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posted by martyb on Friday October 12 2018, @06:27PM   Printer-friendly
from the labor-of-love dept.

C-section births rise rapidly to more than 20 percent worldwide

Rates of caesarean section births almost doubled between 2000 and 2015 – from 12 to 21 percent worldwide - new research has found, with the life-saving surgery unavailable to many women in poor countries while often over-used in richer ones.

The research, published in The Lancet medical journal on Thursday, found that 60 percent of countries overuse C-sections and 25 percent under-use them, suggesting that recommendations for their use in cases of medical need are widely ignored.

In at least 15 countries, more than 40 percent of all babies born are delivered by C-section. The highest rate, of 58.1 percent, was in the Dominican Republic.

Experts estimate that between 10 and 15 percent of births medically require a C-section due to complications such as bleeding, foetal distress, hypertension or a baby being in an abnormal position.

While the procedure can save lives - of both mothers and newborns - it can also create complications and side effects, including higher risks for future births.

"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.

Also at BBC, EurekAlert!, The Guardian, and Voice of America.

See also: New WHO guidance on non-clinical interventions specifically designed to reduce unnecessary caesarean sections

Global epidemiology of use of and disparities in caesarean sections (DOI: 10.1016/S0140-6736(18)31928-7) (DX)


Original Submission #1   Original Submission #2

 
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  • (Score: 2) by Snow on Friday October 12 2018, @09:29PM (5 children)

    by Snow (1601) on Friday October 12 2018, @09:29PM (#748050) Journal

    Interesting.

    My daughter/wife had a CS delivery because my daughter never turned upside down. The operation only took about 30-40 mins total. When they pulled my daughter out, they placed her on a baby station thing with a heat lamp and scale and other stuff. A few minutes later there is a bit of a commotion and they call a 'code green'. I'm wondering what the hell is going on, when less than a minute later some doctor comes in with a cart of some sort and sticks a little rubber tube down her throat and starts sucking out my daughter's lungs.

    Obviously my daughter is fine, but I'm guessing that's not an uncommon occurrence. I would have liked to be warned that was a possibility beforehand.

    My wife really wanted to have a vaginal delivery. Maybe for baby #2.

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  • (Score: 3, Interesting) by bob_super on Friday October 12 2018, @09:47PM (3 children)

    by bob_super (1357) on Friday October 12 2018, @09:47PM (#748060)

    > a CS delivery because my daughter never turned upside down.

    Funny OT: My niece probably wanted to make a grand entrance by going breach.
    The doctor told my sister she'd need a CS. Standard procedure. Safer.
    She told him in no uncertain terms that it was not going to happen, on account of being her 5th delivery, she had an experienced doctor, and how her MD diploma meant she knew what she was talking about.
    Baby didn't turn. So they triggered the delivery a bit early to avoid extra size issues.

    The kicker is that breach vaginal deliveries do not happen anymore, and it was a teaching hospital. Unusual procedures are prized teaching events.
    So pretty much the whole OB department, every single OB intern and quite a few doctors, was in the room. Well over 20 people, pushing my brother-in-law out of the way.
    Talk about an entrance... That princess had more medical personnel in the room than actual royalty.

    • (Score: 0) by Anonymous Coward on Friday October 12 2018, @09:58PM (1 child)

      by Anonymous Coward on Friday October 12 2018, @09:58PM (#748071)

      "So they triggered the delivery a bit early to avoid extra size issues."

      This however causes issues with the cervix. The cervix softens if you wait. Lots of induced births turn into C-section births because the cervix is not ready.

      • (Score: 2) by bob_super on Friday October 12 2018, @10:06PM

        by bob_super (1357) on Friday October 12 2018, @10:06PM (#748075)

        Yup, tradeoffs... 2 weeks early can save up to a couple extra pounds, which can turn a breach from dangerous to deadly.
        As stated, there were lots of trained professionals involved in the timing decision.

    • (Score: 2) by Snow on Friday October 12 2018, @10:02PM

      by Snow (1601) on Friday October 12 2018, @10:02PM (#748074) Journal

      My wife was actually initially given the option to do a breech birth. She wanted to do it, and like you said, her midwife was pretty stoked to be part of a breach birth as they are so rare.

      Anyways, I guess there are different type of breech babies. My daughter was basically sitting cross legged (as opposed to biting her knees), and that made it too high risk to proceed.

  • (Score: 2) by All Your Lawn Are Belong To Us on Friday October 12 2018, @10:27PM

    by All Your Lawn Are Belong To Us (6553) on Friday October 12 2018, @10:27PM (#748087) Journal

    Color codes aren't exactly standardized. (There are even hospitals that are now getting away from "Code blue" declaration since "everyone knows" what that means and it is nobody's business but the patient/family/staff's).

    But at delivery and then at five minutes after birth the baby is given an APGAR scoring [wikipedia.org]. A baby might have a lower (but sufficient) APGAR right after delivery yet sufficient, but then not respond as expected. A not uncommon reason for that is meconium aspiration [stanfordchildrens.org] which causes respiratory problems and the problems do not always (usually don't?) immediately happen at delivery. Basically the baby voided and then aspirates it's stool-like products (meconium) during the delivery process for not well understood reasons. Meconium is green in color which is what made me think of that (it would be natural for an L&D unit to call meconium aspiration a 'code green'.) The staff have to act quickly to protect the baby's respiratory system as the meconium thins or eliminates the surfactant that keeps the lung's air sacs open.

    The staff should have warned you that there are a whole bunch of complications that can happen with an otherwise normal labor and delivery. If you had pre-education you should have been briefed about many of them. But the possibilities are large enough that I doubt they'd actually tell you every single possible one.

    Glad to hear that everything sounds like it turned out fine, though!

    --
    This sig for rent.