Cesareans Around The World

In the past cesarean sections were only done in absolute emergencies, and for good reason. It was extremely dangerous, and very often the woman didn't survive. As medical techniques improved, C-sections became safer and more common, but they were still only considered when there were serious medical issues. Today however, the situation is completely different.

The World Health Organization (WHO) has alarming statistics from around the world.

League Table

Brazil leads the table in having the highest percentage of cesarean sections in the world at 44% of all births. China and Mexico follow close behind with 40.5% and 39.1 respectively. Some slightly more recent Chinese statistics suggest that China may have overtaken Brazil with over 46% of births being cesareans! Overall in Asia, some 27% of births are performed by C-section, whereas the overall average of C-sections for Latin America is 35%. At the other end of the scale, in Cambodia and India the figures are 15% and 18% respectively. In Africa overall, the figures are very low at 9%, which falls below the WHO recommendation. This probably reflects the poorer medical facilities commonly available.

The USA

In the United States, according to the 2006 government statistics, cesareans are now 31.1% of all live births. This is almost one third of all births! This is a dramatic increase of 46% in the 10 years since 1996. In some states, especially southern states like Florida and Texas, and the north-east corridor, the percentage count is even higher, reaching as much as 36% of births. In the upper mid-western and western mountain states the incidents are lower, between 20% and 25%, but this is still a lot higher than the WHO recommends.

Canada

In general the Canadian rate of cesareans is lower than the United States, at 26.3%, although this does vary according to area, with British Columbia being one of the provinces having the most.

WHO Recommendation

The World Health Organization believes that cesareans are medically necessary in about 15% of all live births. It is very concerned about this world-wide increase in operations as opposed to natural deliveries.

Possible Reasons

One possible reason is that women in Western societies are having children much later in life. American statistics seem to indicate that as women get older they are more likely to have a C-section. Whether this is due to caution on behalf of the medical profession who do not want to take a risk with older first-time mothers, or is actually a preference by women is hard to judge.

Many older mothers are busy professionals and may feel safer having a totally planned birth. It is also more dangerous to have a first baby as an older mother so perhaps these operations fall in the category of being medically necessary. On the other hand there may be financial incentives for the doctors as it is much more lucrative to do a cesarean section, than to assist a natural delivery.

Some doctors also have little experience in dealing with anything out of the ordinary, without intervening, and may lack confidence in the mother's ability to give birth normally. The belief in the superiority of technology may also play its part, together with a lack of availability of sufficient midwives committed to the idea of safe, normal, natural deliveries.

Whatever the reason, the situation globally is becoming so bad that it is becoming necessary for governments (Brazil only for the moment) to promote the idea of women having normal, natural deliveries!

So if your doctor suggests a cesarean - think first if you really need one.