Despite medical advances and increasing access to improved obstetric care across the globe, surgical childbirths are still more risky for both mother and baby, according to an ongoing international survey by the World Health Organization (WHO).
A new report from the survey, which was published online today in the medical journal The Lancet, found that in Asia in both developed and developing nations cesarean section births only reduced risks of major complications for mother and child if they were medically recommended. Elected surgical deliveries, on the other hand, put both at greater risk.
“Cesarean section should be done only when there is a medical indication to improve the outcome for the mother or the baby,” the authors of the report concluded. Common reasons for a recommendation for cesarean delivery included a previous cesarean section, cephalopelvic disproportion (when the baby’s head cannot fit through the mother’s pelvic opening) and fetal distress.
With these surgeries comes increased risk of maternal death, , admission into an intensive care unit, blood transfusion, hysterectomy or internal iliac artery ligation (to control bleeding in the pelvis) compared to spontaneous vaginal delivery, according to the report.
But these risks have not necessarily been absorbed into popular, or even medical culture. The rates of cesarean section procedures are on the rise in many countries across the globe, the authors report, and in some countries they “have reached epidemic proportions.” Among the nations studied, China had the highest rate of cesarean sections that were performed without medical indication 11.7 percent; the overall rate for the facilities studied had a rate of 1.9 percent.
Despite the increased risks associated with cesarean deliveries, no babies in the study died after an elected cesarean before hospital release. The most dangerous form of childbirth proved to be vaginal operative delivery, which includes using forceps or a vacuum to assist in delivery and is more rare, occurring in just 3.2 percent of the births analyzed.
Surgical childbirth also requires more resources than a natural vaginal delivery, the authors note. Especially in countries where money, medical practitioners or proper equipment is more limited, unnecessary cesarean sections can drain resources away from those cases in which it can improve the chances of a healthy mother and.
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Image of cesarean surgery team at work courtesy of Wikimedia Commons/Bobjgaliando
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