Indications for and Risks of Elective Cesarean Section.

Area of Science:

• Obstetrics and Gynecology
• Public Health
• Medical Trends Analysis

Background:

• Global cesarean section rates have significantly increased in recent years.
• Understanding the drivers and implications of this trend is a worldwide priority.
• Factors influencing cesarean section decisions are being investigated, but risks require clearer definition.

Purpose of the Study:

• To analyze the trend of rising cesarean section rates globally.
• To identify the primary factors contributing to the increased incidence of cesarean births.
• To evaluate the associated risks and benefits of cesarean delivery.

Main Methods:

• A comprehensive literature review of pertinent publications.
• Searches conducted in PubMed, Scopus, and DIMDI databases.
• Inclusion of media communications, statistical analyses (German Federal Statistical Office), and medical guidelines (AWMF).

Main Results:

• Increased cesarean rates are linked to altered maternal and fetal risk profiles and maternal requests.
• In Germany, cesarean births rose from 15.3% (1991) to 31.7% (2012), with medical indications in less than 10% of cases.
• Potential explanations include risk aversion, risk-adapted obstetric practices, and media influence; risks to mother, child, and subsequent pregnancies are noted.

Conclusions:

• Scientific, social, cultural, and medicolegal factors contribute to cesarean acceptance.
• Cesarean sections carry increased risks for both mother and child.
• The procedure should be reserved for cases with clear advantages.