"The large increases in C-section use - mostly in richer settings for non-medical purposes - are concerning because of the associated risks for women and children", said Marleen Temmerman, an expert from Aga Khan University in Kenya and Ghent University in Belgium who co-led the research.
Of the 169 countries included in the study 15 of them, including Mexico, Brazil, and Turkey, have C-section use that exceeds 40 per cent of births, with the Dominican Republic having the highest figure worldwide with 58.1 per cent of births.
They said it can be a life-saving intervention for women and newborns when complications occur, such as bleeding, foetal distress, hypertensive disease, and babies in abnormal position, but the surgery is not without risk for mother and child, and is associated with complications in future births. It is estimated that 10-15% of births medically require a C-section due to complications, suggesting that average C-section use should lie between these levels.
"The large increases in C-section use - mostly in richer settings for nonmedical purposes - are concerning because of the associated risks for women and children", said Dr. Marleen Temmerman, lead author of three studies published October 11 in The Lancet. C-section use has remained low in sub-Saharan Africa, however.
The Lancet researchers point to several possible reasons for the rise: Younger doctors who perform C-sections may lose confidence in completing vaginal deliveries, driving up the surgery rate over time. In places such as Brazil and China, numerous c-sections performed were in women with low-risk pregnancies, in women who previously had c-sections, and in women who were well-educated. "While the long-term risks of this are not well-researched, the short-term effects include changes in immune development which can increase the risk of allergies and asthma and alter the bacteria in the gut".
"In cases where complications do occur, C-sections save lives, and we must increase accessibility in poorer regions, making C-sections universally available, but we should not overuse them".
"Pregnant mothers must have access to professional and informed advice in order to make a decision".
There is an urgent need for intervention in the medical field to reduce the use of cesarean sections, the researchers said.
Emeritus Professor Gerard Visser, of University Medical Centre Utrecht in the Netherlands, and chairman of FIGO's Committee for Safe Motherhood and Newborn Health, said: "Worldwide there is an alarming increase in caesarean section rates".
"The medical profession on its own can not reverse this trend", Prof.
'Joint actions are urgently needed to stop unnecessary C-sections and enable women and families to be confident of receiving the most appropriate care for their circumstances'. In addition, say the researchers, fear of labor may be fueling patients' requests for C-sections.
In the meantime, World Health Organization has published a guideline alongside the series that explores ways to reduce unnecessary c-sections, including educational intervention for women and families, clinical guidelines, and recommendations for future research. Annually in France, cesarean section is 20% if delivery.