Caesarean Section, Rates of

Factors Playing Roles in Increase of Procedure

According to the World Health Organization (WHO), caesarean section rates have increased beyond the recommended level of 15 percent in many countries, almost doubling in the last decade, particularly in developed nations such as Australia, France, Germany, Italy, North America, and the United States. The WHO also reported a c-section rate increase in less wealthy countries, such as Brazil, China, and India. This was the 11th consecutive year where an increase is indicated. Medical factors play a role in the increase of caesarean sections. Side effects of commonly used labor interventions have been found to be associated with an increase in the likelihood of the use of a caesarean section. For instance, labor induction among first-time mothers increases the risk of a caesarean. The use of continuous fetal monitoring has also been linked to higher rates. It has been found that women with certain medical circumstances, such as a fetus in a breech position, or a history of a previous caesarean section, are not being offered the option of a vaginal birth by their doctors.

Several nonmedical, social factors are also linked to the increase in the rate of caesarean sections. The philosophy of individual doctors and the type of training doctors and nurses receive play a role. A growth in the desire for a pregnancy to be convenient for the doctor and the patient has influenced the rates. A small amount of women are scheduling planned caesarean sections often for reasons of convenience. A rise in the fear of litigation among doctors also serves to increase the caesarean section rate. The increased financial gain associated with performing a caesarean compared to a vaginal birth may also be influencing the rate. In 2005 the average rate charged for a caesarean section without complications was $12,544, whereas the average fee for a vaginal birth without complications performed in a hospital was $6,973. Peer pressure from a [Page 212]culture that condones the use of caesarean sections is also a factor. Furthermore, limited knowledge about the potential negative side effects of a caesarean section serves to trivialize the procedure.

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