Health > Births by caesarean section: Countries Compared
Author: Luke.Metcalfe
The rate of births by caesarian section is used as a health service coverage indicator. It reflects the accessibility of basic health interventions to a given population. It is computed by dividing the number of caesarian section deliveries by the total number of live births.
The most common indications for caesarian section include fetal distress, malpresentation, failure to progress in labor, and previous caesarian section. Worldwide, the average number of CS deliveries is at 16%. In low income countries, the average is at 6%, while those in upper middle and high income countries are at 30%. The African Region has the lowest rates at 4%, while the WHO Region of the Americas has the highest rates at 36%. Countries like Ethiopia, Chad, Madagascar and Mali have CS rates of 2%. The United States, Australia and Germany have CS rates of 32%.
Both underuse and overuse of CS delivery can be dangerous, but the ideal rate for CS deliveries has not been set. The World Health Organization has advised that CS rates should be between 5-15%, but at present, there is no empirical evidence to set the optimum rates of CS deliveries.
The wide differences in number of CS births between high income and low income countries reflect the disparity in access to health care services. Low CS rates indicate unmet obstetric needs while high rates suggest inappropriate use. In low income countries with lower than recommended CS rates, maternal death during childbirth remains one of the leading causes of mortality among women of reproductive age.
On the other hand, excessive or unnecessary CS deliveries are also linked to maternal and infant risks. There are many contributing factors to the increasing trends of CS rates in high income countries. There is an increasing number of CS deliveries upon maternal request. It is higher in women who have private medical insurance and those who have higher income and levels of education. Other factors include legal concerns, with increasing fear of litigation among health practitioners. Advancing maternal age and increased obesity rates are also contributing factors.
Citations:
1) World Health Organization. World Health Statistics 2013. http://www.who.int/gho/publications/worldhealthstatistics/ENWHS2013Full.pdf
2) World Health Organization. Monitoring emergency obstetric care: a handbook. 2009. http://www.unfpa.org/webdav/site/global/shared/documents/publications/2009/obstetric_monitoring.pdf
3) World Health Organization. The global numbers and costs of additionally needed and unnecessary caesarean sections performed per year: overuse as a barrier to universal coverage. 2010. http://www.who.int/healthsystems/topics/financing/healthreport/30C-sectioncosts.pdf
CONTENTS
Citation
Interesting observations about Health > Births by caesarean section
- All of the top 3 countries by births by caesarean section are Christian.
- United Kingdom ranked last for births by caesarean section amongst Group of 7 countries (G7) in 2000.
- All of the bottom 16 countries by births by caesarean section are High income OECD.
- All of the bottom 9 countries by births by caesarean section are European.
- Australia ranked first for births by caesarean section amongst English speaking countries in 2000.
- 8 of the bottom 9 countries by births by caesarean section are European Union.
- 5 of the top 6 countries by births by caesarean section are Heavily indebted.
- Italy ranked first for births by caesarean section amongst Eurozone in 2000.
- 2 of the top 3 countries by births by caesarean section are Former British Colonies'.
- Netherlands ranked last for births by caesarean section amongst Non-religious countries in 2000.
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The rate of births by caesarian section is used as a health service coverage indicator. It reflects the accessibility of basic health interventions to a given population. It is computed by dividing the number of caesarian section deliveries by the total number of live births.
The most common indications for caesarian section include fetal distress, malpresentation, failure to progress in labor, and previous caesarian section. Worldwide, the average number of CS deliveries is at 16%. In low income countries, the average is at 6%, while those in upper middle and high income countries are at 30%. The African Region has the lowest rates at 4%, while the WHO Region of the Americas has the highest rates at 36%. Countries like Ethiopia, Chad, Madagascar and Mali have CS rates of 2%. The United States, Australia and Germany have CS rates of 32%.
Both underuse and overuse of CS delivery can be dangerous, but the ideal rate for CS deliveries has not been set. The World Health Organization has advised that CS rates should be between 5-15%, but at present, there is no empirical evidence to set the optimum rates of CS deliveries.
The wide differences in number of CS births between high income and low income countries reflect the disparity in access to health care services. Low CS rates indicate unmet obstetric needs while high rates suggest inappropriate use. In low income countries with lower than recommended CS rates, maternal death during childbirth remains one of the leading causes of mortality among women of reproductive age.
On the other hand, excessive or unnecessary CS deliveries are also linked to maternal and infant risks. There are many contributing factors to the increasing trends of CS rates in high income countries. There is an increasing number of CS deliveries upon maternal request. It is higher in women who have private medical insurance and those who have higher income and levels of education. Other factors include legal concerns, with increasing fear of litigation among health practitioners. Advancing maternal age and increased obesity rates are also contributing factors.
Citations:
1) World Health Organization. World Health Statistics 2013. http://www.who.int/gho/publications/worldhealthstatistics/ENWHS2013Full.pdf
2) World Health Organization. Monitoring emergency obstetric care: a handbook. 2009. http://www.unfpa.org/webdav/site/global/shared/documents/publications/2009/obstetric_monitoring.pdf
3) World Health Organization. The global numbers and costs of additionally needed and unnecessary caesarean sections performed per year: overuse as a barrier to universal coverage. 2010. http://www.who.int/healthsystems/topics/financing/healthreport/30C-sectioncosts.pdf
Posted on 14 Apr 2014
Luke.Metcalfe
137 Stat enthusiast
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<ul><li>A slow difficult labor</li>
<li>Fetal or maternal distress</li>
<li>Placenta problems</li><li>Cephalopelvic disproportion (A baby with a large head and the mother with a narrow pelvis)</li></ul></p>Some cesarean sections are planned ahead of time. Reasons for this include:
<ul><li>A baby in any position that is not head-down</li><li>Maternal infection with the human immunodeficiency virus (HIV)</li><li>A narrow pelvis and a large baby</li><li>A placenta that is blocking the cervix</li><li>A mother's chronic illness</li><li>Factors linked to a past cesarean delivery</li></ul></p>In developing nations, the rate of cesareans is very low as many births are not <a href=/graph/hea_bir_wit_hea_sta&int=-1>attended by a medical professional</a>. These countries typically have a higher rate of <a href=/graph/hea_mat_mor>maternal mortality</a>. <br>Many nations in Sub-Saharan Africa also have a high proportion of reproductive-age women who are <a href=/graph/hea_hiv_aid_wom_liv_wit_aid_154>living with HIV</a>. The transmission rate of HIV from mother to baby can be reduced by cesarean delivery.</p>
Posted on 07 Mar 2005
Edria Murray, Staff editor