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Rates and implications of caesarean sections in Latin America: ecological study
J M Belizán1, F Althabe, F C Barros
1Latin American Centre for Perinatology, Pan American Health Organisation, World Health Organisation, Hospital de Clínicas s/n, 11000 Montevideo, Uruguay. belizanj@clap.ops-oms.org
Objectives:
To estimate the incidences of caesarean sections in Latin American countries and correlate these with socioeconomic, demographic, and healthcare variables.
Design:
Descriptive and ecological study.
Setting:
19 Latin American countries.
Main Outcome Measures:
National estimates of caesarean section rates in each country.
Results:
Seven countries had caesarean section rates below 15%. The remaining 12 countries had rates above 15% (range 16.8% to 40.0%). These 12 countries account for 81% of the deliveries in the region. A positive and significant correlation was observed between the gross national product per capita and rate of caesarean section (r(s)=0.746), and higher rates were observed in private hospitals than in public ones. Taking 15% as a medically justified accepted rate, over 850 000 unnecessary caesarean sections are performed each year in the region.
Conclusions:
The reported figures represent an unnecessary increased risk for young women and their babies. From the economic perspective, this is a burden to health systems that work with limited budgets.