015. Accessed February 25, 2016.
1/29/2010 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Lumbiganon P, Laopaiboon M, Gülmezoglu AM, et al. Method of delivery and pregnancy outcomes in Asia: the WHO global survey on maternal and perinatal health 2007-08. Lancet. 2010;375(9713):490-499.
- Reviewer: Michael Woods, MD
- Review Date: 02/2016
- Update Date: 02/25/2016