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Reproductive & Child Health News

Unnecessary C-Sections Common in Wealthy Latin Americans
January 28, 2000

A new study has revealed that Latin American women have a very high rate of caesarean delivery. Twelve nations, which represent about 81 percent of all deliveries in the region, had caesarean section rates ranging from 16.8 to 40 percent. Guidelines from the World Health Organization (WHO) recommend that caesarean sections should encompass more than 15 percent of all births.

Researchers from WHO examined data from 19 Latin American countries. Their report, which appeared in November 27, 1999, issue of the "British Medical Journal," found the elevated rate of caesarean section births related to a higher income and social class. The section rate in private hospitals was much higher than in public facilities, which are generally free and serve a less affluent population than private facilities. Three countries reported that caesarean sections accounted for 50 percent of all births in private facilities.

Giving birth by caesarean section involves making a surgical incision in the woman's abdomen, cutting into the uterus and then manually lifting the baby out. While the procedure has become much safer in the past few decades, it is still a major surgery and carries risks for both mother and baby. Caesarean sections are indicated only if it is not possible for the women to give birth vaginally and in emergency situations. The 15 percent figure was proposed by WHO in 1985, based on the section rate of nations which reported extremely low perinatal mortality. This WHO guideline has been adopted by the United States Department of Health and Human Services as a goal for the year 2000.

The researchers estimate that some 850,000 unnecessary caesarean section are performed each year and contend that this puts not only women and their babies at risk, but also places a needless economic burden on health-care systems. As it is now considered a normal method of giving birth, particularly for middle- and upper-class women in Latin America, minimal progress has been made to curb the practice.

To curb the rate of unnecessary caesarean sections, the researchers emphasize that public health authorities, health-care workers, and the media need to get involved to raise public awareness of this problem.

A second study is currently ongoing in six Latin American countries, which is investigating the effect of obtaining a second medical opinion before performing a caesarean section.

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