Analyzing The Rise in Caesarean Section Rates
The World Health Organization officially withdrew its previous recommendation of a 15% C-section rates in June 2010. Their official statement read, "There is no empirical evidence for an optimum percentage. What matters most is that all women who need caesarean sections receive them."
The US National Institutes of Health says rises in rates of Caesarean sections are not, in isolation, a cause for concern, but may reflect changing reproductive patterns:
The World Health Organization has determined an “ideal rate” of all cesarean deliveries (such as 15 percent) for a population. One surgeon's opinion is that there is no consistency in this ideal rate, and artificial declarations of an ideal rate should be discouraged. Goals for achieving an optimal cesarean delivery rate should be based on maximizing the best possible maternal and neonatal outcomes, taking into account available medical and health resources and maternal preferences. This opinion is based on the idea that if left unchallenged, optimal cesarean delivery rates will vary over time and across different populations according to individual and societal circumstances.
The number of C-sections performed has grown rapidly, for example, a fourfold increase from 1971 to 1991 (from 4.2 per 100 births). This may be accredited to the improved technology in detecting prebirth distress. Malpractice has been looked into because of the rapid increase. Some argue the higher costs of C-section births compared to regular births make physicians quicker to recommend surgery. Usually, if a doctor makes a recommendation, people are quick to take it to heart and act upon it. The effect of relative C-section price on C-section usage should be examined.
However, some commentators are concerned by the rise and have noted several evidence-based studies. Louise Silverton, deputy general-secretary of the Royal College of Midwives, says not only has society’s tolerance for pain and illness been “significantly reduced”, but also women are scared of pain and think if they have a Caesarean, there will be less, if any, pain. In the opinion of Silverton and the Royal College of Midwives, “women have lost their confidence in their ability to give birth."
Silverton's analysis is controversial among some surgeons. Dr Maggie Blott, a consultant obstetrician at University College Hospital, London and then a Royal College of Obstetricians and Gynaecologists (RCOG) spokeswoman on Caesareans (and Vice President of the RCOG), responded: 'There isn't any evidence to support Louise Silverton's view that increasingly pain-averse women are pushing up the Caesarean rate. There's an undercurrent that Caesarean sections are a bad thing, but they can be life-saving.'
A previously unexplored hypothesis for the increasing rate is the evolution of birth weight and maternal pelvis size. It is proposed that since the advent of successful Caesarean birth over the last 150 years, mothers with small pelvises and babies with large birth weights have survived and contributed to these traits, increasing in the population percentage. Such a hypothesis is based upon the idea that even without fears of malpractice, without maternal obesity and diabetes, and without other widely quoted factors, the C-section rate would continue to rise simply due to slow changes in population genetics.
Read more about this topic: Caesarean Section
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