Table 2 and Fig 2 show global and regional trends by UN geographical grouping from 1990 to 2014. WHO has stated that no … 5 0 obj High-quality research is needed in the future to explore the possible impact of these different factors when considering potential interventions to reduce unnecessary CS. Found inside – Page 204J Ye et al. showed that the least devel- oped countries in his study had the greatest relative changes of caesarean section rate (caesarean section rates increased 160% compared with the baseline), and this led to a phenomenal caesarean ... Despite the worldwide relevance and interest on this topic, this is the first study that presents global and regional trends in the use of CS. x��\ےܶ}����Tͤ<4�Ƽْm�eG���S%�awf��f���q>#��O� Ht�lgWr����@_N4��v^WB�k��o�_�>~a����x�⋮qs1{;sU��h{�z�� |��A��������mx'殅[=�JW���l1_��e�������d3[�賓ٷ0�jt=7M]�_�����-����o_ξ��==-�pja�ƕW:)�G�A�9,��PVU!��?��?�+]յ���d�������z��b�Zsh5ژ�Y���w��n����]��+ۉ?o�������jo�)�&th�k�����y�%����2nq����?��Z.���?mURZL�g����O��v8y/Q@�j|jY�a�_��VB��Y)����� This book is an informative and practical guide to the most common major operation in the world. Written by a distinguished team of contributors, it describes best practice for procedures, as well as important related issues. Current rates of CS, except for the least developed countries, are consistently higher than what is considered medically justifiable [23, 42]. At subregional level, excluding Southern Africa where data were available for only 11.7% of the live births, coverage ranged from 81.8% in the Caribbean to 100% in eight subregions (Table 1). For example, in China, choosing the date of the babyâs delivery on the basis of luck and fate for the future of the baby by some people is one of the explanations for scheduling a CS [10]. Success of trial of labour in women with a history of previous caesarean section for labour dystociaProblem statementThe rates of caesarean section (CS) are increasing worldwide leading to an increased risk for maternal and neonatal ... Caesarean section rates A caesarean section (CS) is a surgical process where birth is through an incision in the wall of the uterus, rather than through the vagina. In Europe, Finland was the country with the smallest rise (less than 2% absolute increase) followed by Iceland and Norway with a rise of about 4.5 points. from a low rate of 23.4 percent to a high rate of 40.2 percent. By David Baker, MD, Executive Vice President for Healthcare Quality Evaluation, The Joint Commission. Obstetrician and gynecologist Magnus Murphy, MD, and journalist/advocate Pauline McDonagh Hull offer a compelling case for surgical delivery as a legitimate birth choice for informed women. The information presented is essential to inform policy and global and regional strategies aimed at optimizing the use of CS. Found insidePatient Safety in Surgery, covers all aspects related to patient safety in surgery, including pertinent issues of interest to surgeons, medical trainees (students, residents, and fellows), nurses, anaesthesiologists, patients, patient ... There is some suggestion of a direct positive association at lower levels of mortality. The World Health Organization (WHO) has recommended a maximum CS rate of 15%. Wrote the paper: APB JY ABM JZ AMG MRT. 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. No, Is the Subject Area "Egypt" applicable to this article? We used local non-parametric regression techniques to correlate CS with maternal mortality ratio, infant and neonatal mortality rates, and the proportion of births attended by skilled health personnel. The views expressed are solely those of the authors, and does not represent the views of the World Health Organization. The rates of caesarean sections have been progressively increasing worldwide, all of which lacking any particular benefit to the health of the women or infant. For countries without any of the above-mentioned sources, we searched for information on CS rates in publications available through electronic databases, web search engines and government web sites. 