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WHO Warns Against Unnecessary C-Sections

FILE -A woman adjusts cardboard boxes assembled to form a display highlighting the issue of teenage pregnancy outside the National Population Council's headquarters in Mexico City, Thursday, May 29, 2014.

The World Health Organization says the use of surgical childbirth - or Caesarean delivery - is growing worldwide, particularly in high- and middle-income countries. WHO says it is concerned by the possible abuse of this important life-saving surgery.

The World Health Organization is a staunch supporter of Caesarean sections — when justified medically — because these operations can save lives. However, when a Caesarean section is performed without medical need, it says mothers and their babies are put at risk of short- and long-term health problems.

Since 1985, health experts have considered the so-called ideal rate for C-sections to be between 10 and 15 percent. New studies show when the rates go below 10 percent, more mothers and babies die because they have no access to this life-saving intervention. This is borne out by statistics in Africa, which show a linkage between low C-section numbers and high mortality rates.

On the other hand, studies indicate there is no evidence that mortality rates improve when the rate goes above 10 percent. Indeed, Caesarean sections sometimes can have serious consequences.

The director of WHO’s Department of Reproductive Health and Research, Marleen Temmerman, tells VOA a C-section is generally a safe operation, but risks to health do exist.

“The chance of a complication is not that high, but the risk, the mortality can be very serious," he said. "You have like life threatening complications due to bleedings, most of them, but also other complications like thromboembolic risks are higher after surgery than after a vaginal delivery.”

However, Dr. Temmerman stresses a C-section is advisable when a vaginal delivery poses a risk to the mother or baby; for example due to prolonged labor, fetal distress, or because the baby is in an abnormal position.

She says she is concerned about the huge increase in the number of unnecessary Caesarean sections being performed in both developed and developing countries. She says lifestyle issues generally are driving this epidemic of C-sections.

“For a gynecologist actually it is easier to do a Caesarean section sometimes because you can plan your life. You call all your patients in, so to speak, for Caesareans," she said. "Every day you do two Caesareans-one at nine, one at 10 in the theater-no stress, no night duties, no call in emergencies or fetal distress or bleedings or whatever. So, you have a better life.”

Dr. Temmerman says C-sections also are better for hospitals because they are able to organize their work force. As for the women, she says many prefer a C-section to a vaginal birth because they do not want the pain of delivery or may be afraid of the physical after-effects.

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