In the 3^rd phase of an international survey on delivery and maternal & perinatal outcomes conducted by WHO, results have concluded that caesareans should only be done when medically indicated. Almost 50% of babies in China are born via caesarean and overall, 1 in 4 women underwent caesarean.

There is now general acceptance among international maternity service providers that caesarean section rates are too high and should not exceed one in eight births. However, in Australia the caesarean rate is much higher, and women and babies are being subjected to unnecessary operations. In Australia, the caesarean rate of 24.6 per cent for 2008-09 is too high. More efforts need to be made to organise maternity services to offer midwife-led care, which generally promotes normal and natural childbirth without medical interventions like caesareans.

All caesarean sections put women at increased risk of adverse events, including death. The World Health Organization’s Global Survey on Maternal and Perinatal Health found China has the highest overall rate (46.2%) of caesareans, and by far the highest rate of caesareans without indication (11.7%). Compared with spontaneous delivery, the risk for the maternal mortality or morbidity index is 2.7 times higher for antepartum caesarean without indications and 14.2 times higher for intrapartum caesarean without indications. Compared with spontaneous vaginal deliveries, operative vaginal deliveries were associated with just over 3 times more maternal deaths. The WHO research group urges that caesareans be done only when medically indicated for the mother or the baby.

The benefits of a vaginal birth are well documented; among them are a stronger immune system for baby, higher breast feeding rates and less time in hospital. I strongly encourage every woman to have a natural birth and find that HypnoBirthing can greatly assist with these goals.

Method of delivery and pregnancy outcomes in Asia: the WHO global survey on maternal and perinatal health 2007-08.

BACKGROUND: There has been concern about rising rates of caesarean section worldwide. This Article reports the third phase of the WHO global survey, which aimed to estimate the rate of different methods of delivery and to examine the relation between method of delivery and maternal and perinatal outcomes in selected facilities in Africa and Latin America in 2004-05, and in Asia in 2007-08. METHODS: Nine countries participated in the Asia global survey: Cambodia, China, India, Japan, Nepal, Philippines, Sri Lanka, Thailand, and Vietnam. In each country, the capital city and two other regions or provinces were randomly selected. We studied all women admitted for delivery during 3 months in institutions with 6000 or fewer expected deliveries per year and during 2 months in those with more than 6000 deliveries. We gathered data for institutions to obtain a detailed description of the health facility and its resources for obstetric care. We obtained data from women’s medical records to summarise obstetric and perinatal events. FINDINGS: We obtained data for 109 101 of 112 152 deliveries reported in 122 recruited facilities (97% coverage), and analysed 107 950 deliveries. The overall rate of caesarean section was 27.3% (n=29 428) and of operative vaginal delivery was 3.2% (n=3465). Risk of maternal mortality and morbidity index (at least one of: maternal mortality, admission to intensive care unit [ICU], blood transfusion, hysterectomy, or internal iliac artery ligation) was increased for operative vaginal delivery (adjusted odds ratio 2.1, 95% CI 1.7-2.6) and all types of caesarean section (antepartum without indication 2.7, 1.4-5.5; antepartum with indication 10.6, 9.3-12.0; intrapartum without indication 14.2, 9.8-20.7; intrapartum with indication 14.5, 13.2-16.0). For breech presentation, caesarean section, either antepartum (0.2, 0.1-0.3) or intrapartum (0.3, 0.2-0.4), was associated with improved perinatal outcomes, but also with increased risk of stay in neonatal ICU (2.0, 1.1-3.6; and 2.1, 1.2-3.7, respectively). INTERPRETATION: To improve maternal and perinatal outcomes, caesarean section should be done only when there is a medical indication.

Lancet. 2010 Jan 11.

PMID: 20071021