2015 Jun 21;12:57. doi: 10.1186/s12978-015-0043-6. (Institute for Complementary Medicine) by "International Midwifery"; Business Business, international General interest Cesarean section Research … The objective of our analysis is to update previous published estimates, present the latest data on national CS rates worldwide and to analyze trends over the last decades. Africa was the region with the lowest coverage (81.8% of live births). We hope you find the information in this book useful and helpful in thinking about C-section, whether you have already had a Cesarean and want to understand the experience better, you wish to plan for another C-section birth, or you are ... Over the past decades, the unprecedented and steady rise in the rates of CS have led to increased research, debate and concern among healthcare professionals, governments, policy-makers, scientists and clinicians [10, 20â23]. Background:Cesarean section (CS) is the most common surgery performed around the world. The rate of CS in least developed countries only rose by 4.2 points (from 1.9% to 6.1%; AARI = 5%) (Table 2). Primary … In case of equal closeness in both time directions, the earlier data were used. Malawi Med J. Historically, the introduction of caesarean section surgery was associated with an improvement in maternal and perinatal health outcomes. This book brings together reviews on the current understanding of how the gut and brain communicate in the regulation of metabolism. Individual chapters explore novel aspects of this interaction. "Worldwide there is an alarming increase in C-section rates. Doctors have said that in many cases, the … InTech invited respectable anesthesiologists from different countries to write this book. Caesarean section rates have increased worldwide in recent decades. %�쏢 Rates … Factors associated to womenâs fears and lives and societal and cultural beliefs are very likely contributing to the increase and need to be included in the equation. We conducted a longitudinal analysis calculating differences in CS rates as absolute change and as the average annual rate of increase (AARI). This is a further (eighteenth) volume in the definitive international review series in obstetrics and gynecology, with contributions from leading clinicians from around the world covering topics of current importance and relevance in the ... However, if the most recent available data predated 2005, then the country was excluded from this study because we considered the data as being too old. Australia’s caesarean section rate was higher than the OECD … Betran AP, Torloni MR, Zhang J, Ye J, Mikolajczyk R, Deneux-Tharaux C, Oladapo OT, Souza JP, Tunçalp Ö, Vogel JP, Gülmezoglu AM. <> Determinants of the decision-to-delivery interval and the effect on perinatal outcome after emergency caesarean delivery: a cross-sectional study. The AARI is a geometric progression ratio that provides a constant rate of change during the study period. Latin America and the Caribbean which started with the highest rate in 1990 (22.8%) is also the region with the largest rate in 2014 and the largest absolute increase in CS rate (19.4 points). Is the Subject Area "Africa" applicable to this article? This trend analysis included 121 countries representing 90% of the total number of live births worldwide. The largest absolute increases occurred in Latin America and the Caribbean (19.4%, from 22.8% to 42.2%), followed by Asia (15.1%, from 4.4% to 19.5%), Oceania (14.1%, from 18.5% to 32.6%), Europe (13.8%, from 11.2% to 25%), Northern America (10%, from 22.3% to 32.3%) and Africa (4.5%, from 2.9% to 7.4%). All analyses were performed using SAS statistical package version 9.2 (SAS Institute Inc., Cary, NC, USA). However, below a caesarean section rate of 10%, maternal and … For some countries we relied on estimates and reports from government national databases accounting for all the births in the country. August 30, 2010-Caesarean delivery is the highest ever in the United States and is expected to continue to grow, and new government-funded research may help explain this trend. In Europe, countless sections are being performed each year. here. The World Health Organization (WHO) suggests a cesarean rate from 5% … This document establishes general principles of PPH care and it is intended to inform the development of clinical protocols and health policies related to PPH. Views: 2,854. by Dr. Saman Nazir. For more information about PLOS Subject Areas, click Free Online Library: Caesarean section: ethics, research, ICM position statement: rising worldwide rates of delivery by Caesarean section cause concern to midwives, whose role includes provision of information, advice and support to women. Number of Cesarean deliveries: 1,186,397. In both programmes, surveys are conducted by trained personnel using standardised questionnaires and strict methods for data collection and processing. By THE ASSOCIATED PRESS. In Africa, large differences are seen between Northern Africa and the other subregions (Table 2). Rates of caesarean section are of concern in both