Thursday September 19, 2019

C-Section Births Doubles In Number, Reaching Epidemic Proportions: Doctors

C-section is a type of major surgery, which carries risks that require careful consideration

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A newborn, one of 12 babies born by C-section, cries inside an incubator at the Bunda Hospital in Jakarta, Indonesia, Dec. 12, 2012. VOA

Worldwide cesarean section use has nearly doubled in two decades and has reached “epidemic” proportions in some countries, doctors warned Friday, highlighting a huge gap in childbirth care between rich and poor mothers.

They said millions of women each year may be putting themselves and their babies at unnecessary risk by undergoing C-sections at rates “that have virtually nothing to do with evidence-based medicine.”

In 2015, the most recent year for which complete data is available, doctors performed 29.7 million C-sections worldwide, or 21 percent of all births. This was up from 16 million in 2000, or 12 percent of all births, according to research published in The Lancet.

It is estimated that the operation, a vital surgical procedure when complications occur during birth, is necessary 10-15 percent of the time.

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The Yusuf Dantsoho Memorial Hospital has a high success rate with C-sections. Kaduna, Nigeria. Photo by Chika Oduah, VOA

Varying country rates

But the research found wildly varying country rates of C-section use, often according to economic status: In at least 15 countries, more than 40 percent births are performed using the practice, often on wealthier women in private facilities.

In Brazil, Egypt and Turkey, more than half of all births are done via C-section.

The Dominican Republic has the highest rate of any nation, with 58.1 percent of all babies delivered using the procedure.

But in close to a quarter of nations surveyed, C-section use is significantly lower than average.

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Maternal death and disability rates are higher after C-section Flickr

Reasons to opt for surgery

Authors pointed out that while the procedure is generally overused in many middle- and high-income settings, women in low-income situations often lack necessary access to what can be a life-saving procedure.

“We would not expect such differences between countries, between women by socioeconomic status or between provinces/states within countries based on obstetric need,” Ties Boerma, professor of public health at the University of Manitoba, Winnipeg, and a lead author on the study, told AFP.

Jane Sandall, professor of social science and women’s health at King’s College London and a study author, told AFP that there were a variety of reasons women were increasingly opting for surgery.

These include “a lack of midwives to prevent and detect problems, loss of medical skills to confidently and competently attend a vaginal delivery, as well as medico-legal issues.”

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It also identified an emerging gap between wealthy and poorer regions within the same country. Flickr

Doctors are often tempted to organize C-sections to ease the flow of patients through a maternity clinic, and medical professionals are generally less vulnerable to legal action if they choose an operation over a natural birth.

Sandall also said there were often “financial incentives for both doctor and hospital” to perform the procedure.

The study warned that in many settings young doctors were becoming “experts” in C-section while losing confidence in their abilities when it comes to natural birth.

Income a factor

It also identified an emerging gap between wealthy and poorer regions within the same country. In China, C-section rates diverged from 4 percent to 62 percent; in India the range was 7-49 percent.

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Worldwide, more than 11 percent of babies are born premature. Pixabay

While the U.S. saw more than a quarter of all births performed by C-section, some states used the procedure more than twice as often as others.

“It is clear that poor countries have low C-section use because access to services is a problem,” Sandall said. “In many of those countries, however, richer women who live in urban areas, have access to private facilities have much higher C-section use.”

Risks to mother, child

C-sections may be marketed by clinics as the “easy” way to give birth, but they are not without risks.

Maternal death and disability rates are higher after C-section than vaginal birth. The procedure scars the womb, which can lead to bleeding, ectopic pregnancies (where the embryo is stuck in the ovaries), as well as still- and premature future births.

 

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Doctors are often tempted to organize C-sections to ease the flow of patients through a maternity clinic. Flickr

 

The authors suggested better education, more midwifery-led care and improved labor planning as ways of ensuring C-sections are only performed when medically necessary, as well as ensuring women properly understand the risks involved with the procedure.

“C-section is a type of major surgery, which carries risks that require careful consideration,” Sandall said.

Also Read: Novel Blood Test May Predict Autism Risk In Babies During Pregnancy

In a comment accompanying the study, Gerard Visser of the University Medical Centre in the Netherlands, called the rise in C-sections “alarming.”

“The medical profession on its own cannot reverse this trend,” he said. “Joint actions are urgently needed to stop unnecessary C-sections and enable women and families to be confident of receiving the most appropriate care for their circumstances.”

Next Story

Physicians Happy While Traders in Shock on Ban on E-Cigarettes in India

With the Union Cabinet directing a blanket ban on e-cigarettes in the country, physicians welcomed the step while e-cigarette traders expressed shock and anger

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A man exhales while smoking an e-cigarette, Aug. 28, 2019. VOA

With the Union Cabinet directing a blanket ban on e-cigarettes in the country with complete suspension of their manufacturing, import, export, distribution and storage, physicians welcomed the step while e-cigarette traders expressed shock and anger over the decision.

“Although, e-cigarettes are little less lethal then the conventional cigarettes, we cannot shun away the fact that it contains harmful ingredients. These chemicals can potentially affect the lungs and overall health of the individual in the long run,” Rajesh Chawla, Senior Pulmonologist at Indraprastha Apollo Hospital in New Delhi, told IANS.

Industry body TRENDS which represents importers, distributors and marketers of ENDS, or Electronic Nicotine Delivery Systems in India, termed the decision to ban e-cigarettes “ironic and erratic”.

“This ban on e-cigarettes on the basis of ‘selective sourcing of scientific and medical opinion’ and without holding a single stakeholder meeting is nothing short of a complete murder of democratic norms,” said Praveen Rikhy, Convenor, TRENDS (Trade Representatives of ENDS).

“All our representations sharing best practices from other countries – 70 developed countries have allowed regulated sale of e-cigarettes, have been completely ignored. We will now initiate a formal campaign to help MPs understand the issue, clarify misapprehensions and misinformation spread by lobby groups and support the farmer groups who see the growth of the e-cigarette sector as a global market opportunity for nicotine,” Rikhy said.

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The Donald Trump administration on September 12 said that it plans to ban the sale of non-tobacco-flavoured e-cigarettes in the US following six deaths. Pixabay

While e-cigarettes have been marketed as a way for adults to quit conventional smoking, a recent outbreak of lung illness associated with use of vaping products in the US has raised concerns about the safety of these products.

The Donald Trump administration on September 12 said that it plans to ban the sale of non-tobacco-flavoured e-cigarettes in the US following six deaths linked to vaping.

Health authorities have documented a total of 450 cases involving e-cigarettes, according to the US Centers for Disease Control and Prevention (CDC), which issued a health warning against vaping.

ALSO READ: Girls Who Sleep Late At Night Are More Likely To Gain Weight

“I entirely support the idea of a ban on e-cigarettes; it is a step in the right direction,” Manoj Luthra, CEO, Jaypee Hospital in Noida, told IANS.

“E-cigarettes have been projected as a means to help people to quit smoking tobacco and also being non-polluting. However, these have their own health hazards and are addictive as well. These contain nicotine and other chemical vapours which will certainly have ill effects on the heart and lung and other organs as well,” he said. (IANS)