High Cesarean Section Rates in Latin America, a Reflection of a Different Approach to Labor?

Abstract

Increasing rates of cesarean section, as high as 50% in some countries in Latin America, compared with the US and the rest of the world, demand a closer analysis of its causes and implications. The significant morbidity for both mother and baby associated with cesarean section requires immediate action from national and international societies to confront the situation with specific solutions, including patient education. We recommend a consensus meeting of Latin American ACOG (American College of Obstetricians and Gynecologists) section members to address the issue and to consider adopting guidelines based on evidence and reflecting the realities of the countries involved.

Prevalence, indications and neonatal complications of caesarean deliveries in Cameroon: a systematic review and meta-analysis

“…A caesarean delivery is a surgical intervention which consists of making an incision on the walls of the abdomen and the uterus, for delivery of the baby. It is one of the most commonly performed surgical interventions globally [1], and it is primarily performed as a live-saving procedure when the health of the mother or baby is deemed to be at significant risk, if a vaginal delivery is attempted [2,3].…”

Temporal trends in between and within‐country inequalities in caesarean delivery in low‐ and middle‐income countries: a Bayesian analysis

“…25,39 The financial motive and fear of litigation issues have been reported as a cause of unnecessary CD in private health facilities in the context of developing countries. 39,40 Controlling CD at the optimal level is not a one-way application. A multifaceted collaborative approach might usefully play a significant role in controlling the overuse of CD.…”

Private Health Insurance

“…Private insurers in Chile face similar difficulties in controlling provider behaviour, partly due to fee-for-service payment, which provides strong incentives to over-provide services to (and over-charge) privately insured people. For example, caesarean section rates have been consistently higher among privately insured women than among those who give birth in public hospitals (Murray, 2000;Guzmán, 2012;Guzmán, Ludmir & DeFrancesco, 2015). Market fragmentation may also contribute to private insurers' weakness in negotiating with providers.…”