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The rise in caesarean section rate: the same indications but a lower threshold
1University Department of Obstetrics and Gynaecology, Glasgow Royal Maternity Hospital.
British Journal of Obstetrics and Gynaecology
|July 1, 1998
Summary
The caesarean section rate significantly increased from 1962 to 1992, primarily due to a lower threshold for performing the procedure, not major changes in obstetric management. Key indications like failure to progress remained similar.
Area of Science:
- Obstetrics and Gynecology
- Public Health
- Medical History
Background:
- The caesarean section rate has seen a global increase over recent decades.
- Understanding the drivers behind this trend is crucial for maternal and child health outcomes.
Purpose of the Study:
- To analyze the reasons behind the rising caesarean section rates.
- To identify any shifts in the primary indications for caesarean births over time.
Main Methods:
- A retrospective, descriptive study design was employed.
- Data from a large city center teaching hospital were compared between 1962 and 1992.
Main Results:
- The caesarean section rate escalated from 6-8% in 1962 to 18.1% in 1992.
- Failure to progress and fetal indications remained the principal reasons, though malpresentation and previous caesarean sections showed significant relative increases.
Conclusions:
- The rise in caesarean sections appears linked to a decreased threshold for intervention rather than altered obstetric practices.
- A re-evaluation of the risk-benefit balance and the underlying philosophy of caesarean delivery is warranted.