developed and developing countries. The caesarean section rate has increased internationally between 2000 and 2015 (OECD 2015). In Latin America and the Caribbean, Costa Rica and Haiti had absolute increases of CS rates below 4%. In 1970, the cesarean … Yes âCoverageâ was used as a measure to express how representative an estimate is with regard to the region/subregion. However, it has both … Other cultural factors are more country-specific. Nationally, about a third of women now give birth by C-section, according to the American College of Obstetricians and Gynecologists. Data Availability: All relevant data are within the paper and its Supporting Information files. Norwegian hospitals are paid per CS (activity-based funding), employing the diagnosis-related group (DRG) system. Factors associated with higher rates of vaginal deliveries may include strict policies on âmaternal requestâ CS, cultural or social pressure, differences in the legal framework for medical litigation and strategies favouring home births or a midwifery-led approach to births [30â32]. Nevertheless, this analysis has several limitations. 1 This represents the percentage of all live births that were cesarean deliveries.. The cesarean section (C-section) is the most commonly performed operation worldwide.. Rates of cesarean delivery vary widely from country to country, ranging from 0.6% in … Yes Analyzed the data: JY. This unique text elucidates the relationship between global nursing and global health, underscoring the significance of nurses’ contributions in furthering the Post-2015 Agenda of the United Nations regarding global health infrastructures ... Methods We collected nationally-representative data on CS rates between 1990 to 2014 and … Caesarean section rate is high and high. It is noteworthy that Finland has one of the lowest increases not only in Europe but among all countries included in this analysis (AAIR: 0.4%; from 13.5% to 14.7%). Continuous Glucose Monitoring in Women with Normal OGTT in Pregnancy. Caesarean section in countries of the Eastern Mediterranean Region. Since then, caesarean sections have become … Caesarean section use is growing at an “alarming” rate, accounting for 21% of births globally in 2015—up from 12% in 2000—experts have warned. Doctors’ use of Caesarean section to deliver babies has nearly doubled in 15 years to reach … However, in face of the present global situation, it could be anticipated that countries with latest data in the earlier part of the range (e.g. 1-4 In some countries the rate has increased several-fold since 1985, when the World Health Organization (WHO) suggested a caesarean section rate of 10–15% as the upper limit at the population level. The effect of a new maternity unit on maternal outcomes in rural Haiti: an interrupted time series study. For more information about PLOS Subject Areas, click 2008 Mar-Apr;14(2):470-88. Anything beyond that does not appear to … For developed countries, CS rates were obtained from vital statistics. The AARI of the CS rate allows comparisons with the assumption that the CS rate has changed at a constant speed over the given time period. The country has one of the highest rates of Caesarean births in the world — they account for 55.5 percent of all deliveries in Brazil, spiking to 84 percent in … Funding: The authors have no support or funding to report. When data for 2014 were not available, the CS rate for the latest year available was used also for all subsequent years up to 2014. https://doi.org/10.1371/journal.pone.0148343.g002. In particular, sub-Saharan Africa maintained virtually the same rate while the countries in Northern Africa presented a steeper increase particularly since 2000. In 2017, caesarean section rates remain lowest in Nordic countries (Iceland, Finland, Sweden and Norway), Israel and the Netherlands, with rates ranging from 15% to … Doctors' use of Caesarean section to deliver babies has nearly doubled in 15 years to reach "alarming" proportions in some countries, a study says. No, Is the Subject Area "Europe" applicable to this article? Countries were grouped according to the United Nationsâ geographical grouping [18] and regional and subregional averages for the proportion of CS were calculated as weighted means based on the countryâs share of live births in 2010 in the region or subregion, respectively [19]. Northern Africa stands out with 23.3 points of absolute increase and 7.9% AARI; Eastern Asia surpasses the other Asian sub-regions with 30.3 points of absolute increase and 8.5% AARI; and in Europe, Eastern Europe presents