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China’s rate of births by C-section soars

Many not needed medically, study by WHO finds

By Margie Mason
Associated Press / January 13, 2010

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HANOI - Nearly half of all births in China are delivered by caesarean section, the world’s highest rate according to a survey by the World Health Organization, which warned that a boom in unnecessary surgeries is jeopardizing women’s health.

Rates of C-sections have reached “epidemic proportions’’ in many countries worldwide, the WHO said in a report focusing on Asia. In China, 46 percent of births reviewed in a survey of hospital records were C-sections; a quarter of those were not medically necessary, the report said.

The WHO reviewed nearly 110,000 births in nine Asian countries in 2007-08. About 27 percent of births surveyed in the region were done surgically, partially motivated by hospitals eager to make more money.

The survey was published online yesterday in the medical journal Lancet, mirrors similar results reported by WHO in 2005 from Latin America, where 35 percent of pregnant women surveyed were delivering by C-section. “The relative safety of the operation leads people to think it’s as safe as vaginal birth,’’ said Dr. A. Metin Gulmezoglu, from the WHO, who coauthored the report.

Women undergoing C-sections that are not medically necessary are more likely to die or be admitted into intensive care units, require blood transfusions, or encounter complications that lead to hysterectomies, the study found. The procedure was shown to benefit babies during breech births.

Reasons for elective C-sections vary globally, but increasing rates in many developing countries coincide with a rise in patients’ wealth and improved medical facilities.

In the United States, where C-sections are at an all-time high of 31 percent, the surgery is often performed on older mothers, during multiple births, or because patients request it or doctors fear malpractice lawsuits.

Meanwhile, an earlier WHO survey of African countries found that C-sections occurred in about 9 percent of deliveries.

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