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Health > Births by caesarean section: Countries Compared

Author: Luke.Metcalfe

Author: Luke.Metcalfe

The rate of births by caesarian section is used as a health service coverage indicator. It reflects the accessibility of basic health interventions to a given population. It is computed by dividing the number of caesarian section deliveries by the total number of live births.

The most common indications for caesarian section include fetal distress, malpresentation, failure to progress in labor, and previous caesarian section. Worldwide, the average number of CS deliveries is at 16%. In low income countries, the average is at 6%, while those in upper middle and high income countries are at 30%. The African Region has the lowest rates at 4%, while the WHO Region of the Americas has the highest rates at 36%. Countries like Ethiopia, Chad, Madagascar and Mali have CS rates of 2%. The United States, Australia and Germany have CS rates of 32%.

Both underuse and overuse of CS delivery can be dangerous, but the ideal rate for CS deliveries has not been set. The World Health Organization has advised that CS rates should be between 5-15%, but at present, there is no empirical evidence to set the optimum rates of CS deliveries.

The wide differences in number of CS births between high income and low income countries reflect the disparity in access to health care services. Low CS rates indicate unmet obstetric needs while high rates suggest inappropriate use. In low income countries with lower than recommended CS rates, maternal death during childbirth remains one of the leading causes of mortality among women of reproductive age.

On the other hand, excessive or unnecessary CS deliveries are also linked to maternal and infant risks. There are many contributing factors to the increasing trends of CS rates in high income countries. There is an increasing number of CS deliveries upon maternal request. It is higher in women who have private medical insurance and those who have higher income and levels of education. Other factors include legal concerns, with increasing fear of litigation among health practitioners. Advancing maternal age and increased obesity rates are also contributing factors.

Citations:

1) World Health Organization. World Health Statistics 2013. http://www.who.int/gho/publications/worldhealthstatistics/ENWHS2013Full.pdf

2) World Health Organization. Monitoring emergency obstetric care: a handbook. 2009. http://www.unfpa.org/webdav/site/global/shared/documents/publications/2009/obstetric_monitoring.pdf

3) World Health Organization. The global numbers and costs of additionally needed and unnecessary caesarean sections performed per year: overuse as a barrier to universal coverage. 2010. http://www.who.int/healthsystems/topics/financing/healthreport/30C-sectioncosts.pdf

DEFINITION: Number of births by caesarean section per 1000 live births (year 2000)..

CONTENTS

# COUNTRY AMOUNT DATE GRAPH
1 ItalyItaly 333 live births per 1,000 pe 2000
2 AustraliaAustralia 217 live births per 1,000 pe 2000
Group of 7 countries (G7) averageGroup of 7 countries (G7) average 216.5 live births per 1,000 pe 2000
3 United StatesUnited States 211 live births per 1,000 pe 2000
4 GermanyGermany 209 live births per 1,000 pe 2000
5 CanadaCanada 205 live births per 1,000 pe 2000
6 IrelandIreland 204 live births per 1,000 pe 2000
7 New ZealandNew Zealand 202 live births per 1,000 pe 2000
8 AustriaAustria 172 live births per 1,000 pe 2000
9 FranceFrance 171 live births per 1,000 pe 2000
10 United KingdomUnited Kingdom 170 live births per 1,000 pe 2000
11 BelgiumBelgium 159 live births per 1,000 pe 2000
12 FinlandFinland 157 live births per 1,000 pe 2000
13 DenmarkDenmark 145 live births per 1,000 pe 2000
14 SwedenSweden 144 live births per 1,000 pe 2000
15 NorwayNorway 137 live births per 1,000 pe 2000
16 NetherlandsNetherlands 129 live births per 1,000 pe 2000

Citation

"All countries compared for Health > Births by caesarean section", OECD Health Data 2003 and OECD Health Data 2002. Aggregates compiled by NationMaster. Retrieved from http://www.nationmaster.com/country-info/stats/Health/Births-by-caesarean-section

Health > Births by caesarean section: Countries Compared Map

NationMaster

3

The rate of births by caesarian section is used as a health service coverage indicator. It reflects the accessibility of basic health interventions to a given population. It is computed by dividing the number of caesarian section deliveries by the total number of live births.

The most common indications for caesarian section include fetal distress, malpresentation, failure to progress in labor, and previous caesarian section. Worldwide, the average number of CS deliveries is at 16%. In low income countries, the average is at 6%, while those in upper middle and high income countries are at 30%. The African Region has the lowest rates at 4%, while the WHO Region of the Americas has the highest rates at 36%. Countries like Ethiopia, Chad, Madagascar and Mali have CS rates of 2%. The United States, Australia and Germany have CS rates of 32%.

Both underuse and overuse of CS delivery can be dangerous, but the ideal rate for CS deliveries has not been set. The World Health Organization has advised that CS rates should be between 5-15%, but at present, there is no empirical evidence to set the optimum rates of CS deliveries.

The wide differences in number of CS births between high income and low income countries reflect the disparity in access to health care services. Low CS rates indicate unmet obstetric needs while high rates suggest inappropriate use. In low income countries with lower than recommended CS rates, maternal death during childbirth remains one of the leading causes of mortality among women of reproductive age.

On the other hand, excessive or unnecessary CS deliveries are also linked to maternal and infant risks. There are many contributing factors to the increasing trends of CS rates in high income countries. There is an increasing number of CS deliveries upon maternal request. It is higher in women who have private medical insurance and those who have higher income and levels of education. Other factors include legal concerns, with increasing fear of litigation among health practitioners. Advancing maternal age and increased obesity rates are also contributing factors.

Citations:

1) World Health Organization. World Health Statistics 2013. http://www.who.int/gho/publications/worldhealthstatistics/ENWHS2013Full.pdf

2) World Health Organization. Monitoring emergency obstetric care: a handbook. 2009. http://www.unfpa.org/webdav/site/global/shared/documents/publications/2009/obstetric_monitoring.pdf

3) World Health Organization. The global numbers and costs of additionally needed and unnecessary caesarean sections performed per year: overuse as a barrier to universal coverage. 2010. http://www.who.int/healthsystems/topics/financing/healthreport/30C-sectioncosts.pdf

Posted on 14 Apr 2014

Luke.Metcalfe

Luke.Metcalfe

131

0

By the early 1980s, cesarean deliveries in industrialized nations had increased to almost five times the frequency of 1970.

The most common reasons for an unplanned cesarean section are:
  • A slow difficult labor

  • Fetal or maternal distress

  • Placenta problems
  • Cephalopelvic disproportion (A baby with a large head and the mother with a narrow pelvis)

Some cesarean sections are planned ahead of time. Reasons for this include:
  • A baby in any position that is not head-down
  • Maternal infection with the human immunodeficiency virus (HIV)
  • A narrow pelvis and a large baby
  • A placenta that is blocking the cervix
  • A mother's chronic illness
  • Factors linked to a past cesarean delivery

In developing nations, the rate of cesareans is very low as many births are not attended by a medical professional. These countries typically have a higher rate of maternal mortality.
Many nations in Sub-Saharan Africa also have a high proportion of reproductive-age women who are living with HIV. The transmission rate of HIV from mother to baby can be reduced by cesarean delivery.

Posted on 07 Mar 2005

Edria Murray<br>Staff editor

Edria Murray<br>Staff editor

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