Access to Cesarean Section Will Reduce Maternal Mortality in Low-Income Countries: A Mathematical Model

Area of Science:

• Global Health
• Obstetrics and Gynecology
• Public Health Policy

Background:

• Maternal mortality ratio (MMR) remains high in low-income countries (LICs) despite global efforts.
• Timely cesarean section (CS) can prevent maternal deaths from hemorrhage, infection, and obstructed labor.
• Current CS rates in LICs are below the World Health Organization (WHO) recommended levels (10-15%).

Purpose of the Study:

• To quantify the maternal mortality ratio (MMR) gap in LICs.
• To estimate the potential MMR reduction by increasing CS rates to WHO-recommended levels (10-15%).

Main Methods:

• Utilized WHO health statistics to model estimated MMRs for countries with CS rates between 10-15%.
• Calculated a weighted average MMR for countries meeting WHO CS rate recommendations.
• Determined the MMR gap by subtracting the weighted average MMR from the MMR of each LIC.

Main Results:

• An average reduction of 62.75% (95% CI [56.38, 69.11%]) in MMR was observed when CS rates increase to WHO-recommended levels.
• This significant decrease in MMR contributes to achieving global maternal health targets.

Conclusions:

• Maternal mortality in LICs is unacceptably high and requires urgent intervention.
• Increasing cesarean section rates to WHO recommendations is a viable strategy to significantly reduce maternal mortality.
• Achieving higher CS rates can help LICs progress toward the Millennium Development Goal 5 (MDG5) for maternal health.