Inequities in the use of cesarean section deliveries in the world

Gibbons, Luz; Belizán, José M.; Lauer, Jeremy A.; Betrán, Ana Pilar; Merialdi, Mario; Althabe, Fernando

doi:10.1016/j.ajog.2012.02.026

Cited by 305 publications

(302 citation statements)

References 26 publications

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“…Although some less developed countries, mostly in Africa, still have the rate below 10%, the majority of the countries have surpassed this recommendation and some have exceeded it by a wide margin 1, 2, 4. The reasons for such dramatic increases are multifactorial, including medical as well as non‐medical reasons 3, 6, 7. It has been suggested that non‐medical factors, such as social, cultural, or unequal accessibility to health services, as well as clinical practice patterns/styles, might have been major contributors to the wide variation in caesarean section rates across different countries 1, 2, 6, 7, 8, 9, 10.…”

Section: Introductionmentioning

confidence: 99%

Association between rates of caesarean section and maternal and neonatal mortality in the 21st century: a worldwide population‐based ecological study with longitudinal data

Zhang

Mikolajczyk

et al. 2015

BJOG

305

266

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ObjectiveCaesarean section was initially performed to save the lives of the mother and/or her baby. Caesarean section rates have risen substantially worldwide over the past decades. In this study, we set out to compile all available caesarean section rates worldwide at the country level, and to identify the appropriate caesarean section rate at the population level associated with the minimal maternal and neonatal mortality.DesignEcological study using longitudinal data.SettingWorldwide country‐level data.PopulationA total of 159 countries were included in the analyses, representing 98.0% of global live births (2005).MethodsNationally representative caesarean section rates from 2000 to 2012 were compiled. We assessed the relationship between caesarean section rates and mortality outcomes, adjusting for socio‐economic development by means of human development index (HDI) using fractional polynomial regression models.Main outcome measuresMaternal mortality ratio and neonatal mortality rate.ResultsMost countries have experienced increases in caesarean section rate during the study period. In the unadjusted analysis, there was a negative association between caesarean section rates and mortality outcomes for low caesarean section rates, especially among the least developed countries. After adjusting for HDI, this effect was much smaller and was only observed below a caesarean section rate of 5–10%. No important association between the caesarean section rate and maternal and neonatal mortality was observed when the caesarean section rate exceeded 10%.ConclusionsAlthough caesarean section is an effective intervention to save maternal and infant lives, based on the available ecological evidence, caesarean section rates higher than around 10% at the population level are not associated with decreases in maternal and neonatal mortality rates, and thus may not be necessary to achieve the lowest maternal and neonatal mortality.Tweetable abstractThe caesarean section rate of around 10% may be the optimal rate to achieve the lowest mortality.

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Section: Introductionmentioning

confidence: 99%

Association between rates of caesarean section and maternal and neonatal mortality in the 21st century: a worldwide population‐based ecological study with longitudinal data

Zhang

Mikolajczyk

et al. 2015

BJOG

305

266

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“…Due to the presence of wars, famine, poverty and lack of health resources, many children do not have this protection guaranteed (16)(17) . Physical protection and safety are expressed by prenatal care (18) , type of delivery and gestational age (19)(20)(21) , physiological conditions of the child (22)(23) , health care and prevention of injuries to the child (14) , dietary pattern (14) and exposure to harmful agents or situations (11,14) .…”

Section: Individual Vulnerabilitymentioning

confidence: 99%

Vulnerabilidade da criança diante de situações adversas ao seu desenvolvimento: proposta de matriz analítica

Silva

Chiesa

Veríssimo

et al. 2013

Rev. esc. enferm. USP

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RESUMOEstudo teórico que teve como objetivo elaborar uma matriz conceitual para analisar a vulnerabilidade da criança diante de situações adversas para seu desenvolvimento. Propõe-se que vulnerabilidade da criança seja analisada por meio dos aspectos das dimensões individual, relativa a relações sustentadoras contínuas e proteção física e segurança; social, concernente à inserção social da família e ao acesso a direitos à proteção e promoção social, e programática, cenário político-programático, de diretrizes e implementação político-programáticas. A aplicação prática desta matriz permite a captação do processo saúde-doença para além da dimensão individual, possibilitando a articulação das políticas públicas e das ações dos profissionais, a fim de obter eficácia no atendimento às necessidades das crianças. O uso desse instrumento conceitual pode propiciar às equipes de saúde a apreensão, de forma específica, das situações adversas ao desenvolvimento infantil, bem como subsidiar a construção de planos de intervenção a partir das dimensões analíticas da vulnerabilidade. DESCRITORES Análise de vulnerabilidade Desenvolvimento infantil Saúde da criança ABSTRACTThis theoretical study presents a conceptual matrix built to analyze the vulnerability of children in adverse situations to their development. It proposes that the vulnerability of children is analyzed by means of the following dimensions: individual, which is related to ongoing nurturing relationships, physical protection and security; social, which concerns the social insertion of family and access to rights of social protection and promotion; and programmatic, which involves the political-programmatic scenario and the guidelines and political-programmatic implementation. The practical application of this matrix allows apprehending the health-disease process beyond the individual dimension, enabling the articulation of public policies and actions of professionals to achieve effectiveness in meeting the needs of children. The use of this conceptual matrix can provide to health teams a specific understanding of the adverse situations to child development as well as subsidizing intervention plans based on the analytical dimensions of vulnerability. DESCRIPTORS Vulnerability analysis Child development Child health RESUMENEste estudio teórico tuvo como objetivo elaborar una matriz conceptual para analizar la vulnerabilidad del niño delante de situaciones adversas para su desarrollo. Se propone que la vulnerabilidad del niño sea analizada a través de los aspectos de las dimensiones: Individual-relaciones sostenedoras continuas, y protección física y seguridad; Social-inserción social de la familia y acceso a los derechos, a la protección y la promoción social; y Programático-escenario político-programático y directrices y realización político-programáticas. La aplicación práctica de esta matriz permite la captación del proceso salud-enfermedad más allá de la dimensión individual, posibilitando la articulación de las políticas públicas y de las acciones de los profe...

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“…The rates of CS have steadily increased in almost all middle and high-income countries over the last three decades. According to the latest global estimates, the average CS rate is approximately 15%, with large discrepancies between and within different countries [1,3]. Cesarean section is a major abdominal surgery, and the morbidity and mortality rates are greater for women who undergo a cesarean delivery versus those who deliver vaginally [4].…”

Section: Introductionmentioning

confidence: 99%

Involvement of Women with the Decision of Caesarean Section and their Degree of Satisfaction for Post-operative Care and Pain Management

El-Amir¹,

Zewawi²,

Al‐Jaroudi³

2017

J Women's Health Care

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Inequities in the use of cesarean section deliveries in the world

Cited by 305 publications

References 26 publications

Association between rates of caesarean section and maternal and neonatal mortality in the 21st century: a worldwide population‐based ecological study with longitudinal data

Association between rates of caesarean section and maternal and neonatal mortality in the 21st century: a worldwide population‐based ecological study with longitudinal data

Vulnerabilidade da criança diante de situações adversas ao seu desenvolvimento: proposta de matriz analítica

Involvement of Women with the Decision of Caesarean Section and their Degree of Satisfaction for Post-operative Care and Pain Management

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