Growing concern over rising caesarean section rates: Is it a problem for low- and middle-income countries only?

Abstract

The rising caesarean delivery rate is a global concern and is believed by many as a problem in low-income countries exclusively. It has been observed that utilisation of this lifesaving procedure is unusually high in many middle- and high-income countries. Caesarean section (CS) is indicated to save both the mother's and child's life in certain situations. When chosen in the proper indication, it is helpful towards reducing morbidity and mortality in both. There is a vast number of papers evidencing the injudicious use of this necessary procedure. There is an evident disparity in the utilisation of the process too. In some sub-Saharan African countries, women do not have access to or have very minimal access to caesarean delivery due to many factors. On the other hand, certain countries overutilise it. Being a South Asian country, Bangladesh is no different from many other countries, with rising caesarean delivery rates in rural and urban populations. It is of great concern for the Bangladeshi general community and the healthcare workers. There have been claims that it is overutilised injudiciously by the Bangladeshi health force. This review aims to find the facts related to the CSs and compare between the high-, middle- and low-income countries. Being healthcare professionals and medical educators by origin, the authors were explicitly interested in Bangladesh. They conducted the review to contribute to the development of the country's healthcare system.