WHO gives directive on caesarean sections
The World Health Organisation (WHO) says caesarean sections should only be performed when medically necessary.
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According to WHO, although it can save lives, a caesarean section is often performed without medical need, putting women and their babies at risk of short and long-term health problems.
A statement from WHO, which was copied to the Ghana News Agency (GNA) on Friday, underscored the importance of focusing on the needs of the patient, on a case-by-case basis, and discouraging the practice of aiming for “target rates”.
It said caesarean section surgery was one of the most common surgeries in the world, with rates continuing to rise, particularly in high and middle-income countries.
The statement pointed out that caesarean sections might be necessary when vaginal delivery might pose a risk to the mother or baby, for example due to prolonged labour, foetal distress, or because the baby is presenting in an abnormal position.
Significant complications
However, it said caesarean sections could cause significant complications, disability or death, particularly in settings that lacked the facilities to conduct safe surgeries or treat potential complications.
The statement said since 1985, the international healthcare community had considered the “ideal rate” for caesarean sections to be between 10 and 15 per cent.
It observed that new studies had revealed that when caesarean section rates rose towards 10 per cent across a population, the number of maternal and newborn deaths decreased; but when the rate went above 10 per cent, there was no evidence that mortality rates improved.
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“These conclusions highlight the value of caesarean section in saving the lives of mothers and newborns,” Dr Marleen Temmerman, Director of WHO’s Department of Reproductive Health and Research, said.
“They also illustrate how important it is to ensure a caesarean section is provided to the women in need - and not to just focus on achieving any specific rate,” Dr Temmerman said.
It said across a population, the effects of caesarean section rates on maternal and newborn outcomes such as stillbirths or morbidities such as birth asphyxia, were still unknown.
Impact of caesarean section
It noted that more research on the impact of caesarean section on women’s psychological and social well-being was still needed.
The statement said due to the increased cost, high rates of unnecessary caesarean sections could pull resources away from other services in overloaded and weak health systems.
It said the lack of a standardised internationally accepted classification system to monitor and compare caesarean section rates in a consistent and action-oriented manner was one of the factors that had hindered a better understanding of the trend.
The WHO Statement on Caesarean Section Rates is based on two studies carried out by the UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme for Research, Development and Research Training in Human Reproduction.
The programme is the main instrument within the United Nations system for research in human reproduction, working within the Department of Reproductive Health and Research of WHO.