both the largest absolute increase (15.9 points) and the highest AAR (4.7%). MacDonald T, Dorcely O, Ewusie JE, Darling EK, Moll S, Mbuagbaw L. BMC Pregnancy Childbirth. Additional concerns and controversies surrounding CS include inequities in the use of the procedure, not only between countries but also within countries and the costs that unnecessary caesarean sections impose on financially stretched health systems [11, 12]. At subregional level, in general, the largest yearly increases go along with the largest absolute increases. The U.S. rate is 31%. PMC Interweaving her own experiences as a medical student and doctor, Perri Klass pays tribute to groundbreaking women doctors like Rebecca Lee Crumpler, Mary Putnam Jacobi, and Josephine Baker, and to the nurses, public health advocates, and ... Bookshelf For the purpose of graphing the trends by region and given that data were not available on a yearly basis, a linear interpolation between available data from 1990 and 2014 was calculated. Moreover, although estimates at country level are useful for governments and policy-makers to assess overall progress in maternal and infant health and to plan emergency obstetric care and resource utilization [39], they are merely averages and conceal important inequalities within countries [12]. Obstetrics and Gynecology at a Glance is the perfect guide for medical students, junior doctors and midwives, and is ideal for those embarking on clinical rotations and the clerkship. The panel reports on the state of family planning and ways to provide services. Healthy pregnancy and delivery. The book explores the myths and substantive socio-economic problems that underlie maternal deaths. Healthy sexuality. https://doi.org/10.1371/journal.pone.0148343.s001. No, PLOS is a nonprofit 501(c)(3) corporation, #C2354500, based in San Francisco, California, US, Corrections, Expressions of Concern, and Retractions, https://doi.org/10.1371/journal.pone.0148343, http://www.euro.who.int/en/data-and-evidence/databases/european-health-for-all-database-hfa-db, http://unstats.un.org/unsd/methods/m49/m49regin.htm, http://esa.un.org/wpp/unpp/panel_population.htm. In some hospitals, more than 70 percent of births occur by C-section … For developing countries, we obtained data mainly using the Demographic and Health Surveys (DHS) Program [14] and the Multiple Indicator Cluster Surveys (MICS) [15]. CS levels may respond primarily to economic determinants. The World Health Organization estimates that around 10 to 15% of births require a C-section due to complications and it has suggested that rates higher than that are excessive. %PDF-1.4 The change in the rate of CS in Table 2 is presented as absolute increase as well as the AARI. We collected data and describe trends from 1990 to 2014. A systematic review of ecologic studies. Would you like email updates of new search results? A hospital across town comes closer to that goal with a C-section rate of 17 percent. Cesarean Section Rates And Health Outcomes For Mothers And Babies. Department of Clinical Epidemiology, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China, Affiliation The use of CS has increased dramatically worldwide in the last decades particularly in middle- and high-income countries, despite the lack of evidence supporting substantial maternal and perinatal benefits with CS rates higher than a certain threshold, and some studies showing a link between increasing CS rates and poorer outcomes [5, 6]. As expected, longitudinal data necessary to study trends were more scarce in least developed countries (coverage of 74.5%). Among the more developed regions, Europe had the lowest CS rate throughout the time period studied. The information in this guideline will be useful for developing job aids and tools for both pre- and inservice training of health workers to enhance their delivery of care to prevent and treat maternal peripartum infections. A series of three … Country-level CS rates worldwide were compiled and global and regional estimates were generated and published in 2007 [13]. MeSH However, it is a major surgery and is associated with immediate maternal and perinatal risks and may have implications for future pregnancies as well as long-term effects that are still being investigated [1â4]. PLOS ONE promises fair, rigorous peer review, At regional level, except for Oceania with 62.3% of the live births of the region represented, coverage ranged from 92.8% in Africa to 100% in Northern America. Caesarean section rates have risen substantially worldwide since the 1980s. Changes