Cesarean Birth

A recent report (PDF, 856kb) from the U.S. Centers for Disease Control and Prevention found that 32% of American women now give birth through cesarean section—the highest rate ever reported in the United States, and a number that raises questions of medical necessity. Meanwhile, in many parts of Sub-Saharan Africa and South Asia, women who need c-sections still can’t get them, as emergency obstetric care remains out of reach.

The World Health Organization and other agencies suggest that the ideal rate of cesarean section is 15%, but in the United States, this rate has risen rapidly over the last 14 years; cesarean section is now the most common operation in hospitals. This is concurrent with what Amnesty International calls a “maternal health care crisis” in the United States. Their new report, Deadly Delivery, cites a 25% rise in severe pregnancy-related complications, highlighting that quality care remains unattainable for some—particularly poor, minority, and immigrant women.

U.S. medical practices strongly influence approaches to care in other countries, and this is evident in the growing cesarean section trend abroad. In some Latin American countries, cesarean section rates have now reached 40%, and in China nearly half of all births are through c-section.

“What’s happening in the United States is alarming, and it presents a double global health paradox.” said Dr. Ana Langer, EngenderHealth’s President. “Every day, across Africa and Asia, women who need c-sections die due to lack of access, while many U.S. doctors perform them unnecessarily. At the same time, even in the United States, good quality care is inaccessible for women in poorer communities.”

In a 2008 International Herald Tribune op-ed, Dr. Ana Langer argued for the judicious, evidence-based use of c-section. The article, as timely as ever, also called for a heightened focus on providing high-quality obstetric care to all women, no matter where they live.