The WHO recommends that the ‘ideal’ rate of C-section for optimum maternal and fetal
outcome should be around 10-15%,[1] although current statistics suggests it to be
slightly higher at 19%.
A review of
trends around the world shows that currently about 18.6% of births take place
by Cesarean section. Latin America and the Caribbean region has the
highest CS rates (40.5%) while some countries in Africa have the lowest (7%).
Brazil occupies the top slot with a rate that exceeds 50% (55.6%).
The rate in
China have shown a substantial increase from 2008-2014, specially in inner
cities and rural China. The rate jumped from 28.8% to 34.9% according to Hong-Tiang Li, MD, of Peking University Health Science Center
in Beijing, and colleagues. The article was published online January 3, 2017 in
JAMA.[2]
Some of the Urban
city areas like Beijing, Tianjin, Shanghai, and Hangzhou did show a decrease in
C section rate by 15%, with no compromise of maternal and perinatal mortality
rates.
This
descriptive study covered every county in China, utilizing the statistics
collected by the Office for National Maternal & Child Health Statistics of
China, from 2008 through 2014.
Over the
span of 6 years there were 100,873,051 live births, of which 32,947, 229
(32.7%) were by cesarean delivery. Rates did show variations across provinces with
some provinces with Cesarean section rate at 62.5% while others at 4%.
Better access
to hospitals, medical litigations, financial incentives for physicians and
people in general wanting to have safest option under one child policy are some
of the reasons for increase in C-section rates.
Some women
choose to have the C-section and births planned at a specific time after
consulting fortune teller for ‘lucky’ birth time.
Public
health officials are hoping to see an improvement with the ‘one child policy’
off the table now. Many parents are rethinking about natural births and
visiting hospitals and clinics to enquire about it.
The
government is also playing an active part by educating patients, physicians and
other healthcare professionals to curtail the practice of ‘on-demand’ cesarean
sections.
