China leads world in caesarean births
China leads world in caesarean birthsBy Margie Mason4:00 AM Thursday Jan 14, 2010
Nearly half of all births in China are delivered by caesarean section, the world's highest rate, according to a survey by the World Health Organisation (WHO) - a shift towards modernisation that isn't necessarily a good thing.
The boom in unnecessary surgeries is jeopardising women's health, the United Nations health agency warned in the report published in the medical journal the Lancet.
Unnecessary caesarean sections are costlier than natural births and raise the risk of complications for the mother, said the report surveying nine Asian nations. It noted the surgeries have reached "epidemic proportions" in many countries worldwide.
The most dramatic findings were in China, where 46 per cent of births reviewed were caesarean sections - a quarter of them not medically necessary, the report said.
"So many pregnant women ask for a caesarean birth in China, but we always suggest that they have a natural birth," said Dr He Yuanhua, at Capital Antai Obstetrics and Gynaecology Hospital in Beijing, who did not participate in the study.
The WHO, which reviewed nearly 110,000 births across Asia in 2007-08, found 27 per cent were done under the knife, partially motivated by hospitals eager to make more money.
That mirrors similar results reported by WHO in 2005 from Latin America, where 35 per cent of pregnant women surveyed were delivering by caesarean section.
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In the United States, where caesarean sections are at an all-time high of 31 per cent, the surgery is often performed on older expectant mothers, during multiple births or simply because patients request it or doctors fear malpractice lawsuits.
"The relative safety of the operation leads people to think it's as safe as vaginal birth," said Dr Metin Gulmezoglu, who co-authored the Asia report. "That's unlikely to be the case."
Women undergoing caesarean sections that are not medically necessary are more likely to die or be admitted into intensive care units, require blood transfusions or encounter complications that lead to hysterectomies, the WHO study found.
US studies have shown babies born by caesarean have a greater chance for respiratory problems. The Asia survey found the procedure benefits babies during breech births.
In Asia, some women opt for the surgery to choose their delivery day after consulting fortune tellers for "lucky" birthdays or times. Others fear painful natural births or worry their vaginas may be stretched or damaged by a normal delivery. Some women also prefer the operation because they mistakenly believe it is less risky.
The Asian survey examined deliveries in 122 randomly selected public and private hospitals in 2007 and 2008 across Cambodia, China, India, Japan, Nepal, the Philippines, Sri Lanka, Thailand and Vietnam.
The lowest rates were in India, with 18 per cent.
The study did not discuss specific reasons for the high number of caesareans, but it noted that more than 60 per cent of the hospitals studied were motivated by financial incentives to perform surgeries.
- APBy Margie Mason