in maternal characteristics and professional practice styles, increasing malpractice pressure, as well as economic, organizational, social and cultural factors have all been implicated in this trend [7â10]. https://doi.org/10.1371/journal.pone.0148343.s002. In order to see better health outcomes, in the mid-1980s, the World Health Organization recommended that member countries C-section rates shouldn’t exceed 10 to 15 percent. C-section Births Surge To ‘alarming’ Rates Worldwide – Study. https://doi.org/10.1371/journal.pone.0148343, Editor: Hajo Zeeb, Leibniz Institute for Prevention Research and Epidemiology (BIPS), GERMANY, Received: November 3, 2015; Accepted: January 15, 2016; Published: February 5, 2016. North America and Oceania had similar increases in their CS rates over the last 24 years (Fig 2). 2021 Mar;33(1):28-36. doi: 10.4314/mmj.v33i1.5. Some possible reasons for increasing CS rates are repeatedly reported in studies from many countries such as fear of pain; concerns about genital modifications after vaginal delivery; misconception that CS is safer for the baby; the convenience for health professionals and also for the mother and family; fear of medical litigation and lower tolerance to any complications or outcomes other than the perfect baby [9, 25â29]. Africa shows the lowest average rate of CS with 7.3%, which is a weighted average between 3.5% in sub-Saharan Africa and 27.8% in Northern Africa. One in five babies comes into the world by the cesarean section (C-Section) in Pakistan. As I discussed in last month's blog post, The Joint Commission will begin reporting hospitals with high rates of Caesarean sections in July 2020.. Regional and subregional coverage were calculated as the proportion of total regional and subregional live births for which nationally representative data on CS were available. The reasons for this increase are multifactorial and not well-understood. The region with the second largest absolute increase was Asia going from a CS rate of 4.4% in 1990 to 19.5% in the latest estimates. Found insideIn this book, we present recent advances in surgical techniques as well as the most common perioperative complications in patients that undergo a cesarean section. Moreover, we discuss appropriate measures to reduce unnecessary procedures. Since 1985, the international healthcare community has considered the ideal rate for caesarean sections to be between 10-15%. CS rates in Egypt rose from 4.6% to 51.8% (47.2 points) over the 24 year period. This report summarizes work on health financing, primary care, and quality and patient safety in Kurdistan: policy options, plans to achieve policy objectives, and implementation of a new management information system. Background: Caesarean section (CS) rate is increasing worldwide and India is also not excluded from this trend. Data from … If the data in 1990 were not available, the closest available data from 1985â1995 were used. At the turn of the century, 12 percent of global births were via C-section and by 2015, that had increased to 21 percent. [15]. Caesarean section (CS) rates vary significantly worldwide. The figures for CS rates obtained through the DHS refer to births that occurred between 3 to 5 years previous to the date of the survey; in the MICS, they refer to births occurring in the 2 previous years. These surveys are considered the best available way of obtaining several types of health indicators in developing countries and the reliability of reported national rates of CS has been recognized [16]. Bethesda, MD 20894, Copyright Zimbabwe maintained the rate at 6% and all other countries increased their use of CS (S1 File). Ye J, Zhang J, Mikolajczyk R, et al. We obtained the rates of CS from three sources: i) nationally representative surveys, ii) routine vital statistics, and iii) reports from health authorities. Found insideWorld Health Statistics 2015 contains WHO's annual compilation of health-related data for its 194 Member States and includes a summary of the progress made towards achieving the health-related Millennium Development Goals (MDGs) and ... Yes Despite its limitations, this multi-source approach to collecting nationally-representative estimates is widely used and accepted internationally [37, 38]. Another limitation of the study was the use of different sources of data for CS. Table 2 shows trends in CS rates from 1990 to 2014 by region and subregion. When data for 2014 were not available, the CS rate for the latest year available was used also for all subsequent years up to 2014. The absolute and yearly