Increase in the cesarean rate: an issue of global priority

Abstract

Cesarean section (CS) is a surgical intervention to prevent or treat potentially harmful maternal or perinatal complications. Its appropriate use has the clinical objective of reducing the excess risk of maternal and neonatal morbidity and mortality. The global increase over the last 30 years of the value of 10-15% recommended by the WHO would be driven by the indication of CS subject to non-medical determinants. On the other hand, this increase was significantly higher in countries with higher socioeconomic levels, better educational level of women, higher levels of urbanization, higher density of doctors and lower fertility. 3,4. In Argentina, the rate of CS has increased from 28.2 to 35.7% between 2010-18. The objectives were to describe births and the relationships between type of birth and non-medical or socioeconomic variables. The study was carried out based on the data of all the births that occurred in healthcare establishments in the province during the period 2016-17-18 in Mendoza,. Births by CS were 47,010, which gave a cesarean section rate in the analyzed period of 49.84%. Since our interest was to describe CSR according to non-medical variables, we considered the variables as ownership of the establishment (state or private health); the level of education of the mother; the type of health insurance of the mothers (social security, or state), the age of the mother, among others. The monitoring of the caesarean section rate levels in the countries, together with multicomponent interventions to channel its indication to a rational use, would imply great gains for the health of women and families, while optimizing the use of resources and reducing of unnecessary medical practices