Gynecologists are worried about the number of caesarean sections

They affect more than 20% of deliveries worldwide, a percentage that has doubled in fifteen years.

They want to "stop the worldwide epidemic of caesarean sections". Several researchers and gynecologists published in the British medical journal The Lancet an inventory of the number of caesarean sections in the world that has almost doubled.

From 16 million in 2000 their number increased to 29.7 million in 2015. That is 21% of deliveries worldwide, while the rate of cesarean section is estimated at 10 to 15% for medical reasons. In some countries one in two births is involved.

A practice of "rich"

The study, which is based on figures from the WHO and UNICEF, shows considerable differences between countries. While in sub-Saharan Africa only 4.1% of births are carried out by Caesarean section, other regions such as Latin America and the Caribbean are higher than 40%. Western Europe is on average 26.9% of births with cesarean section, less than North America (32%), but more than Asia (18.1%). In France, the caesarean rate in 2016 was 20.4%, a stable percentage since 2010.

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And according to the researchers, in low- and middle-income countries, the richest women are six times more likely to give birth to surgery, and these interventions are also 1.6 times more likely in private clinics. In Brazil, for example, caesarean sections account for more than half of women with a high level of education, and fewer than 20% of women with less education.

Related risks

"The sharp increase in cesarean sections – usually in comfortable settings and without medical reasons – is problematic because of the associated risks for the mother and the child", explains the coordinator of the study, Professor Marleen Temmerman. The researchers regret that young physicians are "more equipped and more confident in their surgical delivery than vaginal", including "financial incentives to perform caesarean section", the rates are more favorable and "ease of planned deliveries". However, for Jane Sandal of King & # 39; s College London, when many women make this choice, it is "for fear of giving birth, sometimes after a first traumatic experience".

"In cases where complications occur, caesarean sections save lives and we need to promote women's access [à cette opération] in poor areas, but we can not abuse it, "says Marleen Temmerman, and these conclusions are similar to the conclusions formulated by the WHO for several years, which regrets the medicalization of a delivery that is too systematic and unnecessary.

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The World Congress for Gynecology, which will meet in Rio de Janeiro, Brazil on October 14, advocates different ways to limit the abuse of caesarean sections: to apply a single rate for births, caesarean sections or not, hospitals must submit their statistics , better inform women about the risks, improve training in natural childbirth.

In France, according to Cédric Grouchka, member of the Board of the High Health Authority, 60% of caesarean sections in France are carried out in an emergency, either after a failed delivery or during work, and 40% is "programmed" for medical reasons ". On the other hand, caesarean sections "programmed for a non-medical reason, at the request of women", would represent "less than 1%" of the total.