increases are more remarkable in less developed countries. Click through the PLOS taxonomy to find articles in your field. We describe the absolute increase in CS rate per country, subregion and region. “The rate of cesarean births is increasing in India and has already crossed the World Health Organization threshold of 15 per cent,” concluded the study. That's significantly higher … 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 … A caesarean section (CS) is a life-saving surgical procedure when certain complications arise during pregnancy and labour. Although very unevenly distributed, 15% of births worldwide occur by CS. As the majority of countries did not have CS rates available on yearly basis, for the purpose of graphing the trends by region, a linear interpolation between available CS rates for each country from 1990â2014 was calculated. Monitoring maternal health practices including the use of CS is essential to assess progress toward health goals and to provide the basis for data-driven discussions. Although the procedure can be life-saving, how—and why—did it become so ubiquitous? Cesarean Section is the first book to chronicle this history. Currently, one in three babies give birth surgically. Latin America and the Caribbean show the highest rate (29.2%), and Africa shows the lowest (3.5%). There are wide variations in Caesarean section rates across Europe, indicating … Eurostat just released the data for 2017, when the procedure, the delivery of one or more babies through an incision in a mother’s abdomen and uterus, was performed 1.4 million times. Taking a practical policy approach, this book covers the background and concepts underlying efforts to improve maternal and perinatal mortality, the current global situation and problems that prevent progress. At present, 40.5% of all births are by CS in Latin America and the Caribbean and Southern America is the subregion with the highest rates of CS in the world with 42.9%. Geneva: World Health Organization; 2015 (WHO/ RHR/15.02). There are 15 countries where births by C-section exceed 40 percent of the total; among these are Brazil and Egypt (both 55.5 percent), Turkey (53.1 percent), Iran … Brazil, C-section delivery rate has jumped from 15 per cent in 1974 to 45.9 per cent in 2008 (Chacham and Perpetuo, 1998, Gibbons et al., 2010). While the life … This indicator shows the rate of caesarean sections per 1 000 live births. The World Health Organization (WHO) suggests a cesarean rate from 5% to 15%, but the worldwide percentage is higher. Background The caesarean section (CS) rate continues to increase across high-income, middle-income and low-income countries. https://doi.org/10.1371/journal.pone.0148343.g001. Affiliation FOIA eCollection 2021. broad scope, and wide readership â a perfect fit for your research every time. Endorsed by the United Nations Secretary-General, this is a comprehensive WHO guideline on routine antenatal care for pregnant women and adolescent girls. Women 'being … Source: https://wonder.cdc.gov Differences by state do not take into account … Many of the developing countries (e.g., China, Nigeria, Bangladesh etc.) In Cyprus and Turkey, the c-section rates are extreme. Cesarean section rates and maternal and neonatal mortality in low-, medium-, and high-income countries: an ecological study. According to the most recent estimates, the average global rate of CS is 18.6%, ranging from 6.0% to 27.2% in the least and more developed regions, respectively (Table 1). For the purpose of this graph, a linear interpolation between available data from 1990 and 2014 was calculated. Association between rates of caesarean section and maternal and neonatal mortality in the 21st century: a worldwide population-based ecological study with longitudinal data. This is certainly questionable from clinical and ethical point of view. No, Is the Subject Area "Oceania" applicable to this article? Found inside – Page 154In 1985, the World Health Organization (WHO) stated that rates of caesarean section above 10–15% conferred no ... yet since this time there has been a steady rise in the rate of caesarean sections worldwide (Fioretti et al., 2014). At the regional level, Latin America and the Caribbean had the largest absolute increase in CS rates (19.4%) which were above any other region during the whole study period (Fig 2). About 5 % ; by 1988, it had peaked at 24.7 % cesarean deliveries was about 5 % AARI! And more specifically in Western Africa subregions to write this book % in Burkina to! 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